Uyar M, Hepaguşlar H, Uğur G, Balcioğlu T
Department of Anaesthesiology, Ege University Hospital, Izmir, Turkey.
Paediatr Anaesth. 1999;9(2):115-8. doi: 10.1046/j.1460-9592.1999.9220328.x.
We compared the time-course of action of vecuronium in 16 burned children undergoing excision and autograft surgery with that of ten unburned children. Standardized anaesthesia was induced with thiopentone 4-6 mg kg-1 and fentanyl 1 microgram.kg-1 and maintained with endtidal 1-1.5% isoflurane in N2O/O2. Neuromuscular responses were monitored by acceleromyography (TOF-Guard, Organon Teknika/Biometer) with supramaximal train-of-four (TOF) stimuli delivered every 15s. Vecuronium 0.1 mg kg-1 was administered intravenously. Onset was recorded as the time, in seconds, between the initial bolus of vecuronium and a decline in the first twitch of TOF (T1) to 5% of control. The times for the recovery of T1-25%, 50% and 75% of control, recovery index and the recovery of TOF 25% and 50% were recorded. Onset of action was found slower in burned patients (189 +/- 70 s) than in control (98 +/- 20 s) (P < 0.01). Recovery times of T1(25), T1(50), T1(75), TOF25 and TOF50 were significantly shorter in burned patients indicative of decreased sensitivity to vecuronium (P < 0.01).
我们比较了16名接受切除和自体移植手术的烧伤儿童与10名未烧伤儿童中维库溴铵的作用时程。用4 - 6mg/kg硫喷妥钠和1μg/kg芬太尼诱导标准化麻醉，并在N₂O/O₂中用1 - 1.5%的异氟烷维持呼气末麻醉。通过加速度肌电图（TOF - Guard，欧加农公司/生物测量仪）监测神经肌肉反应，每15秒给予超强四个成串刺激（TOF）。静脉注射0.1mg/kg维库溴铵。起效时间记录为从维库溴铵首次推注到TOF的第一个肌颤搐（T1）下降至对照值的5%之间的时间（秒）。记录T1恢复至对照值的25%、50%和75%的时间、恢复指数以及TOF恢复至25%和50%的时间。发现烧伤患者的起效时间（189±70秒）比对照组（98±20秒）慢（P<0.01）。烧伤患者T1(25)、T1(50)、T1(75)、TOF25和TOF50的恢复时间显著缩短，表明对维库溴铵的敏感性降低（P<0.01）。
