Chaudhari L S, Shetty A N, Buddhi M, Krishnan G
Department of Anaesthesia, Seth G.S. Medical College and K.E.M. Hospital, Parel, Mumbai, India.
J Postgrad Med. 1999 Jan-Mar;45(1):5-9.
This was a study to compare continuous intravenous infusion of atracurium with continuous intravenous infusion of vecuronium for intraoperative muscle relaxation in 62 ASA I / II patients. Scheduled for laparotomies and pelvic surgeries under general anaesthesia. They were randomly allocated in two groups to receive either vecuronium infusion of 50 microg/kg/hour following a bolus dose of 0.1 microg/kg, or atracurium infusion of 400 microg/kg/hour following a bolus dose of 0.5 microg/kg. The mean infusion dose of atracurium was 478 +/- 44.11 microg/kg/hour and that of vecuronium was 63.2 +/- 74 microg/kg/hour for adequate muscle relaxation. The depth of neuromuscular blockade was monitored by using peripheral nerve stimulator so that only one twitch of train of four was present, resistance to ventilation, surgical relaxation and haemodynamic changes. Vecuronium infusions produced more haemodynamic stability than atracurium infusions. Vecuronium produced lesser change in systolic blood pressure (mean change of 3. 46 +/- 3.33%) from baseline values as compared to atracurium (mean change of 5.81 +/- 3.73%) from baseline values ( p < 0.01) which was statistically significant. The difference in mean pulse rate change from baseline value in the atracurium group (4.78 +/- 2.745%) was less than that in the vecuronium group (5.99 +/- 2.67%), which was not statistically significant. Spontaneous recovery was faster with vecuronium (540.94 +/- 76.46 seconds) as compared to atracurium (596. 33 +/- 72.48 seconds). 84.4% of patients who received vecuronium fell within good to very good category of muscle relaxation as compared to 63.3% in atracurium group. There were no cost benefits when either agents were used in infusion form.
这是一项针对62例ASA I/II级患者，比较持续静脉输注阿曲库铵与持续静脉输注维库溴铵用于术中肌肉松弛效果的研究。这些患者计划在全身麻醉下进行剖腹手术和盆腔手术。他们被随机分为两组，一组在给予0.1μg/kg的负荷剂量后，接受50μg/kg/小时的维库溴铵输注；另一组在给予0.5μg/kg的负荷剂量后，接受400μg/kg/小时的阿曲库铵输注。为达到充分的肌肉松弛，阿曲库铵的平均输注剂量为478±44.11μg/kg/小时，维库溴铵的平均输注剂量为63.2±74μg/kg/小时。使用外周神经刺激器监测神经肌肉阻滞的深度，以使四个成串刺激中仅出现一次颤搐，同时监测通气阻力、手术松弛程度和血流动力学变化。维库溴铵输注比阿曲库铵输注产生更好的血流动力学稳定性。与阿曲库铵相比，维库溴铵使收缩压从基线值的平均变化（平均变化为3.46±3.33%）小于阿曲库铵从基线值的平均变化（平均变化为5.81±3.73%）（p<0.01），具有统计学意义。阿曲库铵组脉搏率从基线值的平均变化差异（4.78±2.745%）小于维库溴铵组（5.99±2.67%），但无统计学意义。维库溴铵的自主恢复（540.94±76.46秒）比阿曲库铵（596.33±72.48秒）更快。接受维库溴铵的患者中84.4%的肌肉松弛程度属于良好至非常好的类别，而阿曲库铵组为63.3%。当以输注形式使用这两种药物时，在成本效益方面没有差异。
