Cardiovascular effects of pancuronium, vecuronium, and atracurium during induction of anesthesia with sufentanil and lorazepam for myocardial revascularization.

The hemodynamic effects of three commonly used muscle relaxants, pancuronium, vecuronium, and atracurium were investigated during induction of anesthesia with sufentanil and lorazepam in patients undergoing coronary artery bypass surgery. Direct hemodynamic variables were recorded, and indirect parameters were calculated using standard formulae. Changes in heart rate differed with the three muscle relaxants. Pancuronium increased the heart rate whereas vecuronium and atracurium produced a decrease 5 minutes after induction (P less than 0.05). No differences were found in any other parameter during the study. A slow induction with sufentanil, lorazepam, and any of the three muscle relaxants was shown to minimize the hemodynamic changes.