HEMODYNAMIC-EFFECTS OF ROCURONIUM BROMIDE IN ADULT CARDIAC SURGICAL PATIENTS

Purpose: To measure the haemodynamic effects of rocuronium in adults u ndergoing cardiac surgery with cardiopulmonary bypass (CPB). Methods: Twenty patients undergoing elective cardiac surgical procedures with m oderate hypothermic nonpulsatile bypass participated in this prospecti ve, observational study. After anaesthetic induction, recovery from su ccinylcholine, and achievement of baseline haemodynamic stability, pat ients received 0.6 mg.kg(-1) rocuronium as an initial rapid intravenou s bolus. Maintenance dosing of 0.2 mg.kg(-1) was continued for the rem ainder of the procedure. Haemodynamic measurements (heart rate, system ic arterial systolic, diastolic, and-mean arterial pressure, pulmonary arterial systolic, diastolic, and mean pressure, pulmonary capillary wedge pressure, central venous pressure, and thermodilution cardiac ou tput measurements) were obtained for the first five minutes after rocu ronium administration,and subjects were observed fbr histamine-related symptoms. Results: Central venous pressure decreased from baseline at two and five minutes after the rocuronium bolus, and mean pulmonary a rtery 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 o ther histamine-related symptoms. Conclusion: The haemodynamic profile for a 0.6 mg.kg(-1) bolus of rocuronium is acceptable for patients wit h cardiovascular disease.