Hudson M E, Rothfield K P, Tullock W C, Firestone L L
Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh, Pennsylvania 15213, USA.
Can J Anaesth. 1998 Feb;45(2):139-43. doi: 10.1007/BF03013252.
To measure the haemodynamic effects of rocuronium in adults undergoing cardiac surgery with cardiopulmonary bypass (CPB).
Twenty patients undergoing elective cardiac surgical procedures with moderate hypothermic nonpulsatile bypass participated in this prospective, observational study. After anaesthetic induction, recovery from succinylcholine, and achievement of baseline haemodynamic stability, patients received 0.6 mg.kg-1 rocuronium as an initial rapid intravenous bolus. Maintenance dosing of 0.2 mg.kg-1 was continued for the remainder of the procedure. Haemodynamic measurements (heart rate, systemic arterial systolic, diastolic, and mean arterial pressure, pulmonary arterial systolic, diastolic, and mean pressure, pulmonary capillary wedge pressure, central venous pressure, and thermodilution cardiac output measurements) were obtained for the first five minutes after rocuronium administration, and subjects were observed for histamine-related symptoms.
Central venous pressure decreased from baseline at two and five minutes after the rocuronium bolus, and mean pulmonary artery pressure decreased at five minutes. No changes were observed in heart rate, mean systemic arterial pressure, pulmonary capillary wedge pressure, cardiac index, stroke volume, systemic vascular resistance, or pulmonary vascular resistance, nor did any patient manifest any other histamine-related symptoms.
The haemodynamic profile for a 0.6 mg.kg-1 bolus of rocuronium is acceptable for patients with cardiovascular disease.
测量罗库溴铵在接受体外循环（CPB）心脏手术的成人中的血流动力学效应。
20例接受中度低温非搏动性体外循环择期心脏手术的患者参与了这项前瞻性观察研究。麻醉诱导、琥珀酰胆碱作用消退且达到基线血流动力学稳定后，患者接受0.6mg·kg-1罗库溴铵作为初始快速静脉推注。在手术剩余时间持续给予0.2mg·kg-1维持剂量。在给予罗库溴铵后的前五分钟测量血流动力学指标（心率、体动脉收缩压、舒张压和平均动脉压、肺动脉收缩压、舒张压和平均压、肺毛细血管楔压、中心静脉压以及热稀释法心输出量测量值），并观察受试者是否出现组胺相关症状。
罗库溴铵推注后两分钟和五分钟时中心静脉压较基线值降低，五分钟时平均肺动脉压降低。心率、体动脉平均压、肺毛细血管楔压、心脏指数、每搏量、体循环血管阻力或肺循环血管阻力均未观察到变化，也没有患者出现任何其他组胺相关症状。
对于心血管疾病患者，0.6mg·kg-1推注剂量的罗库溴铵的血流动力学特征是可接受的。
