Hemodynamic effects of rocuronium in patients with rheumatic heart disease during induction of anesthesia
- VernacularTitle:罗库溴铵对风湿性心脏病患者血液动力学的影响
- Author:
Guo CHEN
;
Bin LIU
- Publication Type:Journal Article
- Keywords:
Androstanols;
Vecuronium;
Rheumatic heart disease;
Hemodynamics
- From:
Chinese Journal of Anesthesiology
1997;0(11):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the hemodynamic effects of rocuronium in patients with rheumatic heart disease during induction of anesthesia.Methods Twenty patients of either sex (ASA classes Ⅲ -Ⅳ ;NYHA classes Ⅱ -Ⅲ) scheduled for valve replacement were included in this double blinded study. Their ages ranged from 34 to 62 yr and weights from 48 to 70 kg. The patients were premedicated with intramuscular morphine 0.2 mg?kg-1 and scopolamine 0.3mg. Radial artery was cannukted for direct BP monitoring and Swan-Ganz catheter was placed via right internal jugular vein for hemodynamic monitoring before induction of anesthesia.TOF,BIS,ECG and SpO2 were also monitored throughout anesthesia. Anesthesia was induced with midazolam 0.05-0.1 mg?g-1 and fentanyl 10-15?g?kg-1. The patients were randomized to receive either rocuronium 0.6 mg?kg-1 (group Ⅰ,n=10) or vecuronium 0.1 mg?kg-1(group Ⅱ,n=10) to facilitate tracheal intubation when BIS value dropped to 60%.The patients were mechanically ventilated (VT 8-10 ml?kg-1 ,RR 10-12 bpm).Systolic arterial pressure (SAP),MAP,HR,cardiac output (CO), PCWP, CVP, mixed venous blood O2 saturation (SvO2), BIS and TOF were recorded and stroke volume (SV), stroke index (SI), LVSWI and rate-pressure product (RPP) were calculated before anesthesia (To), 1 min after administration of muscle relaxant (T1), when TOF reached 0 (T2) and 1,2,3,4,5,7,10,15,20,25,30 min after tracheal intubation (T3-13).Results The demographic data including age, sex and body weight were comparable between the two groups. In rocuronium group HR increased by 17.43% -7.54%,SAP increased by 16.94% - 12.3% and RPP increased by 13.96% - 22.67% respectively during 1-7 min after intubation (T3-8) as compared with the baseline values (To), significantly higher than those in vecuronium group (P
