چكيده لاتين :
Background: The present study was designed to determine and compare the hemodynamic effects of two nondepolarizing neuromuscular blocking agents, atracurium and cisatracurium, in coronary artery bypass grafting surgery (CABG) during anesthetic induction and operating time.
Materials and methods: This study was a randomized, prospective, double blinded, clinical trial. We studied the patients undergoing elective CABG. One hundred patients were randomly divided into two groups; atracurium (n=50) and cisatracurium (n=50). The patients were anesthetized using 100% oxygen, sufentanil, and ethomidate. Tracheal intubation was facilitated with atracurium, (0.6 mg/ Kg ) or cisatracurium, (0.2 mg/ Kg) injection over 45 sec. The systolic and diastolic blood pressure, mean arterial pressure, and heart rate were measured before anesthetic induction, during anesthesia, operating time, and finally before transfer the patients to the intensive care unite.
Results: There were no significant differences between the groups with respect of age, sex, coexisting diseases, preoperative ejection fraction (EF), duration of surgery and cardiopulmonary bypass. There were no significant differences in hemodynamic values (systolic and diastolic blood pressure, mean arterial blood pressure and heart rate) at 11 stages of study among the two groups. There were no episodes of cutaneous flushing or hemodynamic changes requiring therapy during anesthetic induction in any patients of two groups. The cost of atracurium was significantly less.
Conclusion: There is no evidence of a hemodynamic difference between these two neuromuscular blocking drugs. Atracurium and cisatracurium appear suitable for use in cardiac patients undergoing CABG. There is only some cost advantage of atracurium.
