A Comparison of Systemic and Regional Hemodynamic Effects of d-Tubocurarine, Pancuronium, and Vecuronium

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Abstract
The effects of 3 neuromuscular blocking agents, in a clinically relevant dose range, were compared on the regional distribution of blood flow measured with 15-.mu.m radioactive microspheres in anesthetized, optimally ventilated cats. d-Tubocurarine (400, 800 and 1600 .mu.g .cntdot. kg-1) caused hypotension and a decrease in ascending aortic blood flow. Pancuronium (20, 40 and 80 .mu.g .cntdot. kg-1) caused a moderate tachycardia, while vecuronium (40, 80 and 160 .mu.g .cntdot. kg-1) was devoid of any systemic hemodynamic effect. Neither pancuronium nor vecuronium caused major changes in regional blood flows. d-Tubocurarine increased blood flow to the stomach but decreased that to the kidneys, liver, skin, spleen, intestine and adrenal glands. These effects of d-tubocurarine show a striking resemblance to those elicited by the infusion of histamine. Blood flow to the nerve-stimulated tibialis anterior muscle, which was about 6 times that of the unstimulated muscle, was decreased significantly by all 3 neuromuscular blockers. While d-tubocurarine produces major cardiovascular disturbances, pancuronium and, in particular, vecuronium, did not cause serious changes in systemic and regional hemodynamics in doses that are 2-4 times the ED90 [90% effective dose] for neuromuscular blocking action.