Boulanger A, Hardy J F, Lepage Y
Department of Anaesthesia, University of Montreal, Quebec.
Can J Anaesth. 1990 Apr;37(3):296-300. doi: 10.1007/BF03005578.
The purpose of the study was to determine intubating conditions after administration of either succinylcholine or vecuronium in a rapid induction sequence. Patients received either succinylcholine 1.5 mg.kg-1 (Groups I and II) after d-tubocurarine 0.05 mg.kg-1 four minutes earlier, or vecuronium (Groups III and IV) in an initial dose of 0.01 mg.kg-1 followed four minutes later by 0.1 mg.kg-1. In Groups I and III an apnoeic delay of one minute was allowed before intubation whereas in Groups II and IV the delay was 90 sec. There was no significant difference in intubating conditions between Groups I and IV. Intubating conditions in Group III (vecuronium-delay of one minute) were statistically worse than in any of the three other groups. A delay of 90 sec after succinylcholine improved intubating conditions in male patients. Considering that intubating conditions obtained after 90 sec in patients given a priming sequence with vecuronium (Group IV) were not different from those obtained 60 sec after succinylcholine (Group I), the authors conclude that vecuronium is an acceptable alternative for rapid tracheal intubation. In the doses used in this study, intubating conditions 60 sec after vecuronium were unacceptable for rapid induction of anaesthesia.
本研究的目的是确定在快速诱导顺序中给予琥珀酰胆碱或维库溴铵后的插管条件。患者在4分钟前接受0.05mg·kg-1的右旋筒箭毒碱后，要么接受1.5mg·kg-1的琥珀酰胆碱（I组和II组），要么接受初始剂量为0.01mg·kg-1的维库溴铵（III组和IV组），4分钟后再给予0.1mg·kg-1。I组和III组在插管前允许1分钟的呼吸暂停延迟，而II组和IV组的延迟为90秒。I组和IV组之间的插管条件没有显著差异。III组（维库溴铵-1分钟延迟）的插管条件在统计学上比其他三组中的任何一组都差。琥珀酰胆碱给药后90秒的延迟改善了男性患者的插管条件。考虑到接受维库溴铵预充顺序的患者（IV组）在90秒后获得的插管条件与琥珀酰胆碱给药后60秒获得的插管条件没有差异，作者得出结论，维库溴铵是快速气管插管的可接受替代药物。在本研究中使用的剂量下，维库溴铵给药后60秒的插管条件对于快速诱导麻醉是不可接受的。
