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Hudson ME. Rothfield KP. Tullock WC. Firestone LL., Haemodynamic effects of rocuronium bromide in adult cardiac surgical patients. Canadian Journal of Anaesthesia. 45(2):139-43, 1998.
To measure the hemodynamic effects of rocuronium in adults undergoing cardiac surgery with cardiopulmonary bypass (CPB), 20 patients undergoing elective cardiac surgical procedures with moderate hypothermic nonpulsatile bypass participated in this prospective, observational study. After anesthetic induction, recovery from succinylcholine, and achievement of baseline hemodynamic stability, patients received 0.6 mg.kg-1 rocuronium as an initial rapid intravenous bolus. Maintenance dosing of 0.2 mg.kg-1 was continued for the remainder of the procedure. Hemodynamic measurements (heart rate, systemic arterial systolic, diastolic, and mean arterial pressure, pulmonary arterial systolic, diastolic, and mean pressure, pulmonary capillary wedge pressure, central venous pressure, and thermodilution cardiac output measurements) were obtained for the first five minutes after rocuronium administration, and subjects were observed for histamine-related symptoms. Central venous pressure decreased from baseline at two and five minutes after the rocuronium bolus, and mean pulmonary artery pressure decreased at five minutes. No changes were observed in heart rate, mean systemic arterial pressure, pulmonary capillary wedge pressure, cardiac index, stroke volume, systemic vascular resistance, or pulmonary vascular resistance, nor did any patient manifest any other histamine-related symptoms. The authors conclude that the hemodynamic profile for a 0.6 mg.kg-1 bolus of rocuronium is acceptable for patients with cardiovascular disease.
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