A PRELIMINARY STUDY OF THE EFFECT OF ANESTHETIC AGENTS ON THE RHEOLOGICAL PARAMETERS OF GLYCATED ERYTHROCYTES

This paper presents a preliminary study of the effects of the anesthetics propofol, remifentanil, and vecuronium bromide on the rheological properties of glycated erythrocytes in vitro, modeling the glycation by hyperglycemia observed in diabetes. Viscoelastic and aggregation kinetic parameters of erythrocytes were determined using an erythrocyte rheometer and an optical chip aggregometer developed in our laboratory. The results showed significant alterations in the membrane surface viscosity, the elastic modulus, and the erythrocyte deformability index for the different anesthetics studied. Also, the kinetics aggregation parameters showed different types of alterations due to the effect of anesthetics. This preliminary study suggests that the use of these anesthetics in diabetic patients could induce hemorheological alterations that disturb the microcirculation. For this reason, it is recommended to deepen these investigations to prevent complications in surgical procedures.

COMPARISON OF HEMODYNAMIC AND NEUROMUSCULAR PROPERTIES OF ROCURONIUM VERSUS VECURONIUM IN ANESTHESIA

Background: Adequate maintenance of airways in patients undergoing surgeries under general anesthesia was through proper intubation. This was achieved by the extensive usage of neuromuscular blocking drugs, which provided good intubation conditions and relaxation of the muscles. Neuromuscular blockers play a key role in general anesthesia. Rocuronium and vecuronium are used as nondepolarizing muscle relaxants. Objective: To study the neuromuscular properties and cardiovascular effects of rocuronium bromide, the “near-ideal” muscle relaxant and to compare it with vecuronium bromide, an already established drug, during anesthesia. Materials and Methods: This prospective, randomized double-blinded clinical study included 50 patients, 25 patients received 0.6 mg/kg of rocuronium bromide for the maintenance of anesthesia and the other 25 patients received 0.1 mg/kg of vecuronium bromide. The top-up doses administered were 0.15 mg/kg of rocuronium and 0.025 mg/kg of vecuronium. Result: The onset time was significantly shorter in the rocuronium group (Mean ± standard deviation [SD] was 108.8 s ± 28.875 s) compared with vecuronium group (Mean ± SD 188.76 s± 43.78 s). The duration of action of first dose was significantly longer in rocuronium group (31.5 min) compared with vecuronium group (24.5 min).The duration of action of top-up doses was similar in both the groups (p>0.05). There was no significant difference in any of the haemodynamic variables between the two groups. Conclusion: The duration of action of top-up doses was similar in both the groups (p > 0.05). There was no significant difference in any of the hemodynamic variables (heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure) between the two groups.

COMPARATIVE STUDY OF HEMODYNAMIC EFFECTS OF ROCURONIUM AND VECURONIUM DURING INDUCTION OF ANESTHESIAAND TRACHEAL INTUBATION IN PATIENTS UNDERGOING CARDIAC SURGERY

Background: Muscle relaxants are used to provide surgical relaxation and to facilitate endotracheal intubation. Vecuronium and rocuronium decrease the heart rate and should be preferred in patient with faster baseline heart rate. Aim: To assess and compare the hemodynamic effects of Rocuronium Bromide and Vecuronium Bromide during induction of anaesthesia and endotracheal intubation in patients undergoing cardiac surgery Material & Method: Fifty patients of either sex above the age of fourteen years of ASA physical status I, II or III scheduled for elective cardiac surgery were enrolled. The patients were divided into two equal groups of 25 each - Group "V" Vecuronium bromide (0.1 mg. /kg.) and Group "R" Rocuronium bromide (0.9 mg./kg). Hemodynamic parameters were specically recorded at various time intervals basal, after Thiopentone sodium, after relaxant during intubation and 2, 5 and 10 minutes post intubation period. Results:In Group V, the mean heart rate had a signicant rise 2-minute post intubation. Mean SAPcontinued to fall after diazepam administration but the fall became statistically signicant 5 & 10 minutes post intubation, similar to mean DAP pressure and MAP, but the fall became statistically signicant only at 5 & 10 minutes post intubation. While, in Group R the mean heart rate showed minimal change from the base line recording and the value remained statistically insignicant at all intervals. Mean SAP showed a sudden fall after Thiopentone administration (statistically signicant). The rest of the readings were insignicant statistically. Conclusion:Rocuronium was found to be more hemodynamically stable than Vecuronium.