Hemodynamic and pharmacodynamic comparison of doxacurium and high-dose vecuronium during coronary artery bypass surgery: a cost-benefit study. 1994

N R Searle, and P Sahab, and R Blain, and J Taillefer, and N Tremblay, and J F Hardy, and M Roy, and L Gagnon, and S Bélisle
Department of Anaesthesia, Montreal Heart Institute, Quebec, Canada.

Doxacurium (DOX), a new nondepolarizing neuromuscular blocking drug (NMBD), was compared in a randomized, double-blind fashion to high-dose vecuronium (VEC) in 60 coronary artery bypass grafting (CABG) patients. A third group of 15 patients older than 70 years of age (DOX-70) was added to compare the effects of DOX to VEC in the older population. Endpoints of the study were hemodynamic stability, ease of ventilation and intubation, anesthesiologist's satisfaction, drug interventions to correct hemodynamic instability, and total cost of the drug. Anesthesia was induced with fentanyl (30 micrograms/kg) along with the NMBD (DOX 80 micrograms/kg, VEC 400 micrograms/kg) over a 2-minute period. Following induction, heart rate (HR) and mean arterial pressure (MAP) were decreased (P < 0.01) in all groups. Tracheal intubation caused the HR to return to baseline in the DOX-70 group. There was no difference in central venous pressure, pulmonary artery occlusive pressure, cardiac index, systemic vascular resistance, and drug intervention for DOX and VEC. None of the patients had evidence of myocardial ischemia. There was a statistically significant but clinically irrelevant decrease in central venous pressure and systemic vascular resistance in the DOX-70 group. The durations of the induction and maintenance doses of DOX were similar in the younger and older patients. Although the intubating dose of VEC had a faster onset of action, this had no effect on the ease of ventilation, conditions for tracheal intubation, and overall anesthesiologist satisfaction. The total cost for each NMBD was not different.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D007442 Intubation, Intratracheal A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia. Intubation, Endotracheal,Endotracheal Intubation,Endotracheal Intubations,Intratracheal Intubation,Intratracheal Intubations,Intubations, Endotracheal,Intubations, Intratracheal
D007546 Isoquinolines A group of compounds with the heterocyclic ring structure of benzo(c)pyridine. The ring structure is characteristic of the group of opium alkaloids such as papaverine. (From Stedman, 25th ed)
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D012119 Respiration The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration ( Breathing
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D002496 Central Venous Pressure The blood pressure in the central large VEINS of the body. It is distinguished from peripheral venous pressure which occurs in an extremity. Venous Pressure, Central,Central Venous Pressures,Pressure, Central Venous,Pressures, Central Venous,Venous Pressures, Central
D003362 Cost-Benefit Analysis A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. In contrast a cost effectiveness in general compares cost with qualitative outcomes. Cost and Benefit,Cost-Benefit Data,Benefits and Costs,Cost Benefit,Cost Benefit Analysis,Cost-Utility Analysis,Costs and Benefits,Economic Evaluation,Marginal Analysis,Analyses, Cost Benefit,Analysis, Cost Benefit,Analysis, Cost-Benefit,Analysis, Cost-Utility,Analysis, Marginal,Benefit and Cost,Cost Benefit Analyses,Cost Benefit Data,Cost Utility Analysis,Cost-Benefit Analyses,Cost-Utility Analyses,Data, Cost-Benefit,Economic Evaluations,Evaluation, Economic,Marginal Analyses
D003473 Neuromuscular Nondepolarizing Agents Drugs that interrupt transmission at the skeletal neuromuscular junction without causing depolarization of the motor end plate. They prevent acetylcholine from triggering muscle contraction and are used as muscle relaxants during electroshock treatments, in convulsive states, and as anesthesia adjuvants. Curare-Like Agents,Curariform Drugs,Muscle Relaxants, Non-Depolarizing,Neuromuscular Blocking Agents, Competitive,Nondepolarizing Blockers,Agents, Curare-Like,Agents, Neuromuscular Nondepolarizing,Blockers, Nondepolarizing,Curare Like Agents,Drugs, Curariform,Muscle Relaxants, Non Depolarizing,Non-Depolarizing Muscle Relaxants,Nondepolarizing Agents, Neuromuscular
D004311 Double-Blind Method A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment. Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked

Related Publications

N R Searle, and P Sahab, and R Blain, and J Taillefer, and N Tremblay, and J F Hardy, and M Roy, and L Gagnon, and S Bélisle
April 1991, Journal of cardiothoracic and vascular anesthesia,
N R Searle, and P Sahab, and R Blain, and J Taillefer, and N Tremblay, and J F Hardy, and M Roy, and L Gagnon, and S Bélisle
February 1999, Journal of cardiothoracic and vascular anesthesia,
N R Searle, and P Sahab, and R Blain, and J Taillefer, and N Tremblay, and J F Hardy, and M Roy, and L Gagnon, and S Bélisle
October 1990, British journal of anaesthesia,
N R Searle, and P Sahab, and R Blain, and J Taillefer, and N Tremblay, and J F Hardy, and M Roy, and L Gagnon, and S Bélisle
March 1993, Anesthesia and analgesia,
N R Searle, and P Sahab, and R Blain, and J Taillefer, and N Tremblay, and J F Hardy, and M Roy, and L Gagnon, and S Bélisle
July 1986, Acta anaesthesiologica Scandinavica,
N R Searle, and P Sahab, and R Blain, and J Taillefer, and N Tremblay, and J F Hardy, and M Roy, and L Gagnon, and S Bélisle
May 1985, Canadian journal of surgery. Journal canadien de chirurgie,
N R Searle, and P Sahab, and R Blain, and J Taillefer, and N Tremblay, and J F Hardy, and M Roy, and L Gagnon, and S Bélisle
April 2000, Journal of cardiothoracic and vascular anesthesia,
N R Searle, and P Sahab, and R Blain, and J Taillefer, and N Tremblay, and J F Hardy, and M Roy, and L Gagnon, and S Bélisle
April 1989, Journal of cardiothoracic anesthesia,
N R Searle, and P Sahab, and R Blain, and J Taillefer, and N Tremblay, and J F Hardy, and M Roy, and L Gagnon, and S Bélisle
January 1984, Anesthesia and analgesia,
N R Searle, and P Sahab, and R Blain, and J Taillefer, and N Tremblay, and J F Hardy, and M Roy, and L Gagnon, and S Bélisle
February 2016, Indian journal of anaesthesia,
Copied contents to your clipboard!