Measurement of Hemodynamic Changes Caused by Administration of Atracurium Besylate after Pretreatment with Anti-histamine Agent.
10.4097/kjae.2007.52.6.642
- Author:
Young Kyoo CHOI
1
;
Tae Wan LIM
;
Dae Eon KIM
;
Dong Hyun LEE
;
Sung Wook PARK
;
Keon Sik KIM
;
Wha Ja KANG
;
Doo Ik LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, College of Medicine, Kyunghee University, Seoul, Korea. cykyko@unitel.co.kr
- Publication Type:Original Article
- Keywords:
atracurium;
histamine;
pheniramine;
ranitidine
- MeSH:
Anesthesia, General;
Atracurium*;
Blood Pressure;
Heart Rate;
Hemodynamics*;
Histamine;
Humans;
Pheniramine;
Ranitidine;
Skin;
Vascular Resistance
- From:Korean Journal of Anesthesiology
2007;52(6):642-648
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Hemodynamic changes through the histamine-induced release of atracurium are relatively common, but can be particularly dangerous in hemodynamically unstable patients. This study evaluated the effectiveness of a pretreatment with an anti-histamine agent before the administration of atracurium in the prevention of histamine-induced hemodynamic changes. METHODS: Forty-eight ASA class I and II patients were assigned to four groups. Groups 1 and 2 were assigned to receive atracurium through a bolus 0.5 mg/kg. Groups 3 and 4 were assigned to receive atracurium through a bolus 1.0 mg/kg. Group 1 and 3 were pretreated with pheniramine (H1-blocker) and ranitidine (H2-blocker) intravenously before the induction of general anesthesia. After induction, HemosonicTM 100 was installed and the following hemodynamic parameters were measured: systemic vascular resistance (SVR), cardiac index (CI), heart rate (HR) and blood pressure (BP) immediately before, 1, 2, 3, 5 and 10 min after the rapid administration of the atracurium bolus before the skin incision. RESULTS: Groups 1 and 3 showed more stable hemodynamics than groups 2 and 4. Group 2 showed more significant changes in the SVR, CI, BP, HR than group 1 (P< 0.05). Group 4 showed more significant changes in the SVR, CI, BP, HR than group 3, and some cases were significant hemodynamically (P< 0.05). Group 4 showed more significant changes in the SVR, CI, BP, HR than group 2 (P <0.05). CONCLUSIONS: Pretreatment with an anti-histamine drug prior to the administration of atracurium can be effective in attenuating the hemodynamic responses.
