Gregorini P, De Patre P, Pasini T, Ronca A
Servizio di Anestesia I e Rianimazione, USL n. 27, Ospedale Maggiore, Bologna.
Minerva Anestesiol. 1992 Jun;58(6):381-5.
Speed of onset, duration of action and recovery time for a bolus injection of atracurium were measured in two groups of patients. In group I anaesthesia considered of propofol, fentanyl, nitrous oxide and oxygen mixture. The induction dose of propofol was 2 mg/kg-1 followed by an infusion of 9.0 mg/kg-1/h-1 for first half hour and 4.5 mg/Kg-1/h-1 subsequently. In group II anaesthesia consisted of isoflurane, fentanyl, nitrous oxide and oxygen mixture. Isoflurane was given upon clinical needs. Speed of onset, duration of action, and recovery time for atracurium were measured in the two groups. No statistically significant differences between speed of onset and duration of action between the two groups were found. The recovery period from T1 = 10% to T1 = 70% twitch response was considerably longer with isoflurane (25 min +/- 6) than with propofol (18 min +/- 3) (p less than 0.01). Results obtained suggest that for adequate relaxation during tracheal intubation smaller doses of atracurium are not needed during isoflurane than propofol administration. Because of the longer recovery period of residual neuromuscular blockade during isoflurane anaesthesia decreasing doses of atracurium and careful monitoring of twitch depression tension are also suggested.
在两组患者中测量了单次注射阿曲库铵的起效速度、作用持续时间和恢复时间。第一组麻醉采用丙泊酚、芬太尼、氧化亚氮和氧气混合。丙泊酚诱导剂量为2mg/kg-1,随后在前半小时以9.0mg/kg-1/h-1输注,之后以4.5mg/Kg-1/h-1输注。第二组麻醉由异氟烷、芬太尼、氧化亚氮和氧气混合组成。根据临床需要给予异氟烷。在两组中测量了阿曲库铵的起效速度、作用持续时间和恢复时间。两组之间在起效速度和作用持续时间上未发现统计学上的显著差异。从T1 = 10%至T1 = 70%的颤搐反应恢复期,异氟烷组(25分钟±6)比丙泊酚组(18分钟±3)长得多(p<0.01)。所获得的结果表明,在气管插管期间为达到充分肌松,与丙泊酚相比,异氟烷麻醉时所需的阿曲库铵剂量更小。由于异氟烷麻醉期间残余神经肌肉阻滞的恢复期更长,也建议减少阿曲库铵剂量并仔细监测颤搐抑制张力。