Adverse effects of pancuronium during high-dose fentanyl anesthesia for coronary artery bypass grafting.

Abstract:

:Using a randomized double-blind protocol, the authors prospectively compared three nondepolarizing muscle relaxants with respect to their influence on hemodynamics and on the electrocardiogram. Thirty-three patients undergoing elective coronary artery bypass grafting (CABG) with high-dose (100 micrograms/kg) fentanyl anesthesia were studied. Patients received 1.5 X ED95 of either pancuronium (n = 12), metocurine (n = 9), or a metocurine-pancuronium combination (4:1 ratio by weight) (n = 12) for muscle relaxation. Heart rate and rate pressure product (RPP) were significantly higher postinduction in the pancuronium group. Myocardial ischemia, indicated by new ECG ST-segment depression occurred significantly more frequently, and exclusively, in the pancuronium group. The authors' data suggest that since pancuronium is associated with tachycardia and an increased incidence of myocardial ischemia, it is best avoided in patients with severe coronary artery disease undergoing CABG with high-dose fentanyl. Either metocurine or the metocurine-pancuronium combination provides greater hemodynamic stability, without precipitating myocardial ischemia, and can be safely and effectively substituted for pancuronium.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Thomson IR,Putnins CL

doi

10.1097/00000542-198506000-00003

subject

Has Abstract

pub_date

1985-06-01 00:00:00

pages

708-13

issue

6

eissn

0003-3022

issn

1528-1175

journal_volume

62

pub_type

临床试验,杂志文章,随机对照试验
  • Regional gas exchange and cellular metabolic activity in ventilator-induced lung injury.

    abstract:BACKGROUND:Alveolar overdistension and repetitive derecruitment-recruitment contribute to ventilator-induced lung injury (VILI). The authors investigated (1) whether inflammatory cell activation due to VILI was assessable by positron emission tomography and (2) whether cell activation due to dynamic overdistension alon...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/01.anes.0000264748.86145.ac

    authors: Musch G,Venegas JG,Bellani G,Winkler T,Schroeder T,Petersen B,Harris RS,Melo MF

    更新日期:2007-04-01 00:00:00

  • The effect of imidazoline receptors and alpha2-adrenoceptors on the anesthetic requirement (MAC) for halothane in rats.

    abstract:BACKGROUND:Recent evidences have documented that several pharmacologic actions of alpha2-adrenoceptor agonists are mediated via activation of not only alpha2-adrenoceptors, but also by imidazoline receptors, which are nonadrenergic receptors in the central nervous system. However, the effect of imidazoline receptors on...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199710000-00032

    authors: Kagawa K,Mammoto T,Hayashi Y,Kamibayashi T,Mashimo T,Yoshiya I

    更新日期:1997-10-01 00:00:00

  • Pharmacokinetics and pharmacodynamics of rocuronium in patients with cirrhosis.

    abstract:BACKGROUND:Rocuronium, like other steroidal nondepolarizing muscle relaxants, may in part be eliminated by the liver. To determine the influence of liver disease on its neuromuscular blocking effect, we studied the pharmacokinetics and pharmacodynamics of rocuronium in patients with cirrhosis. METHODS:Eighteen patient...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199406000-00011

    authors: Khalil M,D'Honneur G,Duvaldestin P,Slavov V,De Hys C,Gomeni R

    更新日期:1994-06-01 00:00:00

  • Vomiting and recovery after outpatient tonsillectomy and adenoidectomy in children. Comparison of four anesthetic techniques using nitrous oxide with halothane or propofol.

    abstract:BACKGROUND:The authors' purpose in this study was to compare prospectively four different anesthetic induction and maintenance techniques using nitrous oxide with halothane and/or propofol for vomiting and recovery after outpatient tonsillectomy and adenoidectomy procedures in children. METHODS:Eighty unpremedicated c...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199607000-00002

    authors: Ved SA,Walden TL,Montana J,Lea DE,Tefft MC,Kataria BK,Pudimat MA,Nicodemus HF,Milmoe GJ

