Comparison of Rocuronium and Vecuronium in Patients Undergoing Elective Ultrafast-Track Off-Pump Coronary Artery Bypass Surgery

Abstract

Abstract Background Neuromuscular blocking drugs are necessary in cardiac surgery to facilitate smooth intubation and ventilation conditions, avoid patient movement, reduce oxygen consumption, and prevent shivering. Hemodynamic stability is very essential in cardiac surgery because the coronary reserve is below normal in such patients. Aims This study was conducted with the objective of comparing rocuronium, the “near-ideal” muscle relaxant with vecuronium, an already established neuromuscular blocking agent in patients undergoing elective ultrafast-track off-pump coronary artery bypass surgery (CABG). Settings and Design This prospective, randomized comparative study included 60 patients scheduled for elective off-pump CABG procedures under general anesthesia in the period between May 2015 and March 2016. Materials and Methods Patients were randomized in equal numbers to either the rocuronium group or the vecuronium group, and intubating conditions and various hemodynamic parameters were observed at different time points. Statistical Analysis Used Categorical variables were evaluated using the chi-square test, whereas the Student t-test or Mann–Whitney test were used for continuous variables. Results Pulse rate in the rocuronium group was lesser (79.97 ± 7.42) (p < 0.05) at the time of intubation as compared with the vecuronium group (92.33 ± 8.93). Systolic blood pressure was higher in the vecuronium group (150.70 ± 14.05) at the time of intubation as compared with the rocuronium group (130.27 ± 9.95) (p < 0.05). Intubating conditions, mean arterial pressure, and diastolic blood pressure changes were similar in both groups. Conclusions Rocuronium provides good-to-excellent intubating conditions and is devoid of any significant cardiovascular changes causing hemodynamic instability when compared with vecuronium in patients undergoing elective ultrafast-track off-pump CABG.