Adamus Milan, Belohlavek Radim, Koutna Jirina, Vujcikova Mariana, Janaskova Eva
Department of Anaesthesiology and Intensive Care Medicine, University Hospital and Faculty of Medicine, Palacky University, Olomouc, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2006 Nov;150(2):333-8. doi: 10.5507/bp.2006.051.
To compare the pharmacodynamics of cisatracurium and rocuronium-induced neuromuscular block following single dose, allowing either spontaneous or neostigmine-accelerated complete recovery.
Following the ethics committee approval and informed consent, 120 patients scheduled for elective surgery under TIVA with tracheal intubation were randomized into 4 groups with different cisatracurium (CIS, 0.10 or 0.15 mg.kg(-1)) or rocuronium (ROC, 0.60 or 0.90 mg.kg(-1)) doses administered. For each patient, the onset time for 95 % depression of T1, clinical duration until 25 % recovery, recovery index (T1 from 25 to 75 %) and time from T1 25 % to TOF-ratio 0.9 were determined allowing either spontaneous or induced recovery.
The onset times were 277 (SD 58), 220 (46), 91 (16) and 77 (16) s for the CIS 0.10, CIS 0.15, ROC 0.60 and ROC 0.90 groups (p < 0.05), respectively, with lower variability in both ROC groups (p < 0.05). The clinical durations were 42 (7), 52 (7), 35 (11) and 52 (12) min, respectively (p < 0.05 for lower doses). Recovery index was identical in all groups allowing either spontaneous recovery - 15.9 (1.8), 15.5 (1.7), 16.1 (3.7) and 16.1 (4.0) min, or following neostigmine administration - 4.4 (0.9), 4.5 (0.8), 4.3 (0.8) and 4.7 (0.7) min for respective groups. During spontaneous recovery, the variability of DUR25-TOF90 was twice as great for ROC than CIS groups (p < 0.05), while after neostigmine administration it was uniform in all groups.
For equipotent doses, the onset times for CIS were approximately three times longer than for ROC. The average clinical duration for both relaxants ranged from 35 to 52 min with acceptable variability. Neostigmine administration accelerated the recovery and reduced its variability. When allowing for spontaneous recovery, less scatter was demonstrated for both CIS groups than for ROC ones.
比较单次给药后顺式阿曲库铵和罗库溴铵诱导的神经肌肉阻滞的药效学，观察其自发恢复或新斯的明加速完全恢复的情况。
经伦理委员会批准并获得知情同意后，将120例计划在全凭静脉麻醉下行气管插管择期手术的患者随机分为4组，分别给予不同剂量的顺式阿曲库铵（CIS，0.10或0.15mg·kg⁻¹）或罗库溴铵（ROC，0.60或0.90mg·kg⁻¹）。对于每位患者，测定T1波幅抑制95%的起效时间、至25%恢复的临床作用时间、恢复指数（T1波幅从25%恢复至75%）以及从T1波幅25%恢复至四个成串刺激比值为0.9的时间，观察自发恢复或诱导恢复情况。
CIS 0.10组、CIS 0.15组、ROC 0.60组和ROC 0.90组的起效时间分别为277（标准差58）、220（46）、91（16）和77（16）秒（p<0.05），ROC两组的变异性较低（p<0.05）。临床作用时间分别为42（7）、52（7）、35（11）和52（12）分钟（低剂量组p<0.05）。所有组的恢复指数相同，自发恢复时分别为15.9（1.8）、15.5（1.7）、16.1（3.7）和16.1（4.0）分钟，新斯的明给药后分别为4.4（0.9）、4.5（0.8）、4.3（0.8）和4.7（0.7）分钟。自发恢复期间，ROC组DUR25 - TOF90的变异性是CIS组的两倍（p<0.05），而新斯的明给药后所有组变异性一致。
对于等效剂量，CIS的起效时间约为ROC的三倍。两种肌松药的平均临床作用时间为35至52分钟，变异性可接受。新斯的明给药加速了恢复并降低了变异性。自发恢复时，CIS两组的离散度均小于ROC组。
