Starsnic M A, Goldberg M E, Ritter D E, Marr A T, Sosis M, Larijani G E
Thomas Jefferson University Hospital, Department of Anesthesiology, Philadelphia, Pennsylvania 19107.
Can J Anaesth. 1989 Jan;36(1):35-9. doi: 10.1007/BF03010884.
Twenty ASA physical status Class III patients undergoing cadaver renal transplantation were studied. After 90 per cent T1 recovery, as determined by train-of-four measurement, from 1.0 mg.kg-1 succinylcholine to facilitate tracheal intubation, nine patients received atracurium 0.25 mg.kg-1 (Group I) and 11 patients received vecuronium 0.05 mg.kg-1 (Group II) intravenously. The following measurements were made: time to maximum block onset (first dose Max), injection to start of recovery (start REC1), injection to 25 per cent T1 twitch recovery (REC 251), injection to 75 per cent T1 (REC 75(1], injection to 90 per cent T1 (REC 90(1] and time from 25-75 per cent recovery T1 (REC 25-75(1]. Maximum blockade (Max block 1) was also measured. At 90 per cent T1 recovery, if time permitted, an identical dose of the appropriate relaxant was administered. Time from second dose to onset of maximum block (second dose Max) and 90 per cent recovery after second dose (REC 90(2] were then measured. At the conclusion of surgery, neuromuscular blockade was reversed with neostigmine 2.5 mg and glycopyrrolate 0.5 mg. One way ANOVA was performed to determine significance between the groups and a p less than 0.05 was considered significant. A paired t test was also performed between REC 90(1) and REC 90(2) for atracurium and vecuronium respectively. A p less than 0.05 was again considered significant. Measurement of first dose Max, start REC1, REC25(1), REC 75(1), REC 90(1), REC 25-75(1) and Max block 1 revealed no difference between the patients receiving an initial dose of atracurium and those receiving vecuronium.(ABSTRACT TRUNCATED AT 250 WORDS)
对20例接受尸体肾移植的ASAⅢ级患者进行了研究。在通过四个成串刺激测量确定从1.0mg·kg⁻¹琥珀酰胆碱恢复至T1的90%后,为便于气管插管,9例患者静脉注射阿曲库铵0.25mg·kg⁻¹(Ⅰ组),11例患者静脉注射维库溴铵0.05mg·kg⁻¹(Ⅱ组)。进行了以下测量:达到最大阻滞起效时间(首剂Max)、注射至恢复开始时间(开始REC1)、注射至T1颤搐恢复25%的时间(REC 25(1])、注射至T1 75%的时间(REC 75(1])、注射至T1 90%的时间(REC 90(1])以及从T1恢复25%至75%的时间(REC 25 - 75(1])。还测量了最大阻滞(Max block 1)。在T1恢复90%时,如果时间允许,给予相同剂量的相应肌松药。然后测量从第二剂至最大阻滞起效时间(第二剂Max)以及第二剂后90%恢复时间(REC 90(2])。手术结束时,用新斯的明2.5mg和格隆溴铵0.5mg逆转神经肌肉阻滞。进行单因素方差分析以确定组间差异,p小于0.05被认为具有显著性。分别对阿曲库铵和维库溴铵在REC 90(1)和REC 90(2)之间进行配对t检验。p小于0.05再次被认为具有显著性。首剂Max、开始REC1、REC25(1)、REC 75(1)、REC 90(1)、REC 25 - 75(1)和Max block 1的测量结果显示,接受初始剂量阿曲库铵的患者与接受维库溴铵的患者之间无差异。(摘要截取自250字)