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阿曲库铵与琥珀酰胆碱用于气管插管时循环反应的比较研究

[Comparative study of circulatory response to tracheal intubation with atracurium and succinylcholine].

作者信息

Nocite J R, Serzedo P S, Zuccolotto E B, Leães L F, de Carvalho Júnior R J

机构信息

Centro de Ensino e Treinamento, Sociedade Brasileira de Anestesiologia credenciado na Santa Casa de Misericórdia de Ribeirão Preto, SP.

出版信息

Rev Paul Med. 1990 Sep-Oct;108(5):200-4.

PMID:2103060
Abstract

Changes in some circulatory parameters after orotracheal intubation (OTI) were investigated in 40 patients anesthetized with thiopental 5.0 mg.kg-1 and fentanyl 100 micrograms, receiving either atracurium 0.5 mg.kg-1 (n = 20) or succinylcholine 1.0 mg.kg-1 (n = 20) to facilitate intubation. In the succinylcholine group (SC), mean values of SAP, DAP, MAP, and HR rose significantly in relation to control at 30 sec and 2 min after OTI. In the atracurium group (A), mean values of SAP, DAP, and MAP rose significantly at 30 sec after OTI, however, contrary to the SC group, mean values of HR did not rise significantly after OTI. Mean values of the double product HR x SAP rose significantly at 30 sec, 2 min, and 5 min after OTI in the SC group, but only at 30 sec and 2 min after OTI in the A group. The magnitude of elevation of those circulatory parameters studied was always greater in the SC group than in the A group. The authors conclude that atracurium does not modify the nature of circulatory changes after OTI but is associated to such changes in a lesser degree when compared to succinylcholine in a standard induction technique with thiopental/fentanyl.

摘要

对40例接受硫喷妥钠5.0mg·kg⁻¹和芬太尼100μg麻醉的患者进行了研究,这些患者在气管插管(OTI)后接受阿曲库铵0.5mg·kg⁻¹(n = 20)或琥珀胆碱1.0mg·kg⁻¹(n = 20)以利于插管,观察某些循环参数的变化。在琥珀胆碱组(SC)中,OTI后30秒和2分钟时,收缩压(SAP)、舒张压(DAP)、平均动脉压(MAP)和心率(HR)的平均值相对于对照组显著升高。在阿曲库铵组(A)中,OTI后30秒时,SAP、DAP和MAP的平均值显著升高,然而,与SC组相反,OTI后HR的平均值没有显著升高。在SC组中,OTI后30秒、2分钟和5分钟时,心率与收缩压的乘积(HR×SAP)平均值显著升高,但在A组中仅在OTI后30秒和2分钟时升高。所研究的这些循环参数升高的幅度在SC组中总是大于A组。作者得出结论,在硫喷妥钠/芬太尼标准诱导技术中,阿曲库铵不会改变OTI后循环变化的性质,但与琥珀胆碱相比,其与这些变化的关联程度较小。

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