Korean J Anesthesiol.  2003 May;44(5):626-632. 10.4097/kjae.2003.44.5.626.

Effects of Preinduction Atropine on the Hemodynamic Response to Induction with Fentanyl and Vecuronium for Coronary Artery Bypass Grafting

• Kwak HJ
• Lee WK
• Park GM
• Kwak YL

• KMID: 1759980
• DOI: http://doi.org/10.4097/kjae.2003.44.5.626

Abstract

BACKGROUND: Induction of anesthesia with a high dose of fentanyl and vecuronium decreases the heart rate and blood pressure. This study was designed to evaluate the effect of preinduction atropine on these hemodynamic changes in patients undergoing coronary artery bypass graft surgery (CABG).
METHODS
Forty-one patients who underwent CABG were randomly divided into two groups. After insertion of a radial artery cannula and a Swan-Ganz catheter, normal saline 1 ml (control group, n = 20) or atropine 0.5 mg (atropine group, n = 21) was injected intravenously 1 min before the induction of anesthesia. Anesthesia was induced with a first dose of fentanyl (5-8 microgram/kg) and vecuronium (0.12 mg/kg) and a second dose of fentanyl (5-10 microgram/kg). The patient was then intubated. Hemodynamic variables were measured before the induction of anesthesia, 1 min after the administration of each drug during the induction of anesthesia and 5, 10, and 30 min after the intubation.
RESULTS
There was no significant differences between the two groups in terms of demographic data except that the number of patients with diabetes mellitus was greater in the control group than in the atropine group. The number of patients treated for hypotension or bradycardia during the induction of anesthesia was greater in the control group than in the atropine group, but this was not statistically significant. Heart rates significantly decreased in the control group but were maintained in the atropine group without any significant tachycardia. Blood pressure significantly decreased in both groups.
CONCLUSIONS
Intravenous injection of atropine before anesthetic induction in patients undergoing CABG attenuates the decrease in heart rate resulting from anesthetic induction with high dose fentanyl and vecuronium. However, it didn't prevent the decrease in blood pressure nor did it reduce the incidence of treatment for hypotension.

Keyword

Atropine; bradycardia; coronary artery bypass graft surgery; fentanyl; vecuronium

MeSH Terms

Anesthesia
Atropine*
Blood Pressure
Bradycardia
Catheters
Coronary Artery Bypass*
Coronary Vessels*
Diabetes Mellitus
Fentanyl*
Heart Rate
Hemodynamics*
Humans
Hypotension
Incidence
Injections, Intravenous
Intubation
Radial Artery
Tachycardia
Transplants
Vecuronium Bromide*
Atropine
Fentanyl
Vecuronium Bromide