Koyama K, Ishizuka I, Miyao H, Kawasaki J, Kawazoe T
Department of Anesthesiology, Saitama Medical School, Kawagoe.
Masui. 1992 Oct;41(10):1585-9.
The intubating conditions using the timing principle combined with small priming doses of vecuronium were evaluated in forty patients who underwent elective surgery. They were randomly assigned to one of two groups: 1) timing, 2) timing with priming. In timing group, vecuronium 0.15 mg.kg-1 was administered, and at the onset of clinical muscle weakness, thiopental 4-5 mg.kg-1 was given promptly. Sixty seconds after thiopental, patients were intubated. In the timing with priming group, vecuronium 0.005 mg.kg-1 was administered as priming doses. Four minutes later vecuronium 0.15 mg.kg-1 was given. The administration of thiopental and the intubation were done in the same way as in timing group. The time to onset of clinical weakness after the administration of vecuronium 0.15 mg.kg-1 was significantly shorter in the timing with priming group than that in the timing group (46.1 +/- 4.8 vs. 57.6 +/- 7.8, P < 0.01). There were no significant differences in intubating score, T1, TR, onset time, and duration between the two groups. We conclude that the timing principle combined with small priming doses of vecuronium might be safe and useful for rapid tracheal intubation.
在40例接受择期手术的患者中，评估了采用定时原则联合小剂量预注维库溴铵时的插管条件。他们被随机分为两组之一：1）定时组，2）预注定时组。在定时组中，给予维库溴铵0.15mg/kg，在临床肌无力开始时，立即给予硫喷妥钠4-5mg/kg。硫喷妥钠给药60秒后，对患者进行插管。在预注定时组中，给予维库溴铵0.005mg/kg作为预注剂量。4分钟后给予维库溴铵0.15mg/kg。硫喷妥钠的给药和插管方式与定时组相同。预注定时组给予0.15mg/kg维库溴铵后至临床肌无力开始的时间明显短于定时组（46.1±4.8对57.6±7.8，P<0.01）。两组之间在插管评分、T1、TR、起效时间和持续时间方面无显著差异。我们得出结论，定时原则联合小剂量预注维库溴铵可能对快速气管插管安全且有用。
