Comparison between haemodynamic changes during induction with different muscle relaxants in patients of mitral stenosis undergoing mitral valve replacement

Abstract

Aim and Objectives: Aim of the present study was to evaluate different haemodynamic changes between the muscle relaxants (vecuronium and atracurium) and to compare them for their better haemodynamic stability in patients of mitral stenosis undergoing mitral valve replacement. Methods: The study enrolling 60 patients of either sex, age between 18-60 years belonging to ASA Grade I, II and III was undergoing elective mitral valve replacement who were randomly assigned into two groups of 30 patients each. Group V received 0.16 mg/kg vecuronium and group A received 0.75 mg/kg atracurium as muscle relaxants at the time of induction with thiopentone (5 mg/kg). Haemodynamic parameters monitored for comparison include HR, SBP, DBP, MAP, CVP, SPO2 and ETO2. Result: There was significant increase in HR after administration of atracurium when compared to vecuronium. In both the groups, there was fall in blood pressure but fall was more with atracurium than vecuronium. We found no change in SPO2 after induction in both the groups. There was fall in CVP and ETCO2 from baseline but difference was not statistically significant. Conclusion: Vecuronium is better neuromuscular relaxant for haemodynamic stability than atracurium in higher doses in patients of mitral stenosis undergoing mitral valve replacement.