Comparison of the haemodynamic effects of mivacurium and atracurium during fentanyl anaesthesia

• Published in: British journal of anaesthesia : BJA Vol. 74; no. 3; pp. 330 - 332
• Main Authors: LOAN, P.B., ELLIOTT, P., MIRAKHUR, R.K., BUNTING, H.F., BHANUMURTHY, S., MCMURRAY, T.J.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.03.1995; Oxford University Press
• Subjects: Anesthetics. Neuromuscular blocking agents; atracurium; Atracurium - pharmacology; Biological and medical sciences; Blood Pressure - drug effects; Cardiac Output - drug effects; cardiovascular; Cardiovascular system; Coronary Artery Bypass; Drug Administration Schedule; effects; Erythema - chemically induced; Fentanyl; Hemodynamics - drug effects; Humans; Isoquinolines - pharmacology; Medical sciences; Mivacurium; Neuromuscular block; Neuromuscular Depolarizing Agents - pharmacology; Neuropharmacology; Pharmacology. Drug treatments; Surgery; Vascular Resistance - drug effects; Cardiovascular system; effects; Neuromuscular block; Surgery; mivacurium; cardiovascular; atracurium; Human; General anesthesia; Non depolarisant myorelaxant; Hemodynamics; Neuromuscular blocking; Comparative study
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/74.3.330

We have measured the haemodynamic effects of mivacurium 0.15 and 0.2 mg kg−1, and atracurium 0.5 mg kg−1 administered over 10–15 s in patients undergoing coronary artery bypass surgery under fentanyl anaesthesia. There were no significant haemodynamic changes in the atracurium group, other than a transient decrease in pulmonary arterial wedge pressure. Changes in heart rate were small in all three groups. Mivacurium 0.15 mg kg−1 produced changes of only small magnitude (12% decrease in mean arterial pressure and 16% decrease in systemic vascular resistance index) however, mivacurium 0.2 mg kg−1 produced a 25% reduction in mean arterial pressure, a 14% increase in cardiac index and a 35% decrease in systemic vascular resistance index. Erythema developed in two, three and seven patients after atracurium, mivacurium 0.15mgkg−1 and mivacurium 0.2 mg kg−1, respectively. One patient exhibited a 54% decrease in mean arterial pressure, generalized erythema and bronchospasm after mivacurium 0.2mg kg−1. The haemodynamic changes with mivacurium suggested histamine release. (Br. J. Anaesth. 1995; 74: 330–332)