Vali-Asr St. Tehran, Iran
Background- Hemodynamic instability during anesthesia can affect circulation and oxygenation of vital organs (e.g. brain, heart, kidney and liver). Each of the anesthetic drugs has various hemodynamic effects, and the interaction of these drugs may cause critical changes in patients hemodynamics.
Propofol is the most recent intravenous anesthetic to be introduced into clinical practice. This drug has negative inotropic effects on the heart. Based on the cardiovascular effects of propofol and to maintain hemodynamic stability during anesthesia with this drug, it seems that selection of a muscle relaxant with positive effects on the heart rate and especially blood pressure, such as pancuronium, is better than atracurium. Therefore, we performed a study of the effects of pancuronium and atracurium on hemodynamic parameters of patients undergoing CABG surgery, in which these muscle relaxants are used in conjunction with propofol-sufentanil.
Methods- A prospective randomized clinical trial analysis was performed on 100 patients undergoing coronary artery bypass graft surgery in Shaheed Rajaei Heart Center. Fifty of the patients received propofol -pancuronium and 50 of them received propofol - atracurium. The selection of type and dose of premedication drugs and intraoperative opioid use in the two groups was the same. Maintenance of anesthesia in the two groups was achieved by the infusion of specific doses of these drugs.
Results- Hemodynamic changes in the two groups were almost the same. There was no statistically significant difference (p>0.05) in the two groups (Iranian Heart Journal 2002, 2003; 3(4)&4(1): 25-28).