COMPARISON BETWEEN THE EFFECT OF ROCURONIUM AND PIPECURONIUM ON THE HEMODYNAMICS OF PATIENTS DURING MITRALVALVE REPLACEMENT SURGERY

Abstract

The clinical need for new neuromuscular blocking drugs still persists today to provide anesthesiologists with additional clinical options for optimum anesthetic care. One of the most desirable features of a new long acting non• depolarizing agent should be the lack of cardiovascular side effects even at fully paralyzing doses. This study was designed to compare the hemodynamic effects of both rocuronium and pipecuronium in patients undergoing open heart surgery for mitral valve replacement, being among the most frequent open heart surgeries in EGYPT. Pipecuronium appears to be devoid of cardiovascular effects, ganglion• blocking effects and histamine-releasing properties , Rocuronium is a new intermediate acting non depolarizing neuromuscular blocking agent having a rapid onset of action, minimal cardiovascular vagal side effects, with excellent intubating condition Mitral valve diseased patients are very sensitive to changes in heart rate . (tachycardia in mitral stenosis and bradycardia in mitral regurge), and any change in the peripheral vascular resistance. They are also sensitive to exacerbation in pre-existing pulmonary hypertension. So any minimal hemodynamic changes caused by a drug will be magnified in such type of patients ".