    更新日期:1996-07-01 00:00:00

  • Liposome encapsulation prolongs alfentanil spinal analgesia and alters systemic redistribution in the rat.

    abstract::The effect of liposome encapsulation on the analgesia produced by intrathecally administered alfentanil was examined in the rat. In rats prepared with chronic intrathecal catheters, alfentanil in doses of 1-50 micrograms was administered intrathecally in either saline or in multilamellar liposomes (dipalmitoylphosphat...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199209000-00019

    authors: Bernards CM,Luger TJ,Malmberg AB,Hill HF,Yaksh TL

    更新日期:1992-09-01 00:00:00

  • Body position changes redistribute lung computed-tomographic density in patients with acute respiratory failure.

    abstract::Ten patients with parenchymal acute respiratory failure (ARF) underwent computed tomography (CT) scans while in the supine and prone positions. At equal levels of positive end-expiratory pressure, the authors measured the changes of CT density in dorsal and ventral basilar lung regions induced by the change of positio...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199101000-00004

    authors: Gattinoni L,Pelosi P,Vitale G,Pesenti A,D'Andrea L,Mascheroni D

    更新日期:1991-01-01 00:00:00

  • Acid-sensing Ion Channel 3 Overexpression in Incisions Regulated by Nerve Growth Factor Participates in Postoperative Nociception in Rats.

    abstract:BACKGROUND:Acid-sensing ion channel 3 (ASIC3) upregulation has been reported in dorsal root ganglion neurons after incision and contributes to postoperative nociception. This study hypothesized that upregulation of ASIC3 in incised tissues is induced by nerve growth factor through the phosphoinositide 3-kinase/protein ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000003576

    authors: Li H,Li H,Cheng J,Liu X,Zhang Z,Wu C

    更新日期:2020-12-01 00:00:00

  • Thoracic epidural versus intravenous patient-controlled analgesia after cardiac surgery: a randomized controlled trial on length of hospital stay and patient-perceived quality of recovery.

    abstract:BACKGROUND:Perioperative thoracic epidural analgesia reduces stress response and pain scores and may improve outcome after cardiac surgery. This prospective, randomized trial was designed to compare the effectiveness of patient-controlled thoracic epidural analgesia with patient-controlled analgesia with intravenous mo...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/00000542-200601000-00020

    authors: Hansdottir V,Philip J,Olsen MF,Eduard C,Houltz E,Ricksten SE

    更新日期:2006-01-01 00:00:00

  • Agent-selective effects of volatile anesthetics on GABAA receptor-mediated synaptic inhibition in hippocampal interneurons.

    abstract:BACKGROUND:A relatively small number of inhibitory interneurons can control the excitability and synchronization of large numbers of pyramidal cells in hippocampus and other cortical regions. Thus, anesthetic modulation of interneurons could play an important role for the maintenance of anesthesia. The aim of this stud...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200102000-00025

    authors: Nishikawa K,MacIver MB

    更新日期:2001-02-01 00:00:00

  • Lung volumes and closing capacity with continuous positive airway pressure.

    abstract::Total lung capacity, vital capacity, residual volume, and functional residual capacity were determined by body plethysmography and the single-breath oxygen (SBO2) test was performed at 0, 5, and 11 cm H20 continuous positive airway pressure in healthy, awake, seated, spontaneously breathing subjects. Mean values for t...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197502000-00005

    authors: Abboud N,Rehder K,Rodarte JR,Hyatt RE

    更新日期:1975-02-01 00:00:00

  • Incidence and predictors of difficult and impossible mask ventilation.

