Koyama T, Amaki Y, Kobayashi K
Department of Anesthesiology, Jikei University School of Medicine, Tokyo.
Masui. 1991 Aug;40(8):1242-4.
We performed a study on 34 adult surgical patients between 15 and 56 years of age, to evaluate whether synergism between nitroglycerin and pancuronium exists or not. Neuromuscular (NM) transmission was measured by electromyography of the thenar muscle using transcutaneous electrodes. Anesthesia was induced by droperidol 0.2 mg.kg-1, fentanyl 50 micrograms, thiamylal 150-250 mg, and succinylcholine 1 mg.kg-1, and maintained with nitrous oxide and O2 (67:33) supplemented with repeated i.v. doses of fentanyl (within 15 micrograms.kg-1). Pancuronium 4 mg was given at the 20% recovery from succinylcholine induced NM block. Sequential i.v. doses of pancuronium 1 mg were injected repeatedly at the every 20% recovery until the end of operation. To control blood pressure, nitroglycerin, ranging from 0 to 5 micrograms.kg-1.min-1, was given intravenously. The linear multiple regression analysis was performed between the dose of pancuronium (micrograms.kg-1.hr-1) and the dose of nitroglycerin (micrograms.kg-1.min-1), the age, sex, or body weight of the patients. The results show that the dose of pancuronium decreases with increasing dose of nitroglycerin. No relationship was found between the dose of pancuronium and the age, sex, or body weight of the patients. In conclusion, nitroglycerin reduces requirement of pancuronium in surgical patients.
我们对34名年龄在15至56岁之间的成年外科手术患者进行了一项研究,以评估硝酸甘油和潘库溴铵之间是否存在协同作用。使用经皮电极通过对大鱼际肌进行肌电图来测量神经肌肉(NM)传递。麻醉诱导采用0.2mg·kg⁻¹氟哌利多、50微克芬太尼、150 - 250mg硫喷妥钠和1mg·kg⁻¹琥珀酰胆碱,并用一氧化二氮和氧气(67:33)维持,同时静脉重复给予芬太尼(剂量在15微克·kg⁻¹以内)。在琥珀酰胆碱诱导的NM阻滞恢复20%时给予4mg潘库溴铵。在每次恢复20%时重复静脉注射1mg潘库溴铵,直至手术结束。为控制血压,静脉给予剂量范围为0至5微克·kg⁻¹·min⁻¹的硝酸甘油。对潘库溴铵剂量(微克·kg⁻¹·hr⁻¹)与硝酸甘油剂量(微克·kg⁻¹·min⁻¹)、患者年龄、性别或体重之间进行线性多元回归分析。结果表明,潘库溴铵的剂量随硝酸甘油剂量的增加而降低。未发现潘库溴铵剂量与患者年龄、性别或体重之间存在相关性。总之,硝酸甘油可降低外科手术患者对潘库溴铵的需求量。