The Effect of Sufentanil and Vecuronium Affect to Cardiovascular System during Induction of Anesthesia for Open Heart Sugery / 대한마취과학회지

ABSTRACT

Narcotics and Some Neuromuscular blockers are used for open heart sugery anesthesia. Rapid induction of intravenous narcotics techniques may cause some reductjon in blood pressure and systemic vascular resistance, however, the selection of a narcotic and neuromuscular blocker influences subsequent Hemodynamic responses. 72 patients having open heart surgery were investigated using three combination of a narcotic and neuromuscular blocker Group I (fentanyl 50 ug/kg, pancuronium 100 ug/kg) Group II (fentanyl 50 ug/kg, Vecuronium 80 ug/kg) Group III (sufentanil 10 u/kg, vecuronium 80 u/kg), each combination being administered over 2 minutes. Hemodynamic functions were then monitored for 10 minutes before tracheal intubation. 1) Significant changes included increases in heart nate in the groups receiving pancuronium and decrease in those receiving vecuronium. 2) In all groups mean arterial pressure initially decreased systemic vascular resistance index decreased significantly in all groups except sufentanil and vecuronium group. 3) Cardiac index decreased significantly only in ufentanil-Vecuronium groups. Time of onset of neuromuscular blockade did not differ among the three groups, but transient chest wall rigidity occurred significantly more often with sufentanil than with fentanyl. Overall, the fentanyl-Pancuronium combination afforded the greatest hemodynamic stability, whereas the sufentanil-Vecuronium Combination proved least Satisfactory because of bradycardia, hypotension, increase of chest wall rigidity.