De Mey J C, De Baerdemaeker L, De Laat M, Rolly G
Department of Anaesthesia, University Hospital, Gent, Belgium.
Eur J Anaesthesiol. 1999 Jun;16(6):387-9. doi: 10.1046/j.1365-2346.1999.00503.x.
After an intubating dose of rocuronium satisfactory intubating conditions are achieved before the onset time at the adductor pollicis. We examined the possibility that measurement of the relaxation of the masseter muscle is a more appropriate guide when determining the intubating time. Simultaneous accelerometry with a 0.1-Hz single twitch stimulation of the chin and thumb was performed in 20 patients after 0.6 mg kg-1 rocuronium. We observed a significantly more brief mean lag time and onset time at the masseter muscle (22.5 and 61 vs. 32.5 and 160 s). The corresponding mean relaxation at the onset time was also significantly more pronounced at the masseter muscle (99.6 vs. 97.6%). A mean onset time at the masseter muscle of 61 s as produced by rocuronium corresponds clinically with excellent or good intubating conditions. From these results, we suggest that measurement of the onset time of muscle relaxation at the masseter muscle appears to be a better predictor of good intubating conditions than measurements made using the adductor pollicis muscle after administration of rocuronium.
给予罗库溴铵插管剂量后，在拇内收肌起效时间之前即可获得满意的插管条件。我们研究了在确定插管时间时，测量咬肌松弛情况是否是一个更合适的指标。在20例患者给予0.6mg/kg罗库溴铵后，采用0.1Hz单刺激同时对下巴和拇指进行加速度测量。我们观察到咬肌的平均滞后时间和起效时间明显更短（分别为22.5秒和61秒，而拇内收肌为32.5秒和160秒）。咬肌在起效时相应的平均松弛程度也明显更显著（99.6%对97.6%）。罗库溴铵产生的咬肌平均起效时间为61秒，临床上对应着良好或优秀的插管条件。从这些结果来看，我们认为在给予罗库溴铵后，测量咬肌肌肉松弛的起效时间似乎比测量拇内收肌更能准确预测良好的插管条件。
