Hing dose fentanly-pancuroniuim is being used for open heart surgery anaesthesia in Prof. Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center. Pancuronium is selected as a muscular relaxing agent to prevent the bradycardic effect of high dose fentanly caused by vagal mechanism. In this study we compared atracurium,which is an intermedia-acting agent without any with pancuronium regarding postoperative intubation time and heamodynamic effects Pentanly-pancuronium was used in 12 of 24 patients (Grup-I) with coronary artery and valvular disease and fentanly-patracurium for remaining 12 patients (Group-II). Fentanyl (30-50 mg/kg)+pancuranium (0.1mg /kg) were given in group I and fentanly+atracurium 0.5mg/kg in grup II for for induction of anaesthesia. To provide anaesthesia maintanence,half dose pancuronium was given intermittantly and atracurium (0.5mg/kg/h) by infusion. Haemodynamic parameters:mean arterial pressure (MAP), heart rate (HR),mean pulmonary artery pressure (MPAP),pulmonary capillary wedge pressure (PCWP), central venous pressure (CVP), cardiac index (CI), systemic and pulmonary vascular resistance (SVR;PVR) were recorded before and after the induction of anaesthesia and after cardiopulmonary bypass. We also noted intubation duration in the postoperative period. Haemodynamic parameters showed no significant difference in extubation time (P<0.001).

We conclude that, use of atracurium infusion with high dose fentanly is a safe and alternative way to provide haemodynamic stability and has the advantage of earlier extubation in open heart surgery.