McCourt K C, Elliott P, Mirakhur R K, McMurray T J, Phillips A S, Cochrane D
Department of Anaesthetics, Queen's University, Belfast, Ireland, UK.
Br J Anaesth. 1999 Nov;83(5):721-6. doi: 10.1093/bja/83.5.721.
We have assessed the haemodynamic effects of rapacuronium (Org 9487) in adults undergoing cardiac surgery and compared these with vecuronium and placebo. We studied 56 adult patients undergoing coronary artery bypass grafting or valve replacement surgery using a fentanyl-based anaesthetic technique. A pulmonary artery flotation catheter was inserted before induction of anaesthesia. After induction, tracheal intubation and stabilization of haemodynamic measurements, subjects were allocated randomly to receive rapacuronium 1.5 mg kg-1 vecuronium 0.1 mg kg-1 or saline placebo. Haemodynamic measurements were made before drug administration and 1, 3, 5 and 10, and if possible, 15 min after administration. Rapacuronium was associated with statistically significant increases in heart rate (17%) and cardiac index (15%) and decreases in mean arterial pressure (11%) and systemic vascular resistance (18%), whereas vecuronium and placebo were associated with significant decreases in heart rate only (14-15%) (P < 0.05). No cutaneous signs of histamine release were observed. Clinically, the results were within acceptable limits. Our results suggest that administration of rapacuronium may be associated with significant changes in heart rate and arterial pressure in patients undergoing coronary artery bypass grafting.
我们评估了瑞帕库溴铵（Org 9487）对接受心脏手术的成年人的血流动力学影响，并将其与维库溴铵和安慰剂进行了比较。我们研究了56例接受冠状动脉搭桥术或瓣膜置换手术的成年患者，采用基于芬太尼的麻醉技术。在麻醉诱导前插入肺动脉漂浮导管。诱导后，气管插管并稳定血流动力学测量值，将受试者随机分配接受1.5mg/kg瑞帕库溴铵、0.1mg/kg维库溴铵或生理盐水安慰剂。在给药前以及给药后1、3、5和10分钟（如有可能，15分钟）进行血流动力学测量。瑞帕库溴铵与心率显著增加（17%）和心脏指数增加（15%）以及平均动脉压降低（11%）和全身血管阻力降低（18%）相关，而维库溴铵和安慰剂仅与心率显著降低（14 - 15%）相关（P < 0.05）。未观察到组胺释放的皮肤征象。临床上，结果在可接受范围内。我们的结果表明，在接受冠状动脉搭桥术的患者中，给予瑞帕库溴铵可能与心率和动脉压的显著变化相关。
