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Circulatory Changes in Patients with Coronary Artery Disease Following Thiamylal-Succinylcholine and Tracheal Intubation

ROBERT K. STOELTING, MD^*, and CHRISTINE PETERSON, RN

*Associate Professor of Anesthesiology/Pharmacology. Indiana University School of Medicine, Indianapolis, Indiana 46202. Anesthesia Research Nurse. Indiana University School of Medicine, Indianapolis, Indiana 46202.

Abstract

Circulatory responses after thiamylal (4 mg/ kg) and succinylcholine (SCh) (2 mg/kg) administration followed by direct laryngoscopy and tracheal intubation were measured in 20 patients before elective aortocoronary vein bypass graft operations. Compared with awake measurements, the mean arterial pressure (MAP) decreased 19 ± 3 torr (mean ± SE) and heart rate (HR) increased 9 ± 3 bpm 1 minute after thiamylal-SCh. MAP was increased 39 ± 4 torr and HR 20 ± 3 bpm above awake levels in response to laryngoscopy and tracheal intubation. Blood pressure and HR returned spontaneously to near awake levels without additional anesthesia within 5 minutes of anesthetic induction. Stroke volume index was decreased significantly after tracheal intuhation but cardiac index was not altered. The authors conclude that thiamylal-SCh followed by tracheal intubation is an acceptable anesthetic induction sequence for patients without evidence of left ventricular heart failure who require anesthesia for elective coronary artery revascularization.