Ardigò M, Venturini M, Amicucci G, Dicembrini A, Prandini A, Latronico N, Candiani A. [Evaluation of the hemodynamic effects of pipecuronium bromide. Absence of adverse hemodynamic effects].
Minerva Anestesiol 1995;
61:271-6. [PMID:
8584193]
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Abstract
INTRODUCTION
Pipecuronium bromide is a new non depolarising muscle relaxant with a long duration of action; we considered its haemodynamic effects during general anaesthesia.
MATERIALS AND METHODS
Eight surgical patients (4 males, 4 females), mean age 44 years (range 29-65 years), ASA I-II, were studied. All patients were undergoing elective neurosurgical procedures (Hunt-Hess I-II). A radial artery-cannula was put in for blood pressure monitoring and a Swan-Ganz volumetric/ejection fraction fiber optic catheter was put in pulmonary artery via right internal jugular vein (EFV/OTDC-Baxter). A diazo-analgesic high dose fentanyl anaesthesia was given. All patients received pipecuronium bromide 0,1 mg/kg during stable haemodynamic conditions. Haemodynamic determinations were performed over following three times: T0 before the pipecuronium administration, T1 and T2, 3 and 15 minutes after administration respectively. These parameters were analysed: HR, MAP, MPAP, RAP, PCWP, CI RVEDVI, RVESVI, RVEF, SVRI, LVWI, RVWI, SvO2, DO2I, VO2I, O2ER, Qs/Qt (statistics: analysis of variance (two ways ANOVA) and orthogonal decomposition; for all statistical comparison, differences were considered significant when p < 0.05).
RESULTS
Only MAP and SVRI showed significant changes (p = 0.02 and p = 0.04), even if clinically modest. No other parameter showed any change at all.
CONCLUSIONS
Pipecuronium bromide did not show adverse haemodynamic effects; its haemodynamic repercussions are clinically negligible. The drug could be considered as first choice in long lasting operations for patients with potential cardiovascular instability.
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