Haemodynamic effects of rapacuronium in adults with coronary artery or valvular disease

We have assessed the haemodynamic effects of rapacuronium (Org 9487) in adu lts undergoing cardiac surgery and compared these with vecuronium and place bo. 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 ana esthesia. After induction, tracheal intubation and stabilization of haemody namic measurements, subjects were allocated randomly to receive rapacuroniu m 1.5 mg kg(-1), vecuronium 0.1 mg kg(-1) or saline placebo. Haemodynamic m easurements were made before drug administration and 1, 3, 5 and 10, and if possible, 15 min after administration. Rapacuronium was associated with st atistically significant increases in heart rate (17%) and cardiac index (15 %) and decreases in mean arterial pressure (11%) and systemic vascular resi stance (18%), whereas vecuronium and placebo were associated with significa nt decreases in heart rate only (14-15%) (P<0.05). No cutaneous signs of hi stamine release were observed. Clinically, the results were within acceptab le limits. Our results suggest that administration of rapacuronium may be a ssociated with significant changes in heart rate and arterial pressure in p atients undergoing coronary artery bypass grafting.