Cerebral and cardiovascular haemodynamics with vecuronium as an intubating agent in neurosurgical patients

The effects of vecuronium and pancuronium, administered for muscle relaxation prior to endotracheal intubation, on intracranial pressure and systemic haemodynamics were compared in 20 patients undergoing supratentorial surgery. The patients were randomly divided into two groups of 10 patients each depending upon the muscle relaxant used. Patients in group I received pancuronium (0.15 mg kg-1) following thiopentone induction while patients in group II were given vecuronium (0.15 mg kg-1) for intubation. Intracranial pressure, heart rate, mean systolic and diastolic blood pressures, central venous pressure, nasopharyngeal temperature and arterial blood gases were monitored at 3 minutes before induction, 1 and 3 minutes after thiopentone and relaxant intubation and 4, 6, 8 and 10 minutes after intubation. Induction of anaesthesia resulted in a small but significant fall in intracranial pressure in both the groups at 1 and 3 minutes (p < 0.05). The rise in intracranial pressure at intubation was significantly higher in group I patients (26.4 ñ 3.2 mm Hg) compared to group II patients (14 ñ 2.8 mm Hg). A significantly greater degree of rise in heart rate, and systolic and mean arterial pressure was observed in group I patients as compared to group II patients.