Haemodynamic effects of rocuronium bromide in adult cardiac surgical patients (original) (raw)

1998, Canadian Journal of Anaesthesia

Haemodynamic effects of rocuronium bromide in adult cardiac surgical patients I'urpose: To measure the haemodynamic effects of rocuronium in adults undergoing cardiac surgery with cardiopulmonary bypass (CPB). Methods: Twenty patients undergoing elective cardiac surgical procedures with moderate hypothermic nonpulsatile bypass participated in this prospective, observational study. After anaesthetic induction, recovery from succinylcholine, and achievement of baseline haemodynamic stability, patients received 0.6 mg'kg-I rocuronium as an initial rapid intravenous bolus. Maintenance dosing of 0.2 mg'kg-I was continued for the remainder of the procedure. Haemodynamic measurements (heart rate, systemic artedal systolic, diastolic, and mean arterial pressure, pulmonary artedal systolic, diastolic, and mean pressure, pulmonary capillary wedge pressure, central venous pressure, and thermodilution cardiac output measurements) were obtained for the fi~ tire minutes after rocurenium administration, and subjects were observed for histamine-related symptoms. Results: Central venous pressure decreased from baseline at two and five minutes after the rocuronium bolus, and mean pulmonary artery pressure decreased at five minutes. No changes were observed in hearL rate, mean systemic arterial pressure, pulmonary capillary wedge pressure, cardiac index, stroke volume, systemic vascular resistance, or pulmonary vascular resistance, nor did any patient manifest any other histamine-related symptoms. Conclusion: The haemodynamic profile for a 0.6 mg-kg-' bolus of rocuronium is acceptable for patients with cardiovascular disease. Objectif : Mesurer les effets h~modynamiques du rocuronium chez des adultes subissant une chirurgie cardiaque sous CEC. M&hodes : Vingt patients subissant une chirurgie cardiaque sous CEC ~ riot non pulsatile et sous hypothermie mod4r4e ont particil~ ~ cette ~tude d'observation prospective. Apr~s I'inductian de I'anesth&ie, r~cup~ration de I'effet de la succinylcholine et obtention d'une stabilit~ h~modynamique de base, les patients ont regu par voie IV rapide un bolus initial de 0,6 mg-kE "l de rocuronium suivi de doses de malntien de 0,2 mg.kg-~ durant route la dur6e de la procfidure. Durant les premi&es cinq minutes apr~s radministration de rocuronium, les mesures h~modynamiques suivantes ont ~t4 obtenues : rythme cardiaque, pression art&ielle syst~mique et pulmonaire, systolique, diastolique et moyenne, pression capillaire bloqu~e, pression veineuse centrale et mesures du d~bit cardiaque par thermodilution. On a aussi recherch6 chez les patients de sympt6mes li~s ~ la lib&ation d'histamine. R~sultats : Apr& un bolus de rocuronium, on a observ~ une diminution de la pression veineuse centrale apr~s deux et cinq minutes. Les autres variables, rythme cardJaque, pression art&ielle moyenne, pression capillaire bloqu6e, index cardiaque, volume d'~jection, r&istance vasculaire pulmonaire et syst~mique, n'ont pr&ent~ aucun changement. Aucun patJent n'a d~montr~ de sympt6mes li& ~ la lib6ration d'histamine. Conclusion : Une dose bolus de 0,6 mg-kg "l de racuronium poss~de un profil h4modynamique acceptable pour des patients pr&entant maJadie cardiovasculaire.