Authors : Satwik Telkar, Basavaraj Padara, Hulkhund S Y, Ajay B.C
DOI : 10.18231/j.ijca.2019.070
Volume : 6
Issue : 3
Year : 2019
Page No : 366-370
Aims: Patients requiring coronary artery bypass graft surgery are usually in compromised cardiac status and factors altering the myocardial oxygen demand and supply ratio, like, changes in heart rate, systolic diastolic and mean arterial blood pressure, myocardial contractility and vascular resistance may aggravate the underlying problem. Aim of our study was to compare the hemodynamic effects of neuromuscular blocking drugs like rocuronium, vecuronium and atracurium in patients undergoing elective coronary artery bypass graft (CABG) under Total intravenous anaesthesia.
Materials and Methods: Total of 90 cases were studied who were posted for elective beating heart CABG surgery, and were categorized into 3 groups with 30 patients in each group. Patients in group A were given vecuronium and group B and group C patients were administered with rocuronium and atracurium respectively, before intubation and for maintenance according to standard calculated doses. Hemodynamic parameters like HR, MAP, MPAP, PCWP, CI, SVI etc are measured at critical events and data analysed for assessing hemodynamic stability following use of the above said skeletal muscle relaxants.
Results: Overall vecuronium group was shown to be associated with decrease in HR, MAP, while other parameters were maintained. In rocuronium group there were increases in HR, MAP, MPAP, PCWP, CI, SVI, SVR, which were statistically significant but clinically not that significant.In atracurium group there was decrease in HR, MAP, MPAP, PCWP, CI, SVI, SVR which were significant but clinically not that significant. From the present study it was concluded that vecuronium had a better and more cardiac favorable variables and more cardiovascular stability when compared to rocuronium and atracurium. Rocuronium was more cardio stable than atracurium. Vecuronium >Rocuronium >Atracurium (>=is better than).
Keywords: Hemodynamic stability, Total intravenous anaesthesia, Vecuronium, Rocuronium, Atracurium.