Naguib M, Riad W
Department of Anesthesia at the University of Iowa College of Medicine, Iowa City 52242-1009, USA.
Can J Anaesth. 2000 Nov;47(11):1074-81. doi: 10.1007/BF03027958.
To study the dose-response relationships for neostigmine and edrophonium during antagonism of neuromuscular block induced by atracurium and cisatracurium.
One hundred and twenty eight, ASA group 1 or 2 adults were given either 0.5 mg x kg(-1) atracurium or 0.1 mg x kg(-1) cisatracurium during fentanyl-thiopental-nitrous oxide-isoflurane anesthesia. The neuromuscular block was measured by an acceleration-responsive transducer. Responses were defined in terms of percent depression in the first twitch (T1) and train-of-four (TOF) response. When spontaneous recovery of first twitch height reached 10% of its initial control value, edrophonium (0.1, 0.2, 0.4, or 1 mg x kg(-1)) or neostigmine (0.005, 0.01, 0.02, or 0.05 mg x kg(-1)) was administered by random allocation. Neuromuscular function in another sixteen subjects was allowed to recover spontaneously.
At five minutes, unlike edrophonium, neostigmine was equally effective against atracurium and cisatracurium with respect to T1 recovery. The neostigmine T1-ED50 was 10.3 +/- 1.06 (SEM) microg x kg(-1) after atracurium and 11.2 +/- 1.06) microg x kg(-1) after cisatracurium. The edrophonium ED50 was 157 +/- 1.07 microg x kg(-1) with atracurium and 47.4 +/- 1.07 microg x kg(-1) with cisatracurium, giving a neostigmine:edrophonium potency ratios of 15.2 +/- 1.7 and 4.2 +/- 0.41 (P < 0.001) for atracurium and cisatracurium, respectively. At 10 min neostigmine was 13 +/- 1.4 times as potent as edrophonium for achieving 50% TOF recovery after atracurium paralysis. After cisatracurium the potency ratio was 11.8 +/- 1.3 (NS).
Although there were differences at five minutes, neostigmine:edrophonium potency ratios at 10 min, were similar in both relaxants studied.
研究新斯的明和依酚氯铵在拮抗阿曲库铵和顺式阿曲库铵诱导的神经肌肉阻滞过程中的剂量 - 反应关系。
128例美国麻醉医师协会（ASA）1或2级的成年患者，在芬太尼 - 硫喷妥钠 - 氧化亚氮 - 异氟烷麻醉期间，给予0.5mg·kg⁻¹阿曲库铵或0.1mg·kg⁻¹顺式阿曲库铵。通过加速度响应换能器测量神经肌肉阻滞。反应根据第一个肌颤搐（T1）和四个成串刺激（TOF）反应的抑制百分比来定义。当第一个肌颤搐高度自发恢复到其初始对照值的10%时，随机给予依酚氯铵（0.1、0.2、0.4或1mg·kg⁻¹）或新斯的明（0.005、0.01、0.02或0.05mg·kg⁻¹）。另外16名受试者的神经肌肉功能让其自发恢复。
5分钟时，与依酚氯铵不同，新斯的明在T1恢复方面对阿曲库铵和顺式阿曲库铵的效果相同。阿曲库铵后新斯的明的T1 - ED50为10.3±1.06（SEM）μg·kg⁻¹，顺式阿曲库铵后为11.2±1.06μg·kg⁻¹。依酚氯铵的ED50在阿曲库铵时为157±1.07μg·kg⁻¹，顺式阿曲库铵时为47.4±1.07μg·kg⁻¹，阿曲库铵和顺式阿曲库铵的新斯的明：依酚氯铵效价比分别为15.2±1.7和4.2±0.41（P<0.001）。10分钟时，新斯的明在阿曲库铵麻痹后实现50%TOF恢复的效力是依酚氯铵的13±1.4倍。顺式阿曲库铵后效价比为11.8±1.3（无显著性差异）。
虽然5分钟时有差异，但在研究的两种肌松药中，10分钟时新斯的明：依酚氯铵效价比相似。
