Measurement of Hemodynamic Changes Caused by Administration of Atracurium Besylate after Pretreatment with Anti-histamine Agent.

Choi,  Young Kyoo; Lim,  Tae Wan; Kim,  Dae Eon; Lee,  Dong Hyun; Park,  Sung Wook; Kim,  Keon Sik; Kang,  Wha Ja; Lee,  Doo Ik

doi:2007.52.6.642

Original Article

Korean Journal of Anesthesiology 2007;52(6):642-648.
DOI: https://doi.org/10.4097/kjae.2007.52.6.642

Measurement of Hemodynamic Changes Caused by Administration of Atracurium Besylate after Pretreatment with Anti-histamine Agent.

Young Kyoo Choi, Tae Wan Lim, Dae Eon Kim, Dong Hyun Lee, Sung Wook Park, Keon Sik Kim, Wha Ja Kang, Doo Ik Lee

Department of Anesthesiology and Pain Medicine, College of Medicine, Kyunghee University, Seoul, Korea. cykyko@unitel.co.kr

Abstract

BACKGROUND
Hemodynamic changes through the histamine-induced release of atracurium are relatively common, but can be particularly dangerous in hemodynamically unstable patients. This study evaluated the effectiveness of a pretreatment with an anti-histamine agent before the administration of atracurium in the prevention of histamine-induced hemodynamic changes. METHODS: Forty-eight ASA class I and II patients were assigned to four groups. Groups 1 and 2 were assigned to receive atracurium through a bolus 0.5 mg/kg. Groups 3 and 4 were assigned to receive atracurium through a bolus 1.0 mg/kg. Group 1 and 3 were pretreated with pheniramine (H1-blocker) and ranitidine (H2-blocker) intravenously before the induction of general anesthesia. After induction, HemosonicTM 100 was installed and the following hemodynamic parameters were measured: systemic vascular resistance (SVR), cardiac index (CI), heart rate (HR) and blood pressure (BP) immediately before, 1, 2, 3, 5 and 10 min after the rapid administration of the atracurium bolus before the skin incision. RESULTS: Groups 1 and 3 showed more stable hemodynamics than groups 2 and 4. Group 2 showed more significant changes in the SVR, CI, BP, HR than group 1 (P< 0.05). Group 4 showed more significant changes in the SVR, CI, BP, HR than group 3, and some cases were significant hemodynamically (P< 0.05). Group 4 showed more significant changes in the SVR, CI, BP, HR than group 2 (P <0.05). CONCLUSIONS: Pretreatment with an anti-histamine drug prior to the administration of atracurium can be effective in attenuating the hemodynamic responses.

Key Words: atracurium; histamine; pheniramine; ranitidine