Respostas circulatórias à induçåo e intubaçåo traqueal com associaçåo de vecurônio ao tiopental ou etomidato / Circulatory responses to induction and tracheal intubation under vecuronium associated with thiopental or etomidate

RESUMO

Background and Objectives - Vecuronium has been shown to cause minimum cardiovascular effects. However, some authors have demonstrated bradycardia associated with its use. The purpose of this study was evaluate the changes in arterial blood pressure and heart rate following the use of vecuronium, in patients induced with etomidate or thiopental. Methods - Forty adult patients submitted to elective surgical procedures were studied and were allocated into 4 groups as folows Group NT = 10 normotensive patients induced with thiopental; Group NE = 10 normotensive patients induced with etomidate; Group HT = 10 hypertensive patients induced with thiopental; Group HE = 10 hypertensive patients induced with etomidate. All patients were sedated with diazepan and fentanyl, and received fentanyl and vecuronium during induction, besides the specific induction agent for each group. Systolic and diastolic blood pressure and heart rate were evaluated at six consecutive moments M1 = control, beforeinduction; M2 = two minutes following sedation; M3 = immediately following induction; M4 = one minute following orotracheal intubation; M5 = three minutes following orotracheal intubation. M6 = six minutes following orotracheal intubation. Results - Anthropometric data were similar in all groups (p<0.05). Systolic and diastolic blood pressures were evaluated separetely and a statistically significant decrease was observed at moment 3, as compared to moments 1 and 2, although the values were not clinically relevant in any of the groups. Regarding heart rate, statistically significant decreases were observed in the groups induced with etomidate (NE and HE). Conclusions - It is concluded that vecuronium is associated with stable blood pressure. Heart rate is decreased following the vecuronium-etomidate association, both in normotensive and hypertensive patients