HAEMODYNAMIC EFFECTS OF VECURONIUM, PANCURONIUM AND ATRACURIUM IN PATIENTS WITH CORONARY ARTERY DISEASE

Thirty patients with ischaemic heart disease scheduled for coronaryartery bypass grafting were randomly allocated to three equalgroups. Following morphine, hyoscine and pentobarbi-tone premedication,anaesthesia was induced with diazepam 0.3 mg kg¹. Five minuteslater neuromuscular blockade was induced with pancuronium 0.1mg kg¹, vecuronium 0.1 mg^–1 or atracurium 0.5 mg kg^–1,followed after 6 min by fentanyl 25 µg kg^–1. Pancuroniumand atracurium caused significant increases in heart rate, whilevecuronium induced little change. Systemic vascular resistancedecreased significantly from 1515 dyn s cm^–6 to 1200 dyns cm^–5 following atracurium. Cardiac index was increasedtransiently in the atracurium group, but a more sustained increasewas observed following pancuronium. Nine patients in the atracuriumgroup showed skin flushing and one developed skin weals.