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异氟烷麻醉马匹中维库溴铵效能和作用持续时间的观察

Observations of the potency and duration of vecuronium in isoflurane-anesthetized horses.

作者信息

Martin-Flores Manuel, Pare Monique D, Adams Wendy, Campoy Luis, Gleed Robin D

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.

出版信息

Vet Anaesth Analg. 2012 Jul;39(4):385-9. doi: 10.1111/j.1467-2995.2012.00720.x. Epub 2012 May 30.

Abstract

OBJECTIVE

To evaluate the potency and duration of three subparalyzing doses of vecuronium (VEC) in isoflurane-anesthetized horses.

STUDY DESIGN

Prospective experimental study.

ANIMALS

Thirteen healthy adult horses undergoing arthroscopic surgery.

METHODS

During isoflurane anesthesia, horses received one of three doses of vecuronium (25, 50, or 100 μg kg(-1)). Neuromuscular transmission was monitored with acceleromyography (AMG) with train-of-four (TOF) stimulation of the radial nerve. Maximal depression of the first twitch (T1), and onset time were recorded for each dose. Recovery time to a TOF ratio >90% was also evaluated.

RESULTS

Vecuronium 25 μg kg(-1) produced no observable T1 depression in four horses. VEC 50 μg kg(-1) (n = 5) produced a maximal T1 depression of [median (min, max)] 41 (20, 71) % in four horses, and no neuromuscular block was seen in the fifth. VEC 100 μg kg(-1) was given to four horses and produced a T1 depression of 73 (64, 78) %. Of the four horses in which VEC 50 μg kg(-1) produced a measurable neuromuscular block, three recovered spontaneously 43 (40, 52) minutes after VEC administration; a fourth subject received edrophonium to reverse residual block at the end of the surgery. Spontaneous recovery after VEC 100 μg kg(-1) occurred by 112 minutes in one horse, and had to be facilitated by edrophonium in the remaining three horses, more than 2 hours after VEC had been given.

CONCLUSIONS AND CLINICAL RELEVANCE

A dose of 100 μg kg(-1) VEC in isoflurane anesthetized horses failed to produce complete paralysis. The partial neuromuscular block lasted at least 2 hours after this dose had been administered. Edrophonium was required to reverse the neuromuscular block in three of four horses. It is likely that more than 100 μg kg(-1) VEC would be necessary for complete neuromuscular blockade in horses, and that this dose will last >2 hours.

摘要

目的

评估三种低于麻痹剂量的维库溴铵(VEC)在异氟烷麻醉马匹中的效能和持续时间。

研究设计

前瞻性实验研究。

动物

13匹接受关节镜手术的健康成年马。

方法

在异氟烷麻醉期间,马匹接受三种剂量之一的维库溴铵(25、50或100μg/kg)。通过对桡神经进行四个成串刺激(TOF)的加速度肌电图(AMG)监测神经肌肉传递。记录每种剂量下第一个肌颤搐(T1)的最大抑制程度和起效时间。还评估了恢复到TOF比值>90%的恢复时间。

结果

25μg/kg的维库溴铵在4匹马中未产生可观察到的T1抑制。50μg/kg的维库溴铵(n = 5)在4匹马中产生的T1最大抑制程度为[中位数(最小值,最大值)]41(20,71)%,第5匹马未出现神经肌肉阻滞。给4匹马注射100μg/kg的维库溴铵,产生的T1抑制程度为73(64,78)%。在50μg/kg的维库溴铵产生可测量神经肌肉阻滞的4匹马中,3匹马在注射维库溴铵后43(40,52)分钟自发恢复;第4匹马在手术结束时接受依酚氯铵以逆转残余阻滞。100μg/kg的维库溴铵给药后,1匹马在112分钟时自发恢复,其余3匹马在给药2小时以上后必须用依酚氯铵促进恢复。

结论及临床意义

在异氟烷麻醉的马匹中,100μg/kg的维库溴铵剂量未能产生完全麻痹。该剂量给药后部分神经肌肉阻滞持续至少2小时。4匹马中有3匹需要依酚氯铵来逆转神经肌肉阻滞。对于马匹,可能需要超过100μg/kg的维库溴铵才能实现完全神经肌肉阻滞且该剂量将持续>2小时。

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