一定剂量的去极化型筒箭毒碱会导致对琥珀酰胆碱产生抗性。

A defasciculating dose of d-tubocurarine causes resistance to succinylcholine.

作者信息

Eisenkraft J B, Mingus M L, Herlich A, Book W J, Kopman A F

机构信息

Department of Anesthesiology, Mount Sinai School of Medicine, City University of New York.

出版信息

Can J Anaesth. 1990 Jul;37(5):538-42. doi: 10.1007/BF03006322.

DOI:10.1007/BF03006322

PMID:2372857

Abstract

Forty-four patients, ASA physical status I or II, undergoing thiamylal, fentanyl, N2O/O2 anaesthesia were studied to determine the dose-response to succinylcholine (Sch) without prior defasciculation (24 pt - Group 1), or three minutes following d-tubocurarine (dTC), 0.043 mg.kg-1 (20 pt - Group 2). The individual log dose-logit response curve for each patient was determined using a cumulative dose plus infusion technique and integrated EMG monitoring of the first dorsal interosseous muscle. The mean (+/- SEM) ED50, ED90 and ED95 values for Sch in Group 1 were 0.13 +/- 0.01, 0.19 +/- 0.01 and 0.22 +- 0.01 mg.kg-1, and in Group 2 were 0.16 +/- 0.01, 0.25 +/- 0.01 and 0.29 +/- 0.02 mg.kg-1, respectively. The mean ED values in Group 2 were significantly greater than the equivalent values in Group 1 (P less than 0.05). Compared with values in Group 1, ED values in Group 2 represented mean increases of 23, 32, and 32 per cent, respectively. These pharmacodynamic data indicate that the dose of Sch needs to be increased by 32 per cent following a defasciculating dose of dTC 3 mg.70 kg-1 (0.043 mg.kg-1).

摘要

对44例ASA身体状况为I或II级、接受硫喷妥钠、芬太尼、N2O/O2麻醉的患者进行了研究，以确定在未预先去极化（24例 - 第1组）或注射筒箭毒碱（dTC）0.043mg·kg-1三分钟后（20例 - 第2组）对琥珀酰胆碱（Sch）的剂量反应。使用累积剂量加输注技术以及对第一背侧骨间肌进行肌电图监测，确定每位患者的个体对数剂量-对数反应曲线。第1组中Sch的平均（±SEM）ED50、ED90和ED95值分别为0.13±0.01、0.19±0.01和0.22±0.01mg·kg-1，第2组分别为0.16±0.01、0.25±0.01和0.29±0.02mg·kg-1。第2组的平均ED值显著高于第1组的相应值（P<0.05）。与第1组的值相比，第2组的ED值分别平均增加了23%、32%和32%。这些药效学数据表明，在注射3mg/70kg（0.043mg·kg-1）的去极化剂量的dTC后，Sch的剂量需要增加32%。