Motamed C, Kirov K, Combes X, Dhonneur G, Duvaldestin P
Service d'Anesthésie-Réanimation Hôpital Henri-Mondor, AP-HP et Université Paris XII, Créteil, France.
Acta Anaesthesiol Scand. 2002 Feb;46(2):214-6. doi: 10.1034/j.1399-6576.2002.460217.x.
In order to investigate the effect of metoclopramide on the duration of action of mivacurium, 45 patients were randomized into three groups. Group M10 (n = 15) and M20 (n = 15) received 10 and 20 mg of metoclopramide i.v., respectively, and group S (n = 15) received saline 2 min before induction of anesthesia with fentanyl, thiopental and mivacurium. Plasma cholinesterase activity (pCHE) was measured before induction of anesthesia and 2 min after injection of metoclopramide and saline. Neuromuscular block was monitored by a force transducer using train of four nerve stimulation. Anesthesia was maintained with isoflurane and N2O. Time to recovery of a twitch height of 90% was significantly prolonged in group M10 and M20 (44 +/- 15 and 57 +/- 10 min) as compared to group S, 32 +/- 9 min, P < 0.05). A slight but significant decrease in pCHE was observed in group M20. Because of the risk of prolonged duration of action of mivacurium, neuromuscular blockade should always be monitored whenever metoclopramide is given before injection of mivacurium.
为研究甲氧氯普胺对米库氯铵作用持续时间的影响，将45例患者随机分为三组。M10组（n = 15）和M20组（n = 15）分别静脉注射10 mg和20 mg甲氧氯普胺，S组（n = 15）在使用芬太尼、硫喷妥钠和米库氯铵诱导麻醉前2分钟静脉注射生理盐水。在麻醉诱导前以及注射甲氧氯普胺和生理盐水后2分钟测定血浆胆碱酯酶活性（pCHE）。使用四个成串刺激通过力换能器监测神经肌肉阻滞。用异氟烷和N2O维持麻醉。与S组（32±9分钟）相比，M10组和M20组（44±15分钟和57±10分钟）恢复至90%颤搐高度的时间显著延长（P<0.05）。M20组观察到pCHE有轻微但显著的降低。由于米库氯铵作用持续时间延长的风险，在注射米库氯铵前给予甲氧氯普胺时，应始终监测神经肌肉阻滞情况。
