Munhoz Derli Conceição, Braga Angélica de Fátima de Assunção, Potério Glória Maria Braga
Hospital de Clínicas, UNICAMP.
Rev Bras Anestesiol. 2002 Nov;52(6):673-80.
Some hypnotics may interact with neuromuscular blockers and potentiate their effects. This study aimed at evaluating the influence of propofol and etomidate on rocuronium-induced neuromuscular block.
Participated in this study 60 patients, physical status ASA I and II, scheduled for elective surgeries under general anesthesia, who were randomly distributed in two groups according to the hypnotic drug: Group I (propofol) and Group II (etomidate). All patients were premedicated with intramuscular midazolam (0.1 mg.kg-1), 30 minutes before surgery. Anesthesia was induced with propofol (2.5 mg.kg-1) or etomidate (0.3 mg.kg-1) preceded by alfentanil (50 microg.kg-1) and followed by rocuronium (0.6 mg.kg-1). Patients were ventilated under mask with 100% oxygen until achieving a decrease of 75% or more in the adductor pollicis muscle response amplitude. Neuromuscular function was monitored by accelerometry. The following parameters were evaluated: rocuronium onset (T1 <= 25%); time for complete neuromuscular block; neuromuscular block degree at tracheal intubation; tracheal intubation conditions and hemodynamic effects.
Complete rocuronium-induced neuromuscular block onset times (in seconds) were: Group I (48.20 +/- 10.85 s and 58.87 +/- 10.73 s) and Group II (51.20 +/- 13.80 s and 64.27 +/- 18.55 s). Neuromuscular block degree at tracheal intubation was: Group I (77.50%) and Group II (76.96%). Tracheal intubation conditions were satisfactory in 100% of Group I patients and in 83.33% of Group II patients. There has been a significant decrease in mean blood pressure, followed by an increase after hypnotic injection, in both groups.
Propofol and etomidate had a similar behavior regarding time for rocuronium-induced neuromuscular block and tracheal intubation conditions.
某些催眠药可能与神经肌肉阻滞剂相互作用并增强其效果。本研究旨在评估丙泊酚和依托咪酯对罗库溴铵诱导的神经肌肉阻滞的影响。
60例美国麻醉医师协会（ASA）身体状况分级为Ⅰ级和Ⅱ级、计划在全身麻醉下进行择期手术的患者参与了本研究，根据所使用的催眠药将其随机分为两组：Ⅰ组（丙泊酚）和Ⅱ组（依托咪酯）。所有患者在手术前30分钟肌肉注射咪达唑仑（0.1mg/kg）进行术前用药。麻醉诱导采用阿芬太尼（50μg/kg）后依次给予丙泊酚（2.5mg/kg）或依托咪酯（0.3mg/kg），随后给予罗库溴铵（0.6mg/kg）。患者通过面罩给予100%氧气通气，直至拇内收肌肌肉反应幅度下降75%或更多。通过加速度计监测神经肌肉功能。评估以下参数：罗库溴铵起效时间（T1≤25%）；完全神经肌肉阻滞时间；气管插管时的神经肌肉阻滞程度；气管插管条件和血流动力学效应。
罗库溴铵诱导的完全神经肌肉阻滞起效时间（以秒计）为：Ⅰ组（48.20±10.85秒和58.87±10.73秒）和Ⅱ组（51.20±13.80秒和64.27±18.55秒）。气管插管时的神经肌肉阻滞程度为：Ⅰ组（77.50%）和Ⅱ组（76.96%）。Ⅰ组100%的患者和Ⅱ组83.33%的患者气管插管条件满意。两组患者的平均血压均显著下降，随后在注射催眠药后升高。
丙泊酚和依托咪酯在罗库溴铵诱导的神经肌肉阻滞时间和气管插管条件方面表现相似。
