Otomo Shigeaki, Iwasaki Hajime, Takahoko Kenichi, Onodera Yoshiko, Sasakawa Tomoki, Kunisawa Takayuki, Iwasaki Hiroshi
Department of Anesthesiology and Critical Care, Asahikawa Medical University, 2-1-1-1 Midorigaoka-higashi, Asahikawa, Hokkaido 078-8510, Japan.
Anesthesiol Res Pract. 2014;2014:848051. doi: 10.1155/2014/848051. Epub 2014 Feb 11.
The objective of this study was to determine the point after sugammadex administration at which sufficient or insufficient dose could be determined, using first twitch height of train-of-four (T1 height) or train-of-four ratio (TOFR) as indicators. Groups A and B received 1 mg/kg and 0.5 mg/kg of sugammadex, respectively, as a first dose when the second twitch reappeared in train-of-four stimulation, and Groups C and D received 1 mg/kg and 0.5 mg/kg of sugammadex, respectively, as the first dose at posttetanic counts 1-3. Five minutes after the first dose, an additional 1 mg/kg of sugammadex was administered and changes in T1 height and TOFR were observed. Patients were divided into a recovered group and a partly recovered group, based on percentage changes in T1 height after additional dosing. T1 height and TOFR during the 5 min after first dose were then compared. In the recovered group, TOFR exceeded 90% in all patients at 3 min after sugammadex administration. In the partly recovered group, none of the patients had a TOFR above 90% at 3 min after sugammadex administration. An additional dose of sugammadex can be considered unnecessary if the train-of-four ratio is ≥90% at 3 min after sugammadex administration. This trial is registered with UMIN000007245.
本研究的目的是使用四个成串刺激的第一个肌颤搐高度（T1高度）或四个成串刺激比率（TOFR）作为指标，确定给予舒更葡糖钠后能够判定剂量充足或不足的时间点。当四个成串刺激中第二个肌颤搐重新出现时，A组和B组分别给予1mg/kg和0.5mg/kg的舒更葡糖钠作为首剂，C组和D组分别在强直刺激后计数1 - 3时给予1mg/kg和0.5mg/kg的舒更葡糖钠作为首剂。首剂给药后5分钟，再给予1mg/kg的舒更葡糖钠，并观察T1高度和TOFR的变化。根据追加给药后T1高度的变化百分比，将患者分为恢复组和部分恢复组。然后比较首剂给药后5分钟内的T1高度和TOFR。在恢复组中，舒更葡糖钠给药后3分钟时所有患者的TOFR均超过90%。在部分恢复组中，舒更葡糖钠给药后3分钟时没有患者的TOFR高于90%。如果舒更葡糖钠给药后3分钟时四个成串刺激比率≥90%，则可认为无需追加舒更葡糖钠剂量。本试验已在UMIN000007245注册。
