title: Muscle relaxation does not influence venous oxygen saturation during cardiopulmonary bypass.
abstract: OBJECTIVE
  To examine whether the omission of neuromuscular blocking drugs during cardiopulmonary bypass (CPB) is associated with increased anesthetic requirements, higher frequency of intraoperative movements, and lower venous oxygen saturation (SvO(2)).
  
  
  METHODS
  Prospective, randomized study.
  
  
  METHODS
  Large community hospital.
  
  
  METHODS
  30 ASA physical status III and IV patients scheduled for cardiac surgery.
  
  
  METHODS
  Patients were randomized to one of two groups: group 1 (n = 15) received a 3xED(95) bolus dose of cisatracurium at induction and thereafter no more neuromuscular blocking drug; group 2 (n = 15) received a continuous infusion of cisatracurium during the entire procedure.
  
  
  METHODS
  Both groups received a standardized anesthetic with bispectral index-guided propofol target-controlled infusion and a remifentanil infusion steered by hemodynamic changes. Venous oxygen saturation was continuously determined during CPB.
  
  
  RESULTS
  Propofol consumption was 5.4 +/- 1.7 and 4.4 +/- 1.0 mg/(kg/h) in groups 1 and 2, respectively (P = 0.07). Remifentanil consumption was 0.15 +/- 0.05 and 0.17 +/- 0.05 mug/(kg/min) in groups 1 and 2, respectively (P = 0.19). In groups 1 and 2, no patient recalled any intraoperative phenomena; none moved or had diaphragmatic contractions. During CPB, SvO(2) was 81.3 +/- 3.2% (76%-85%) in group 1 and 80.6 +/- 3.1% (73%-85%) in group 2 (P = 0.53).
  
  
  CONCLUSIONS
  Omitting the continuous administration of neuromuscular blocking drugs during CPB did not increase anesthetic requirements. No intraoperative movements occurred, nor was there decreased SvO(2).
authors: Department of Anesthesia and Critical Care Medicine, O.L.V. Clinic, 9300 Aalst, Belgium. guy.cammu@olvz-aalst.be
authors: Guy
authors: G
authors: Cammu
authors: Sara
authors: S
authors: Cardinael
authors: Sabine
authors: S
authors: Lahousse
authors: Gudrun Ver
authors: GV
authors: Eecke
authors: José
authors: J
authors: Coddens
authors: Luc
authors: L
authors: Foubert
authors: Theo
authors: T
authors: Gooris
authors: Thierry
authors: T
authors: Deloof
mesh_terms: D000368:Aged; D000762:Anesthesia Recovery Period; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001279:Atracurium / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D002315:Cardiopulmonary Bypass / Q000379:methods*; D004569:Electroencephalography / Q000379:methods; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods; D007275:Injections, Intravenous / Q000379:methods; D007902:Length of Stay; D008297:Male; D009126:Muscle Relaxation / Q000187:drug effects*; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage / Q000494:pharmacology*; D010100:Oxygen / Q000097:blood*; D010880:Piperidines / Q000008:administration & dosage; D015742:Propofol / Q000008:administration & dosage; D011446:Prospective Studies; D000077208:Remifentanil; D014680:Veins
chemical_list: D018686:Anesthetics, Intravenous; D009466:Neuromuscular Blocking Agents; D010880:Piperidines; D001279:Atracurium; D000077208:Remifentanil; C101584:cisatracurium; D010100:Oxygen; D015742:Propofol