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顺式阿曲库铵肌松效应的临床观察

The Clinical Neuromuscular Pharmacology of Cisatracurium in Patients under3Nitrous Oxicde/Opioid/Propofol Anesthesia

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【作者】 黄文起莫利求窦云凌陈秉学

【Author】 Huang Wenqi, Mo Liqiu, Dou Yunling, et al Department of Anesthesiology, First Affliated Hospital of SUMS, Guang zhou

【机构】 广州市中山医科大学附一医院麻醉科

【摘要】 目的:观察顺式阿曲库铵的肌松效应,并与阿曲库铵相比,以了解该药在国人的作用特点。方法:ASAⅠ~Ⅱ级择期手术病人30例,随机分为三组,每组10例,分别予顺式阿曲库铵01mg/kg(Cis1组),015mg/kg(Cis2组)和阿曲库铵05mg/kg(Atr组),诱导麻醉,观察心率、血压和全身皮肤情况以及TOF的变化。结果:顺式阿曲库铵01mg/kg、015mg/kg与阿曲库铵05mg/kg均未引起心率、血压明显变化与皮肤潮红。肌松起效时间分别为56±09、40±08和25±06,差别具有显著性(P<001);临床作用时间分别为40±25、456±92和384±45;25%~75%的恢复指数分别为108±11、126±29和98±30,无统计学差异。结论:顺式阿曲库铵肌松效应与阿曲库铵相似,均为中时效。同等强度剂量相比,前者起效较慢。但增加剂量可使其起效加快。两者肌松恢复过程相似,无蓄积作用。

【Abstract】 Objectives:Cisatracurium is one of the ten isomer of atracurium. Both the preclinical and premier clinical studies have suggested that it may be relatively an ideal intermediate nondepolarizing muscle relaxant. However, repeated studies are required to find out its advantages and disadvantages, especially by comparing with atracurium. The purpose of the present study is to evaluate its neuromuscular blocking effects by comparing with atracurium. Methods: 30ASA patients undergoing selective surgery under nitrous oxide/opioid/propofol anesthesia were randomly allocated into three groups: Cis1(n=10)Cis2(n=10) and Atr(n=10). Cisatracurium 01mg/kg(2ED95)015mg/kg(3ED95) or atracurium 05mg/kg(2ED95) was given respectively. HR BP skin flushing and TrainofFour(TOF) reponse of the adductor pollicis muscle following supramaximal electrical stimulation of the ulnar nerve were monitored until T4T107. Results: No significant changes of HRBPwere found in three groups. Onset time of Cis1Cis2 and Atr were5609scular block4008and 2506, clinical duration were 4002545692 and 38445, respectively. 25%75% recovery index was 1081112620and 9830respectively. Conclusion: At equipotent dose, the onset time of cisatracurium is slower than that of atracurium but lager dose can reduce the difference. They have a similar recovery profile and show no accumulation.

【关键词】 顺式阿曲库铵阿曲库铵肌松
【Key words】 CisatracuriumAtracuriumNeuromu
  • 【文献出处】 临床麻醉学杂志 ,THE JOURNAL OF CLINICAL ANESTHESILOLGY , 编辑部邮箱 ,1999年03期
  • 【分类号】R971.2,R614.22
  • 【被引频次】35
  • 【下载频次】286
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