Pipecuronium and pancuronium: a comparative clinical study

30 patients were randomly allocated into 2 groups to receive either pipecuronium or pancuronium. Further randomization divided the patients into four subgroups, based on recovery from blockade [25% to 75%] spontaneous versus antagonist induced reversal. Equipotent doses of pipecuronium and pancuronium 35 and 45 mug/kg respectively were given. Pipecuronium was found to have a significantly shorter duration of the first maintenance dose and a faster spontaneous recovery rate. The train-of-four ratio was statistically the same in all groups at checked times during single twitch recovery. Pipecuronium is a cardiovascular clean drug without counteraction of the bradycardiac response caused by other agents [e.g. opiates]

Role of H1 + H2 histamine blocking drugs during morphine anesthesia in open heart surgery

High doses of morphine can produce significant cardiovascular effects generally attributed to histamine release. The authors examined the possibility that H1 and H2 histamine blocking drugs might prove beneficial in preventing this response. In a randomized study, two groups of 10 patients each received 1/mg/kg morphine and either a placebo or diphenhydramine [H1] and cimeidine [H2]. The morphine placebo group demonstrated a decrease in diastolic BP [71 +/- 6 to 59 +/- 5 torr] a decrease in systemic vascular resistance [SVR] [1250 +/- 80 to 950 +/- 70 dyne-sec cm-5] and an increase in cardiac index [CI] [2.6 +/- 0.7 to 3.0 +/- 50 to 1120 +/- 70 dyne-sec cm-5, diastolic BP 7 +/- 6 to 64 torr]. These data demonstrate that significant haemodynamic protection can be obtained by the use of histamine blockings drugs