Janda A, Mühlsteiger B, Schwarz S
Institut für Anästhesiologie des Krankenhauses Stadt Wien-Lainz.
Anasth Intensivther Notfallmed. 1990 Jun;25(3):203-5.
The duration of action of a supplementary dose of Atracurium 0.125 mg/kg after an initial dose of Atracurium 0.5 mg/kg respectively Alcuronium 0.25 mg/kg was investigated in 2 groups of 7 patients each. The average duration of action of Atracurium after Alcuronium (44.62 +/- 9.95 min) was 1.75 times longer than that of Atracurium after Atracurium (25.49 +/- 4.08 min). The difference is statistically significant (p = 0.05). For the clinical application of a combination of Atracurium with Alcuronium, 2 conclusions which might appear contradictory can be considered: 1. the pretreatment with Alcuronium can enhance intentionally the duration of action of Atracurium and spare total dosage of muscle relaxants at the same time. Prompt antagonism of muscle blockade of Atracurium remains unchanged according to our experience. 2. the pretreatment with Alcuronium may be dangerous whenever Atracurium is administered close to the end of the operation because of the possibility of prolonged postoperative muscle relaxation.
在两组患者中进行了研究，每组7例，分别给予初始剂量阿曲库铵0.5mg/kg或阿库氯铵0.25mg/kg后，追加剂量阿曲库铵0.125mg/kg的作用持续时间。阿库氯铵后阿曲库铵的平均作用持续时间（44.62±9.95分钟）比阿曲库铵后阿曲库铵的平均作用持续时间（25.49±4.08分钟）长1.75倍。差异具有统计学意义（p = 0.05）。对于阿曲库铵与阿库氯铵联合应用的临床情况，可以考虑两个看似矛盾的结论：1. 阿库氯铵预处理可有意延长阿曲库铵的作用持续时间，同时节省肌肉松弛剂的总剂量。根据我们的经验，阿曲库铵肌肉阻滞的快速拮抗作用保持不变。2. 由于术后肌肉松弛时间延长的可能性，当手术接近结束时给予阿曲库铵时，阿库氯铵预处理可能是危险的。
