Hemodynamic effects of sufentanil-pancuronium-diazepam interaction during anesthetic induction for coronary bypass surgery
Okamoto, K.; Komatsu, T.; Shibutani, K.
Masui. Japanese Journal of Anesthesiology 36(5): 713-718
1987
ISSN/ISBN: 0021-4892 PMID: 2958646 Document Number: 303456
We examined the hemodynamic effects of sufentanil-pancuronium diazepam intoxication during anesthetic induction. Seven patients undergoing coronary bypass surgery were studied under strict control of fluid administration. Following concomitant use of sufentanil (10 .mu.g kg) and pancuronium (0.1 mg kg), small incremental doses of diazepam (0.025 mg kg) were administered up to a total of 0.1 mg kg. Hemodynamic measurements were made prior to induction, following administration of sufentanil plus pancuronium, and after 0.025 mg/kg, 0.05 mg/kg. 0.075 mg/kg and 0.1 mg/kg of diazepam, respectively. The combination of sufentanil and pancuronium decreased systemic vascular resistance, resulting in mild decreases in systolic and mean arterial blood pressure. Addition of diazepam decreased cardiac index, stroke volume index and left ventricular work index due to a decrease in preload and presumably a direct myocardial depression. Out of seven patients studied, one patient had severe hypotension after 0.05 mg/kg diazepam i.v. Since diazepam produced significant hemodynamic changes when combined with sufentanil, diazepam should be used with caution.