Why the study?
Does vecuronium compared to pancuronium prevent deterioration in left ventricular performance in healthy patients during ketamine anaesthesia?
Does vecuronium compared to pancuronium prevent deterioration in left ventricular performance in healthy patients during ketamine anaesthesia?
Vecuronium is preferable to pancuronium during ketamine anaesthesia as it avoids the chronotropic effects and subsequent deterioration in left ventricular performance.
May warrant vecuronium preference with ketamine to avoid LV effects; leaves open randomized confirmation before practice change.
The haemodynamic effects of vecuronium and pancuronium were studied in 20 healthy patients during diazepam/ketamine anaesthesia. Anaesthesia was induced with glycopyrrolate 3 micrograms/kg, diazepam 0.3 mg/kg and ketamine 1.0 mg/kg as a bolus and 1.0 mg/kg over 10 min. After induction, anaesthesia was maintained with ketamine infusion 1.0 mg/kg/h. The lungs were ventilated with 50% nitrous oxide in oxygen. Equipotent doses of vecuronium (74 micrograms/kg) or pancuronium (99 micrograms/kg) were administered for intubation. The thoracic impedance, ECG and phonocardiogram were recorded during the induction of anaesthesia. The results suggest that vecuronium has no cardiovascular effects during ketamine anaesthesia, whereas pancuronium due to its chronotropic effect, causes a deterioration in left ventricular performance.
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Pedersen et al. (1984) studied this question.
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