Taivainen T, Meakin G H, Meretoja O A, Wirtavuori K, Perkins R J, Murphy A K, Fisher G R, Waiter M R
Department of Anaesthesia & Intensive Care Medicine, Helsinki University Hospital, PL281, FIN-00029 HUS, Finland.
Anaesthesia. 2000 Nov;55(11):1047-51. doi: 10.1046/j.1365-2044.2000.01623.x.
We studied the neuromuscular and cardiovascular effects of a single, rapidly administered intravenous dose of cisatracurium 0.15 mg.kg(-1) in 27 infants (aged 1-23 months) and 24 children (aged 2-12.5 years). After midazolam premedication, anaesthesia was induced and maintained with thiopental and alfentanil in addition to nitrous oxide in oxygen. Neuromuscular function was monitored by evoked adductor pollicis electromyography. At least 15 min after intubation, each patient received cisatracurium 0.15 mg.kg(-1) over 5 s. Complete neuromuscular blockade was produced by this dose in all but one infant. The mean (SD) onset time of maximal blockade was more rapid in infants [2.0 (0.8) min] than in children [3.0 (1.2) min], p = 0. 0011. The clinical duration of action of cisatracurium (recovery of evoked response to 25% of control) was significantly longer in infants [43.3 (6.2) min] than in children [36.0 (5.4) min], p < 0.0001. Once neuromuscular function started to recover, the rate of recovery was similar in both age groups. Changes in blood pressure and heart rate after the administration of cisatracurium were negligible in both age groups. Cisatracurium, at a dose of 0.15 mg. kg(-1), was effective and well tolerated in infants and children.
我们研究了在27名婴儿（年龄1至23个月）和24名儿童（年龄2至12.5岁）中单次快速静脉注射0.15mg·kg⁻¹顺式阿曲库铵的神经肌肉和心血管效应。在咪达唑仑预处理后，除了氧气中的氧化亚氮外，用硫喷妥钠和阿芬太尼诱导并维持麻醉。通过诱发的拇内收肌肌电图监测神经肌肉功能。插管后至少15分钟，每位患者在5秒内接受0.15mg·kg⁻¹顺式阿曲库铵。除一名婴儿外，该剂量在所有患者中均产生了完全的神经肌肉阻滞。最大阻滞的平均（标准差）起效时间在婴儿中[2.0（0.8）分钟]比在儿童中[3.0（1.2）分钟]更快，p = 0.0011。顺式阿曲库铵的临床作用持续时间（诱发反应恢复至对照的25%）在婴儿中[43.3（6.2）分钟]比在儿童中[36.0（5.4）分钟]显著更长，p < 0.0001。一旦神经肌肉功能开始恢复，两个年龄组的恢复速率相似。两个年龄组在给予顺式阿曲库铵后血压和心率的变化均可忽略不计。0.15mg·kg⁻¹剂量的顺式阿曲库铵在婴儿和儿童中有效且耐受性良好。
