WHICH ANESTHETIC DRUG REGIMEN IS SUITABLE FOR CABG SURGERY: PROPOFOL - ATRACURIUM OR PROPOFOL - PANCURONIUM?

Abstract

Background- Hemodynamic instability during anesthesia can affect circulation and ‎oxygenation of vital organs (e.g. brain, heart, kidney and liver). Each of the anesthetic ‎drugs has various hemodynamic effects, and the interaction of these drugs may cause ‎critical changes in‏ ‏patients hemodynamics‏.‏‎<br />‎ Propofol is the most recent intravenous anesthetic to be introduced into clinical ‎practice. This drug has negative inotropic effects on the heart. Based on the ‎cardiovascular effects of propofol and to maintain hemodynamic stability during ‎anesthesia with this drug, it seems that selection of a muscle relaxant with positive ‎effects on the heart rate and especially blood pressure, such as pancuronium, is better ‎than atracurium. Therefore, we performed a study of the effects of pancuronium and ‎atracurium on hemodynamic parameters of patients undergoing CABG surgery, in ‎which these muscle relaxants are used in conjunction with propofol-sufentanil‏.‏‎ <br />‎ Methods- A prospective randomized clinical trial analysis was performed on 100 ‎patients undergoing coronary artery bypass graft surgery in Shaheed Rajaei Heart ‎Center. Fifty of the patients received propofol -pancuronium and 50 of them received ‎propofol - atracurium. The selection of type and dose of premedication drugs and ‎intraoperative opioid use in the two groups was the same. Maintenance of anesthesia ‎in the two groups was achieved by the infusion of specific doses of these drugs‏.‏‎ <br />‎ Results- Hemodynamic changes in the two groups were almost the same. There was ‎no statistically significant difference (p>0.05) in the two groups (Iranian Heart ‎Journal 2002, 2003; 3(4)&4(1): 25-28).‎