    abstract:BACKGROUND:Mask ventilation is an essential element of airway management that has rarely been studied as the primary outcome. The authors sought to determine the incidence and predictors of difficult and impossible mask ventilation. METHODS:A four-point scale to grade difficulty in performing mask ventilation (MV) is ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200611000-00007

    authors: Kheterpal S,Han R,Tremper KK,Shanks A,Tait AR,O'Reilly M,Ludwig TA

    更新日期:2006-11-01 00:00:00

  • Analgesic effects of Sazetidine-A, a new nicotinic cholinergic drug.

    abstract:BACKGROUND:The use of nicotinic agonists for analgesia is limited by their unacceptable side effects. Sazetidine-A is a new partial agonist nicotinic ligand that has very high selectivity for beta2-containing nicotinic acetylcholine receptors. It potently and selectively desensitizes alpha4beta2 nicotinic acetylcholine...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3181834490

    authors: Cucchiaro G,Xiao Y,Gonzalez-Sulser A,Kellar KJ

    更新日期:2008-09-01 00:00:00

  • Gabapentin suppresses cutaneous hyperalgesia following heat-capsaicin sensitization.

    abstract:BACKGROUND:The anticonvulsant gabapentin, proven effective for neuropathic pain in two large, placebo-controlled clinical trials, is widely used for treatment of chronic pain. Preclinical studies have demonstrated analgesic and antiallodynic effects in models involving neuronal sensitization and nerve injury, without a...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200207000-00015

    authors: Dirks J,Petersen KL,Rowbotham MC,Dahl JB

    更新日期:2002-07-01 00:00:00

  • Ability of the bispectral index, autoregressive modelling with exogenous input-derived auditory evoked potentials, and predicted propofol concentrations to measure patient responsiveness during anesthesia with propofol and remifentanil.

    abstract:BACKGROUND:This study was conducted to compare the performance accuracy of the independent variables Bispectral Index (BIS), A-Line ARX index (AAI), and predicted propofol effect-site concentration (CePROP) to measure the dependent variables of loss of responses to different stimulation defined as loss of response to v...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200310000-00010

    authors: Struys MM,Vereecke H,Moerman A,Jensen EW,Verhaeghen D,De Neve N,Dumortier FJ,Mortier EP

    更新日期:2003-10-01 00:00:00

  • Improved resuscitation after cardiac arrest in rats expressing the baculovirus caspase inhibitor protein p35 in central neurons.

    abstract:BACKGROUND:Global cerebral ischemia is associated with delayed neuronal death. Given the role of caspases in apoptosis, caspase inhibitors may provide neuronal protection after cardiac arrest. To this end, the authors generated a transgenic rat line expressing baculovirus p35, a broad-spectrum caspase inhibitor, in cen...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200307000-00020

    authors: Vogel P,Putten Hv,Popp E,Krumnikl JJ,Teschendorf P,Galmbacher R,Kisielow M,Wiessner C,Schmitz A,Tomaselli KJ,Schmitz B,Martin E,Böttiger BW

    更新日期:2003-07-01 00:00:00

  • Drug actions at mammalian motor nerve endings: the suppression of neostigmine-induced fasciculations by vecuronium and isoflurane.

    abstract::The occurrence of fasciculations following administration of agents is a well-known pharmacologic phenomenon. Using the cat soleus nerve-muscle preparation, intravenous neostigmine doses between 20-200 micrograms/kg evoked fasciculations in a dose-related manner. The data demonstrate that the fasciculations were the r...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198712000-00011

    authors: Baker T,Stanec A

    更新日期:1987-12-01 00:00:00

  • Modulation of platelet surface adhesion receptors during cardiopulmonary bypass.

    abstract::Alterations in platelet receptors critical to adhesion may play a role in the pathogenesis of the qualitative platelet defect associated with cardiopulmonary bypass. Using flow cytometry, we measured changes in the following platelet surface adhesive proteins: the von Willebrand factor receptor, glycoprotein Ib; the f...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199110000-00004

    authors: Rinder CS,Mathew JP,Rinder HM,Bonan J,Ault KA,Smith BR

    更新日期:1991-10-01 00:00:00

  • Cardiorespiratory effects of automatic tube compensation during airway pressure release ventilation in patients with acute lung injury.

