氧化亚氮对顺式阿曲库铵输注需求的影响：一项随机对照试验。

Effect of nitrous oxide on cisatracurium infusion demands: a randomized controlled trial.

机构信息

Department of Anesthesiology, Intensive Care, Emergency Care and Pain Medicine, University of Turku and Turku University Hospital, Turku, Finland.

出版信息

BMC Anesthesiol. 2010 Aug 18;10:14. doi: 10.1186/1471-2253-10-14.

DOI:10.1186/1471-2253-10-14

PMID:20718983

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2931508/

Abstract

BACKGROUND

Recent studies have questioned our previous understanding on the effect of nitrous oxide on muscle relaxants, since nitrous oxide has been shown to potentiate the action of bolus doses of mivacurium, rocuronium and vecuronium. This study was aimed to investigate the possible effect of nitrous oxide on the infusion requirements of cisatracurium.

METHODS

70 ASA physical status I-III patients aged 18-75 years were enrolled in this randomized trial. The patients were undergoing elective surgery requiring general anesthesia with a duration of at least 90 minutes. Patients were randomized to receive propofol and remifentanil by target controlled infusion in combination with either a mixture of oxygen and nitrous oxide (Nitrous oxide/TIVA group) or oxygen in air (Air/TIVA group). A 0.1 mg/kg initial bolus of cisatracurium was administered before tracheal intubation, followed by a closed-loop computer controlled infusion of cisatracurium to produce and maintain a 90% neuromuscular block. Cumulative dose requirements of cisatracurium during the 90-min study period after bolus administration were measured and the asymptotic steady state rate of infusion to produce a constant 90% block was determined by applying nonlinear curve fitting to the data on the cumulative dose requirement during the study period.

RESULTS

Controller performance, i.e. the ability of the controller to maintain neuromuscular block constant at the setpoint and patient characteristics were similar in both groups. The administration of nitrous oxide did not affect cisatracurium infusion requirements. The mean steady-state rates of infusion were 0.072 +/- 0.018 and 0.066 +/- 0.017 mg * kg-1 * h-1 in Air/TIVA and Nitrous oxide/TIVA groups, respectively.

CONCLUSIONS

Nitrous oxide does not affect the infusion requirements of cisatracurium.

TRIAL REGISTRATION

ClinicalTrials.gov NCT01152905; European Clinical Trials Database at http://eudract.emea.eu.int/2006-006037-41.

摘要

背景

最近的研究质疑了我们之前对一氧化二氮对肌肉松弛剂作用的理解，因为一氧化二氮已被证明可增强维库溴铵、罗库溴铵和顺式阿曲库铵推注剂量的作用。本研究旨在研究一氧化二氮对顺式阿曲库铵输注需求的可能影响。

方法

本随机试验纳入了 70 名 ASA 身体状况 I-III 级、年龄在 18-75 岁的患者。这些患者接受需要至少 90 分钟的全身麻醉下的择期手术。患者随机接受依托咪酯和瑞芬太尼靶控输注，同时接受氧和一氧化二氮混合（一氧化二氮/TIVA 组）或空气（空气/TIVA 组）。在气管插管前给予初始剂量 0.1mg/kg 的顺式阿曲库铵，然后进行顺式阿曲库铵闭环计算机控制输注，以产生并维持 90%的神经肌肉阻滞。在推注后 90 分钟的研究期间，测量累积顺式阿曲库铵剂量需求，并通过对研究期间累积剂量需求数据进行非线性曲线拟合来确定产生恒定 90%阻滞的渐近稳态输注率。