A comparison of the effects of suxamethonium, atracurium and vecuronium on intracranial haemodynamics in swine

J. P. Ducey, S. A. Deppe, Kevin Foley

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Sixteen Yorkshire swine weighing 15-20 kg were studied to compare the effects of suxamethonium, atracurium, and vecuronium on intracranial pressure (ICP), heart rate (HR), arterial blood pressure (BP), and cerebral perfusion pressure (CPP) in swine with normal or elevated ICP. In each animal an intracranial pressure-volume curve was produced by the inflation of an epidural balloon. The baseline ICP (P0), the ICP at the inflection point (P(i)) and on the steep portion (P(max)) of the pressure-volume curve were identified and the balloon volumes recorded. The animals were assigned to receive either sexamethonium 1.0 mg/kg, atracurium 0.6 mg/kg, vecuronium 0.2 mg/kg, or saline placebo intravenously at three conditions: First, with the epidural balloon deflated P0, next at P(i), then at P(max). Neither atracurium, vecuronium, nor placebo produced any statistically significant effect on HR, BP, ICP, or CPP at any baseline level of ICP. Suxamethonium produced an early fall in ICP (0.8 ± 0.3, 2.6 ± 1.0 and 3.5 ± 1.3 mmHg at P0, P(i) and P(max) respectively: P = .0005) followed by a rapid rise above the pre-infusion level (1.8 ± 0.6, 2.8 ± 0.6 mmHg, and 2.2 ± 0.5 mmHg at P0, P(i) and P(max) respectively: P = .0005). A fall in BP coupled with the rise in ICP resulted in a fall in CPP (5.8 ± 2.3, 6.1 ± 1.2, and 6.3 ± 1.8 mmHg at P0, P(i) and P(max) respectively: P = .0005). Although the fall in CPP was not large, in the presence of elevated ICP, where CPP already is marginal, such a decrease may compromise cerebral blood flow. Atracurium and vecuronium had no effect on ICP or haemodynamics, even in the presence of an elevated ICP. These agents may be preferred in settings of suboptimal CPP or in the presence of pre-existing intracranial hypertension.

Original languageEnglish (US)
Pages (from-to)448-455
Number of pages8
JournalAnaesthesia and Intensive Care
Volume17
Issue number4
StatePublished - Jan 1 1989
Externally publishedYes

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Atracurium
Cerebrovascular Circulation
Vecuronium Bromide
Succinylcholine
Intracranial Pressure
Swine
Hemodynamics
Intracranial Hypertension
Heart Rate
Placebos
Blood Pressure
Economic Inflation
Arterial Pressure
Pressure

All Science Journal Classification (ASJC) codes

  • Medicine(all)
  • Critical Care and Intensive Care Medicine
  • Anesthesiology and Pain Medicine

Cite this

A comparison of the effects of suxamethonium, atracurium and vecuronium on intracranial haemodynamics in swine. / Ducey, J. P.; Deppe, S. A.; Foley, Kevin.

In: Anaesthesia and Intensive Care, Vol. 17, No. 4, 01.01.1989, p. 448-455.

Research output: Contribution to journalArticle

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