Tullock W C, Diana P, Cook D R, Wilks D H, Brandom B W, Stiller R L, Beach C A
Department of Anesthesiology, University of Pittsburgh, Montefiore Hospital, Pennsylvania 15213.
Anesth Analg. 1990 Jan;70(1):86-90. doi: 10.1213/00000539-199001000-00015.
The effects of bolus administration of large doses of vecuronium on the onset and duration of neuromuscular blockade and histamine release were studied during fentanyl-nitrous oxide anesthesia. Forty adults were randomly assigned to receive a bolus injection of either 0.1, 0.2, 0.3, or 0.4 mg/kg of vecuronium. The evoked electromyogram of thumb adduction to train-of-four stimulation was monitored. The time of onset and clinical duration (mean +/- SEM) after each dose were as follows: 0.1 mg/kg, 164 +/- 27 s and 42 +/- 5 min; 0.2 mg/kg, 120 +/- 17 s and 68 +/- 8 min; 0.3 mg/kg, 88 +/- 17 s and 111 +/- 19 min; 0.4 mg/kg, 78 +/- 19 s and 115 +/- 19 min. Both time of onset and duration after doses of 0.3 or 0.4 mg/kg were significantly different from values after the lower doses. No dose-related changes in blood pressure, heart rate, or histamine release were observed. The authors conclude that large bolus doses of vecuronium can be safely used to speed the onset of blockade, but with a significantly prolonged duration of action.
在芬太尼-氧化亚氮麻醉期间，研究了大剂量维库溴铵单次给药对神经肌肉阻滞的起效时间、持续时间及组胺释放的影响。40名成年人被随机分配接受0.1、0.2、0.3或0.4mg/kg维库溴铵的单次注射。监测拇内收肌对四个成串刺激的诱发肌电图。各剂量后的起效时间和临床持续时间（平均值±标准误）如下：0.1mg/kg，164±27秒和42±5分钟；0.2mg/kg，120±17秒和68±8分钟；0.3mg/kg，88±17秒和111±19分钟；0.4mg/kg，78±19秒和115±19分钟。0.3或0.4mg/kg剂量后的起效时间和持续时间均与较低剂量后的数值有显著差异。未观察到血压、心率或组胺释放的剂量相关变化。作者得出结论，大剂量单次注射维库溴铵可安全用于加速阻滞起效，但作用持续时间会显著延长。
