Abstract

FERNANDEZ, Paulo; ANDRUSKEVICIUS, Martín; CASTANOLA, Diego  and  CRISTIANI, Federico. ¿Es necesario utilizar relajantes musculares en infusión continua durante la anestesia en pacientes sometidos a cirugía cardíaca?. Anest Analg Reanim [online]. 2011, vol.24, n.1, pp.3-3. ISSN 1688-1273.

SUMMARY  In cardiac surgery neuromuscular relaxants are selected according to their pharmacodynamic and pharmacokinetic profile, and also by the patients´ characteristics. The most used are those of long-acting. The aim of this study is to compare the incidence and duration of neuromuscular residual blockade with intermediate-acting relaxants administrated in two different ways, at the beginning of surgery in bolus or in infusion, both in patients undergoing cardiac surgery with extracorporeal circulation. A prospective, controlled, parallel, randomized and blind study was performed. Twenty-two patients coordinated for cardiac surgery with extracorporeal circulation for myocardic revascularization and/or valvular replacement were included. The patients were randomized in two groups. The first group received a single dose of 0,6 mg/kg i/v of atracurium at the induction of anaesthesia. The second group received in a dose of 0,6 mg/kg i/v of atracurium at the induction of anaesthesia, followed by a perfusion of 0,4 mg/kg/h until the sternum was closed. The neuromuscular relaxation was monitored from the induction of anaesthesia, and then every 15 minutes until the neuromuscular blockade reversion was achieved (T4/T1 > 0,9). The neuromuscular recuperation time was longer in the group of patients subject to the infusion protocol (90 vs 310 minutes, p: < 0.05%). All patients subject to atracurium continuous perfusion presented neuromuscular residual blockade at the end of surgery. In the other group no neuromuscular residual blockade was observed. Atracurium used in bolus at the beginning of the surgery is an effective and safe option in these patients. It is necessary to reconsider the use of neuromuscular relaxants in continuous perfusion in this surgery

Keywords : artacurium; cardiac surgery; monitorization; neuromuscular blockade .

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