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阿曲库铵与维库溴铵用于婴幼儿中等长度外科手术的比较研究

[Comparative studies of atracurium and vecuronium for medium-length surgical procedures in infants and young children].

作者信息

Grundmann U, Ismaily A J, Kleinschmidt S, Motsch J

机构信息

Institut für Anästhesie der Universitätskliniken des Saarlandes, Homburg/Saar.

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 1991 Feb;26(1):25-8. doi: 10.1055/s-2007-1000532.

Abstract

Onset time, intubation condition and recovery time after single bolus injection of atracurium (0.3 mg/kg in body weight less than 10 kg (Group 1), 0.5 mg/kg in body weight greater than 10 kg (Group 2] and vecuronium (0.05 mg/kg in body weight less than 10 kg (Group 3), 0.1 mg/kg in body weight greater than 10 kg (Group 4] were studied in 40 infants and children anaesthetised with halothane. At the end of the onset time (time from the end of the bolus injection of the muscle relaxant until the maximal twitch depression of the m. adductor pollicis) the intubation conditions were judged as good or very good in both groups. The onset time after bolus injection of atracurium (92.5 +/- 31.9 sec in Group 1, 117.0 +/- 25.2 sec in Group 2) was slightly shorter than after vecuronium (135.7 +/- 64.1 sec in Group 3, 123.3 +/- 26.8 sec in Group 4). The duration from the time of injection to 75% recovery of T1 had been longer by using atracurium (45.2 min in Group 1 + 2) than by vecuronium (36.6 min in Group 3, 34.2 min in Group 4). In infants (Group 1 + 3) the recovery time (duration from 25% to 75% recovery of control twitch height) after relaxation with atracurium as well as vecuronium was longer than in children (Group 2 + 4). Neither cardiovascular side effects nor signs of histamine release occurred after the injection of both muscle relaxants at our dosage level. It is concluded that in infants and children atracurium is a real alternative to vecuronium for relaxation for medium long surgical procedures.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对40例接受氟烷麻醉的婴幼儿及儿童,研究单次推注阿曲库铵(体重小于10kg者0.3mg/kg,第1组;体重大于10kg者0.5mg/kg,第2组)和维库溴铵(体重小于10kg者0.05mg/kg,第3组;体重大于10kg者0.1mg/kg,第4组)后的起效时间、插管条件及恢复时间。在起效时间结束时(从肌肉松弛剂推注结束至拇内收肌最大抽搐抑制的时间),两组的插管条件均判定为良好或非常好。阿曲库铵推注后的起效时间(第1组92.5±31.9秒,第2组117.0±25.2秒)略短于维库溴铵(第3组135.7±64.1秒,第4组123.3±26.8秒)。使用阿曲库铵时从注射到T1恢复75%的时间(第1组+第2组为45.2分钟)比维库溴铵(第3组36.6分钟,第4组34.2分钟)更长。在婴幼儿(第1组+第3组)中,阿曲库铵和维库溴铵松弛后恢复时间(从对照抽搐高度恢复25%至75%的持续时间)比儿童(第2组+第4组)更长。在我们的剂量水平下,注射两种肌肉松弛剂后均未出现心血管副作用或组胺释放迹象。得出结论,在婴幼儿及儿童中,对于中长时间的外科手术松弛,阿曲库铵是维库溴铵的一种切实可行的替代药物。(摘要截选至250词)

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