Canadian Journal of Anaesthesia

, Volume 45, Issue 6, pp 515–520 | Cite as

Pharmacokinetics of doxacurium during normothermic and hypothermic cardiopulmonary bypass surgery

  • Buvanendran Asokumar
  • Davy Cheng
  • Frances Chung
  • Charles Peniston
  • Alan Sandler
  • France Varin
Reports of Investigation



To compare the pharmacokinetic behaviour of doxacurium in patients undergoing normothermic or hypothermic cardiopulmonary bypass (CPB) for coronary artery bypass graft surgery.


Twenty patients in two equal groups were studied. Anaesthesia was induced with sufentanil and midazolam after a standard premedication. Doxacurium was administered at 3 × ED95 (80μ·kg−1), and anaesthesia was maintained with 0.5 μg·kg−1 hr−1 sufentanil, 0.05 mg·kg−1 midazolam and isoflurane 0.5–1%. Systemic temperature for patients in the normothermic and hypothermic groups was maintained at 33–36C and 26–30C respectively. Timed blood and urine samples were collected and pharmacokinetic parameters were estimated using a non-compartmental approach.


For the normothermic and hypothermie groups, terminal elimination half-life (t1/2B) was 100.1 ± 28 and 183.8 ± 60 min (P < 0.05) respectively, elimination half-life during the CPB phase (T1/2 CPB) 114.5 ± 10 and 183.8 ± 60 min (P < 0.05), mean residence time 108.8 ± 25 and 164.8 ± 34 min (P < 0.05) and apparent volume of distribution at steady state 0.20 ± 0.03 and 0.26 ± 0.04 L·kg−1 (P < 0.05). Compared with the hypothermie group, the normothermic group had a higher rate of renal clearance (1.40 ± 0.4 vs 0.93 ± 0.3 ml·min−1·kg−1;P < 0.05) and a higher value for renal clearance as a percentage of the total clearance (76.2 ± 10 vs 58.3 ± 20%).


The elimination rate of doxacurium during normothermic CPB is faster than that in hypothermic CPB.


Renal Clearance Sufentanil Mean Residence Time Doxacurium Hypothermic Group 
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Comparer le comportement pharmacocinétique du doxacurium chez des patients subissant une CEC normothermique ou une CEC hypothermique lors d’une chirurgie pour un pontage coronaire.


Vingt patients répartis en deux groupes égaux ont été étudiés. Lanesthésie a été induite avec du sufentanil et du midazolam après une prémédication standard. Le doxacurium a été administré à raison de 3 × ED95 (80 μg·kg−1). et l’anesthésie a été maintenue avec 0,5 μg·kg−1hr−1 de sufentanil, 0,05 mg·kg−1 de midazolam et de l’isoflurane 0,5 – 1 %. La température systémique pour les patients des groupes normothermique et hypothermique a été maintenue à 33–36 °C et 26–30 °C respectivement. Les échantillons de sang et d’urine ont été prélevés à des moments déterminés et les paramètres pharmacocinétiques ont été estimés selon une approche non compartimentale.


Pour les groupes normothermique et hypothermique, la demi-vie d’élimination finale (t1/2ß) était de 100,1 ± 28 et de 183,8 ± 60 min (P < 0,05) respectivement, la demi-vie d’élimination durant la phase de CEC (T1/2 CEC) était de 114,5 ± 10 et de 183,8 ± 60 min (P < 0,05), la durée de séjour moléculaire moyenne (MRT) était de 108,8 ± 25 et de 164,8 ± 34 min (P < 0,05) et le volume de distribution à l’état d’équilibre était de 0,20 ± 0,03 et de 0,26 ± 0,04 L·kg−1 (P < 0,05). Comparé au groupe hypothermique, le groupe normothermique avait une clairance rénale à un taux plus élevé (1,40 ± 0,4 vs 0,93 ± 0,3 ml·min−1·kg−1,P < 0,05) et une valeur de clairance rénale plus grande en proportion de la dairance totale (76,2 ± 10 vs 58,3 ± 20 %).


Le taux d’élimination du doxacurium pendant la CEC nonmothermique est plus élevé que pendant la CEC hypothermique.


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Copyright information

© Canadian Anesthesiologists 1998

Authors and Affiliations

  • Buvanendran Asokumar
    • 3
  • Davy Cheng
    • 4
  • Frances Chung
  • Charles Peniston
    • 1
  • Alan Sandler
  • France Varin
    • 2
  1. 1.Department of Anaesthesia and Division of Cardiovascular SurgeryThe Toronto Hospital, University of TorontoCanada
  2. 2.Faculty of PharmacyUniversity of MontrealCanada
  3. 3.Department of AnesthesiologyRush-Presbyterian-St.Luke’s Medical Center, Rush UniversityChicagoUSA
  4. 4.Department of AnaesthesiaThe Toronto Hospital BW 4-646TorontoCanada

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