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Cardiovascular Effects of Meperidine-N₂O Anesthesia Before and After Pancuronium

THEODORE H. STANLEY, MD^*, and WEN-SHIN LIU, MD

*Associate Professor of Anesthesiology/Surgery, Department of Anesthesiology, The University of Utah College of Medicine, Salt Lake City, Utah 84132. Instructor in Anesthesiology, Department of Anesthesiology, The University of Utah College of Medicine, Salt Lake City, Utah 84132.

Abstract

The cardiovascular effects of 2 and 3 mg/kg of meperidine plus 60 to 67% N₂O in O₂ on cardiovascular dynamics in man were measured before and after the administration of 0.08 mg/kg of IV pancuronium. N₂O and 2 mg/kg of meperidine did not change heart rate (HR) but produced a marked reduction (–49%) in cardiac output (_T) plus significant decreases in stroke volume (SV) and blood pressure (BP) and an increase in peripheral arterial resistance (PVR). Additional meperidine did not further alter any of the variables; however, surgical stimulation caused significant increases in HR, BP, and PVR. SV and _T were not significantly changed by surgical stimulation and were still markedly depressed when compared to control values. Pancuronium produced marked increases in HR, SV, _T, and BP and a reduction in PVR. These changes were maximal 4 to 8 minutes after pancuronium and returned toward pre-pancuronium values thereafter. These data demonstrate that N₂O-meperidine anesthesia results in a moderate reduction in BP but a marked depression in _T. The findings also indicate that pancuronium reverses the cardiovascular depression produced by N₂O-meperi-dine and is therefore, a desirable muscle relaxant when the above technic is employed.

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999