Comparison between Rocuronium and Atracurium Effect on Blood Pressure during General Anaesthesia in Baghdad Hospital

  • Adel Amen Hama Middle Technical University
  • Noor Faris Hoobi Middle Technical University/College of health and medical technology/Baghdad
  • Sara Emad Majeed Middle Technical University/College of health and medical technology/Baghdad
Keywords: Rocuronium, Atracuruim, Neuromuscular blocking drugs, Blood pressure, MAP

Abstract

This study was aimed to assess the blood pressure influence of rocuronium drug under general anesthesia and compares it with atracurium drug. The study recruited 50 adult patients, divided in to two groups the rocuronium drug groups which included 25 patients and atracurium drug group which included 25 patients, age ranged from (18-60 years) of both sexes who were (ASAI and ASAII) patients undergoing (elective surgeries) in Baghdad education hospital during the period from (October 2019 to March 2020). Anesthesia was induced with using I.V. propofol drug (1.5-2.5 mg/kg), ketamine drug (0.5 mg/kg) or (2-3 mg/kg) propofol drug.  For the endotreacheal tube, and facility of intubation injection muscle relaxation the rocuronium drug (0.6 mg/kg) or atracurium drug (0.5 mg/kg), for maintenance rocuronium drug (0.1-0.2 mg/kg). 60 sec. was used after administration of the relaxant, attempt of intubation. Next intubation, lungs were mechanically ventilated, monitored, blood pressure recorded and MAP after five minutes and every five minute for 15 minutes. The resulting P-value of MAP in Rocuronium drug groups and Atracuruim drug group at pre-operative was 0.811 which was non-significant (P> 0.05). While at induction it was 0.309 which was also non-significant (P> 0.05). After 1min it was 0.574 which was non-significant (P> 0.05). After 5min it was 0.321 which was non-significant. After 10 min it was 0.954 which was non-significant (P> 0.05). The blood pressure effected from rocuronium drug and atracurium drug are different under general anesthesia. The Atracurium drugs has less marked change in MAP. In healthy patients it maybe not be of importance, nevertheless it could be nonessential in patients with preexisting cerebral, cardiac diseases, hypertension or the elderly, but Rocuronium drug has a marked change in MAP. This could be cautiously in the patients with preexisting cardiac or cerebral pathology or elderly or hypertension. In conclusions the MAP was increased at induction of rocuronium drug and was decreased at induction of atracurium drug in this study.

References

T. Fuchs-Buder, E. Tassonyi. “Intubating conditions and time course of rocuronium-induced neuromuscular block in children”. Brit. Jour. of anaest,77 (3): 335-8, Sep 1996.

L. Wecker. (2018 May 31). Brody's Human Pharmacology (Online). Elsevier Health Sciences.

M. Wang, MY. Argalious. Smith and Aitkenhead’s Textbook of Anaesthesia. 2020, 103-4.

SA. Magder. The highs and lows of blood pressure: toward meaningful clinical targets in patients with shock. Critical care medicine. 2014, 1241-51.

M. Gulenay, JK. Mathai. (2018 Oct 27). Depolarizing Neuromuscular Blocking Drugs (Online). StatPearls Publishing.

R. Cooper, RK. Mirakhur, RS. Clarke, Z. Boules. “Comparison of intubating conditions after administration of Org 9426 (rocuronium) and suxamethonium”. Brit. Jour. of anaest, 69 (3): 269-73. Sep 1992.

G. Scheiber, FC. Ribeiro, A. Marichal, M. Bredendiek, K.Renzing. (1996 Aug 1). Intubating conditions and onset of action after rocuronium, vecuronium, and atracurium in young children, 83(2): 320-4.

JK. Hicks, HM. Dunnenberger, KF. Gumpper, Haidar CE, JM. Hoffman. “Integrating pharmacogenomics into electronic health records with clinical decision support”. Amer. Jour. of Heal.Sys. Pharm, 73 (23): 1967-76. Dec 2016.

S. Gursoy, I. Bagcivan, N. Durmus, K. Kaygusuz, IO. Kol, C. Duger, S. Yildirim, C. Mimaroglu. “Investigation of the cardiac effects of pancuronium, rocuronium, vecuronium, and mivacurium on the isolated rat atrium”. Current therapeutic research,72 (5): 195-203. Oct 2011.

T. Yang, Li Z, L. Jiang, Y. Wang, X. Xi. “Risk factors for intensive care unit‐acquired weakness”. Acta Neurologica Scandinavica,138 (2):104-14. Aug 2018.

A. Doenicke, J. Moss, W. Lorenz, R. Hoernecke, M. Gottardis. “Are hypotension and rash after atracurium really caused by histamine release”. Anesthesia and analgesia, 78 (5): 967-72. Aug 1994.

DJ. McLean, D. Diaz-Gil, HN. Farhan, KS. Ladha, M. Kurth,. Eikermann. “Dose-dependent association between intermediate-acting neuromuscular-blocking agents and postoperative respiratory complications”. The Jour. of the Amer. Soci. of Anes.122 (6): 1201-13. Jun 2015.

LP. Fortier, D. McKeen, K. Turner, É. de Médicis, B. Warriner, A. PM Jones, JF. Chaput, A. Galarneau. “a Canadian prospective, multicenter study of the incidence and severity of residual neuromuscular blockade”. Anesthesia & Analgesia. 121(2): 366-72. Aug 2015.

SJ. Basta. “Histamine releasing potencies of atracurium, dimethyl tubocurarine and tubocurarine”. Br. J. Anaesth. 55 (1): 105S-6S. Aug 1983.

T. Heier, AB. Guttormsen. “Anaphylactic reactions during induction of anaesthesia using rocuronium for muscle relaxation”. Acta anaesthesiologica scandinavica.44 (7): 775-81. Aug 2000.

T. Takazawa, H. Mitsuhata, PM. Mertes. “Sugammadex and rocuronium-induced anaphylaxis”. Jour. of anesth. 30 (2): 290-7. Apr 2016.

A. Mathew, AN. Sharma, P. Ganapathi, P. Shankaranarayana, M. Nazim, DS. Aiyappa. “Intraoperative hemodynamics with vecuronium bromide and rocuronium for maintenance under general anesthesia”. Anesthesia, essays and researches.10 (1): 59. Jan 2016.

MR. Belmont, RB. Maehr, WB. Wastila, JJ. Savarese. “Pharmacodynamics and pharmacokinetics of benzylisoquinolinium (curare-like) neuromuscular blocking drugs”. Anesthesiology Clinics of North America.11 (2): 251-81. Apr 1993.

Published
2021-03-30
How to Cite
Hama, A., Hoobi, N., & Majeed, S. (2021). Comparison between Rocuronium and Atracurium Effect on Blood Pressure during General Anaesthesia in Baghdad Hospital. Journal of Techniques, 3(1), 13-19. https://doi.org/10.51173/jt.v3i1.251
Section
definition