Kim J H, Min K T, Ahn E K, Kim K H, Shin Y S
Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 1999 Aug;40(4):371-6. doi: 10.3349/ymj.1999.40.4.371.
Mivacurium is mainly metabolized by plasma cholinesterase, whereas atracurium is removed by Hofman elimination. The purpose of this study was to compare the infusion rate of atracurium and mivacurium in maintaining surgical relaxation, and to compare their recovery indices between parturients and non-pregnant women. Muscle relaxation was maintained by the continuous infusion of relaxants to retain the first response of train-of-four (TOF) at 5% of control. When mivacurium was used, Bolus-T5 (duration from the end of mivacurium bolus injection to 5% single twitch recovery) was measured. After discontinuing the infusion, the recovery index was measured. The infusion rate of mivacurium, not atracurium, was significantly lower in parturients and Bolus-T5 of parturients was significantly longer than that of non-pregnant women. There was no significant difference in the recovery indices of both relaxants. The authors concluded that the infusion rate of mivacurium in maintaining muscle relaxation in parturients should be reduced compared to the rate in non-pregnant women and measuring Bolus-T5 may be helpful in determining the infusion rate to maintain muscle relaxation.
米库氯铵主要通过血浆胆碱酯酶代谢，而阿曲库铵则通过霍夫曼消除作用被清除。本研究的目的是比较阿曲库铵和米库氯铵维持手术松弛状态时的输注速率，并比较产妇和非孕女性之间它们的恢复指标。通过持续输注肌松药来维持肌肉松弛，使四个成串刺激（TOF）的第一个反应保持在对照值的5%。使用米库氯铵时，测量推注后T5（从米库氯铵推注结束至单刺激恢复5%的持续时间）。停止输注后，测量恢复指标。产妇中米库氯铵而非阿曲库铵的输注速率显著更低，且产妇的推注后T5显著长于非孕女性。两种肌松药的恢复指标无显著差异。作者得出结论，与非孕女性相比，产妇维持肌肉松弛时米库氯铵的输注速率应降低，测量推注后T5可能有助于确定维持肌肉松弛的输注速率。
