Haemodynamic and neuromuscular blocking effects of cisatracurium and pancuronium in patients undergoing coronary artery bypass operations

Objective. The aim of the study was to compare haemodynamic and neuromuscul ar effects of cisatracurium and pancuronium in patients undergoing coronary artery bypass grafting (ASA Ill, good or moderately impaired LV function) who were chronically medicated with beta -adrenergic blocking agents. Methods. 60 Patients were randomly assigned in a double-blind fashion to re ceive sufentanil/midazolam/etomidate and either pancuronium (ZxED(95), grou p P) or cisatracurium (2xED(95),group C-2 and 4xED(95), group C-4) Haemodyn amic variables were measured using arterial and pulmonary arterial catheter s, neu ro muscular transmission was measured using electromyography. Results. The heart rate was significantly lower in group C-2 (50,2+/-6,8 bp m) and in group C-4 (54,3+/-11 bpm) than in the pancuronium group (62,4+/-1 3,2 bpm) 3 min after induction of anaesthesia and until 60 min after induct ion. None of the other haemodynamic parameters showed any difference betwee n groups. Onset time was 5.22+/-3.43 min in group P,6.42+/-2.1 min in group Ct and 2.92+/-1.2 min in group C-4 Conclusion. Under high-dose opioid induction bradycardia must be considered if cis atracurium is administered to cardiac surgery patients.