Hemodynamic Effects of Vecuronium, Pancuronium and Rocuronium during O2-Midazolam-Fentanyl Anesthesia in Patients with Coronary Artery Disease or Valvular Heart Diseases

Background: This study was designed to evaluate the hemodynamic effects of vecuronium, pancuronium and rocuronium in patients with coronary artery disease (CABG) or valvular heart disease (VHD).Methods: With IRB approval, 121 patients (61 patients with CABG and 60 patients with VHD) were randomly divided into a vecuronium, pancuronium and rocuronium group, respectively.Midazolam and fentanyl were administered and then 3 times of ED95 of a muscle relaxant (vecuronium, 0.12 mg/kg; pancuronium, 0.12 mg/kg; or rocuronium, 0.9 mg/kg) was injected.Additional dose of fentanyl was given and the patient was intubated.Hemodynamic variables were measured before the induction of anesthesia, just prior and 1 min after the administration of the muscle relaxant, just before intubation, 5 and 10 min after intubation.Results: The number of patients enrolled in the CABG-vecuronium, CABG-pancuronium, CABGrocuronium, VHD-vecuronium, VHD-pancuronium, and VHD-rocuronium was 20, 20, 21, 19, 20, and 21 respectively.Each of 10, 4, 4, 5, 1, and 1, respectively, were treated for hypotension or bradycardia during the induction of anesthesia.The heart rate (HR) changed significantly only in the CABGvecuronium group compared with the control value.All three muscle relaxants decreased mean systemic artery pressure (MAP) significantly in both CABG and VHD patients.The decrease in HR and MAP were significantly greater in CABG-vecuronium and VHD-vecuronium than in CABG-pancuronium and VHD-pancuronium, respectively.The decrease in HR was also greater in VHD-vecuronium than ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ 논문접수일：2002년 9월 11일 책임저자：홍용우, 서울시 서대문구 신촌동 134, 연세의료원 마취과, 우편번호: 120-752