    abstract:BACKGROUND:Spontaneous breaths during airway pressure release ventilation (APRV) have to overcome the resistance of the artificial airway. Automatic tube compensation provides ventilatory assistance by increasing airway pressure during inspiration and lowering airway pressure during expiration, thereby compensating for...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200108000-00020

    authors: Wrigge H,Zinserling J,Hering R,Schwalfenberg N,Stüber F,von Spiegel T,Schroeder S,Hedenstierna G,Putensen C

    更新日期:2001-08-01 00:00:00

  • The effect of dobutamine on hepatic blood flow and oxygen supply-uptake ratio during enflurane nitrous oxide anesthesia in humans undergoing liver resection.

    abstract::Liver surgery is often accompanied by hepatic hypoperfusion and hypoxia, and it is controversial whether catecholamines increase hepatic blood flow and oxygen supply. The effects of 3 micrograms.kg-1.min-1 dobutamine on hepatic circulation and oxygen balance were examined in patients anesthetized with enflurane, nitro...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199209000-00005

    authors: Kainuma M,Kimura N,Nonami T,Kurokawa T,Ito T,Nakashima K,Shimada Y

    更新日期:1992-09-01 00:00:00

  • Influence of erythrocyte concentrate storage time on postsurgical morbidity in cardiac surgery patients.

    abstract:BACKGROUND:The transfusion of erythrocytes that have been stored for long periods of time can produce visceral ischemia and favor the acquisition of postsurgical infections. To estimate the role of the duration of storage of erythrocytes on morbidity in cardiac surgery, we performed an observational study. METHODS:All...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000542-200304000-00005

    authors: Leal-Noval SR,Jara-López I,García-Garmendia JL,Marín-Niebla A,Herruzo-Avilés A,Camacho-Laraña P,Loscertales J

    更新日期:2003-04-01 00:00:00

  • Effect of sevoflurane on hypoxic pulmonary vasoconstriction in the perfused rabbit lung.

    abstract:BACKGROUND:In vitro studies have shown that isoflurane, enflurane, and halothane inhibit the hypoxic pulmonary vasoconstriction (HPV) with essentially the same potency. The aim of this study is to compare the effects of sevoflurane and isoflurane on HPV in constant-flow perfused rabbit lungs. METHODS:Constant-flow per...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199312000-00026

    authors: Ishibe Y,Gui X,Uno H,Shiokawa Y,Umeda T,Suekane K

    更新日期:1993-12-01 00:00:00

  • The effect of 30% nitrous oxide on thermoregulatory responses in humans during hypothermia.

    abstract::Clinical studies have reported that body core temperature decreases during prolonged surgery and anesthesia. Although this finding has been attributed primarily to increased heat loss resulting from exposure of body cavities and infusion of cold solutions, it is generally recognized that anesthesia interferes with the...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199204000-00011

    authors: Passias TC,Mekjavić IB,Eiken O

    更新日期:1992-04-01 00:00:00

  • Neutrophil elastase inhibitor, ONO-5046, modulates acid-induced lung and systemic injury in rabbits.

    abstract:BACKGROUND:Acid instillation leads to direct lung and to secondary systemic organ injury, probably via activated macrophages and neutrophils. This study investigated the effects of neutrophil elastase on organ injury after unilateral lung acid instillation by administrating a specific neutrophil elastase inhibitor, ONO...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199709000-00025

    authors: Kaneko K,Kudoh I,Hattori S,Yamada H,Ohara M,Wiener-Kronish J,Okumura F

    更新日期:1997-09-01 00:00:00

  • Patient-controlled epidural analgesia during labor: a comparison of three solutions with a continuous infusion control.

