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KMID : 0356920070520060642
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Korean Journal of Anesthesiology
2007 Volume.52 No. 6 p.642 ~ p.648
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TMeasurement of Hemodynamic Changes Caused by Administration of Atracurium Besylate after Pretreatment with Anti-histamine Agent
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Choi Young-Kyu
Lim Tae-Wan
Kim Dae-Eon
Lee Dong-Hyun
Park Sung-Wook
Kim Keon-Sik
Kang Hwa-Ja
Lee Doo-Ik
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Abstract
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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. (Korean J Anesthesiol 2007; 52: 642∼8)
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KEYWORD
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atracurium, histamine, pheniramine, ranitidine
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