Beattie W S, Buckley D N, Forrest J B
Department of Anaesthesia, McMaster University, Hamilton, Ontario.
Can J Anaesth. 1992 Nov;39(9):925-31. doi: 10.1007/BF03008341.
This study was designed to determine the effect of prolonged infusion on the ease of reversal of atracurium and vecuronium, and whether factors which potentiate the block delayed reversal. In phase one, 40 patients were randomized (double blind) to determine the steady state conditions for atracurium and vecuronium. Fourteen atracurium patients and 17 vecuronium patients were evaluable. The unblinded second phase involved the steady state conditions using halothane or isoflurane and atracurium infusions. The infusion required for 95% twitch depression (TD95) for atracurium was 7.6 +/- 1.1 micrograms.kg-1 x min-1. The requirement for vecuronium changes with time: TD95 at 30 min was 1.01 +/- 0.16, at 60 min 0.89 +/- 0.12 and after 90 min 0.85 +/- 0.17 micrograms.kg-1 x min-1 (P < 0.05). The mean TD95 was 0.94 +/- 0.23 micrograms.kg-1 x min-1. Multivariate regression analysis of the infusion data revealed a vecuronium model predicting TD95 by the duration of infusion (P < 0.05) and weight (P = 0.05). Atracurium TD95 was predicted by age (P = 0.05). The addition of an inhalation agent to atracurium reduced the infusion rate by 2.01 +/- 0.28 micrograms.kg-1 x min-1 (P = 0.0001) for each increase in MAC. The mean reversal times for atracurium with three different anaesthetics and for vecuronium were not different. Reversal of pancuronium blockade, from less profound twitch depression (86.4 vs 95%) took twice as long as for atracurium and vecuronium for which the following predictors were identified: age, weight, duration of infusion, level of blockade, and type of anaesthetic, using a stepwise regression model.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究旨在确定长时间输注对阿曲库铵和维库溴铵逆转难易程度的影响，以及增强阻滞作用的因素是否会延迟逆转。在第一阶段，40例患者被随机分组（双盲）以确定阿曲库铵和维库溴铵的稳态条件。14例阿曲库铵患者和17例维库溴铵患者可进行评估。非盲法的第二阶段涉及使用氟烷或异氟烷以及阿曲库铵输注的稳态条件。阿曲库铵达到95% 颤搐抑制（TD95）所需的输注速率为7.6±1.1微克·千克⁻¹·分钟⁻¹。维库溴铵的需求量随时间变化：30分钟时TD95为1.01±0.16，60分钟时为0.89±0.12，90分钟后为0.85±0.17微克·千克⁻¹·分钟⁻¹（P<0.05）。平均TD95为0.94±0.23微克·千克⁻¹·分钟⁻¹。对输注数据进行多变量回归分析显示，维库溴铵模型可通过输注持续时间（P<0.05）和体重（P = 0.05）预测TD95。阿曲库铵的TD95可通过年龄预测（P = 0.05）。阿曲库铵每增加1个MAC，吸入麻醉药的加入可使输注速率降低2.01±0.28微克·千克⁻¹·分钟⁻¹（P = 0.0001）。使用三种不同麻醉药时阿曲库铵以及维库溴铵的平均逆转时间无差异。潘库溴铵阻滞从较浅的颤搐抑制（86.4% 对95%）逆转所需时间是阿曲库铵和维库溴铵的两倍，使用逐步回归模型确定了以下预测因素：年龄、体重、输注持续时间、阻滞程度和麻醉药类型。（摘要截断于250字）