    abstract::This study examined the efficacy of patient-controlled epidural analgesia (PCEA) during labor and compared the suitability of three different PCEA solutions. After establishing effective epidural analgesia with 12 ml of 0.25% bupivacaine, 72 parturients in active labor were randomly assigned to one of four groups: phy...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199001000-00009

    authors: Lysak SZ,Eisenach JC,Dobson CE 2nd

    更新日期:1990-01-01 00:00:00

  • Anesthetic influence on arteriolar diameters and tissue oxygen tension in hemorrhaged rats.

    abstract::Arteriolar diameters and tissue oxygen tensions were measured in the cremaster muscles of 68 hemorrhaged rats which were anesthetized with either intramuscular ketamine, 125 mg/kg, plus 30 mg/kg supplements as needed, or enflurane, 2.2% inspired. Animals breathed room air, or room air plus enflurane, throughout the ex...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198209000-00006

    authors: Longnecker DE,Ross DC,Silver IA

    更新日期:1982-09-01 00:00:00

  • Relaxation before Debriefing during High-fidelity Simulation Improves Memory Retention of Residents at Three Months: A Prospective Randomized Controlled Study.

    abstract:BACKGROUND:High-fidelity simulation is known to improve participant learning and behavioral performance. Simulation scenarios generate stress that affects memory retention and may impact future performance. The authors hypothesized that more participants would recall three or more critical key messages at three months ...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/ALN.0000000000002045

    authors: Lilot M,Evain JN,Bauer C,Cejka JC,Faure A,Balança B,Vassal O,Payet C,Bui Xuan B,Duclos A,Lehot JJ,Rimmelé T

    更新日期:2018-03-01 00:00:00

  • Resistance to metocurine-induced neuromuscular blockade in patients receiving phenytoin.

    abstract::Recent reports have described resistance to pancuronium-induced neuromuscular blockade in patients chronically receiving anticonvulsants. This study examines the pharmacokinetics and pharmacodynamics of metocurine (MTC) in 12 patients undergoing craniotomy--six on chronic phenytoin therapy and six comparable controls....

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198509000-00009

    authors: Ornstein E,Matteo RS,Young WL,Diaz J

    更新日期:1985-09-01 00:00:00

  • Differential effects of fentanyl and morphine on intracellular Ca2+ transients and contraction in rat ventricular myocytes.

    abstract:BACKGROUND:Our objective was to elucidate the direct effects of fentanyl and morphine on cardiac excitation-contraction coupling using individual, field-stimulated rat ventricular myocytes. METHODS:Freshly isolated myocytes were loaded with fura-2 and field stimulated (0.3 Hz) at 28 degrees C. Amplitude and timing of ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199812000-00033

    authors: Kanaya N,Zakhary DR,Murray PA,Damron DS

    更新日期:1998-12-01 00:00:00

  • The detrimental effects of prolonged hypothermia and rewarming in the dog.

    abstract::The authors had previously observed a deleterious cerebrovascular effect of prolonged hypothermia in primates and cats. In this study they examined the systemic as well as cerebral hemodynamic and metabolic effects of 24 hours of hypothermia in the dog. With decreases in temperature to 29 C, cardiac output (Q) and who...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198003000-00007

    authors: Steen PA,Milde JH,Michenfelder JD

    更新日期:1980-03-01 00:00:00

  • Antinociceptive effect of low-dose intrathecal neostigmine combined with intrathecal morphine following gynecologic surgery.

    abstract:BACKGROUND:The purpose of this study was to determine whether combination of 1-5 microg intrathecal neostigmine would enhance analgesia from a fixed intrathecal dose of morphine. METHODS:A total of 60 patients undergoing gynecologic surgery were randomized to one of five groups. Patients received 15 mg bupivacaine plu...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200302000-00031

    authors: Almeida RA,Lauretti GR,Mattos AL

    更新日期:2003-02-01 00:00:00