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维库溴铵在肾移植患者体内会蓄积吗?

Does vecuronium accumulate in the renal transplant patient?

作者信息

Starsnic M A, Goldberg M E, Ritter D E, Marr A T, Sosis M, Larijani G E

机构信息

Thomas Jefferson University Hospital, Department of Anesthesiology, Philadelphia, Pennsylvania 19107.

出版信息

Can J Anaesth. 1989 Jan;36(1):35-9. doi: 10.1007/BF03010884.

DOI:10.1007/BF03010884
PMID:2563340
Abstract

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)

摘要

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)

相似文献

1
Does vecuronium accumulate in the renal transplant patient?维库溴铵在肾移植患者体内会蓄积吗?
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2
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引用本文的文献

1
Pharmacodynamics of vecuronium in patients with and without renal failure: a meta-analysis.维库溴铵在肾衰竭和非肾衰竭患者中的药效学:一项荟萃分析。
Can J Anaesth. 1993 Aug;40(8):696-702. doi: 10.1007/BF03009763.
2
Anaesthesia for renal transplantation in sickle cell disease.镰状细胞病患者肾移植的麻醉
Can J Anaesth. 1990 Oct;37(7):778-85. doi: 10.1007/BF03006536.
3
Prolonged neuromuscular blockade and ventilatory failure after renal transplantation and cyclosporine.肾移植及使用环孢素后出现的长时间神经肌肉阻滞和呼吸衰竭。

本文引用的文献

1
Use of atracurium in patients with no renal function.阿曲库铵在无肾功能患者中的应用。
Br J Anaesth. 1982 Dec;54(12):1251-8. doi: 10.1093/bja/54.12.1251.
2
Neuromuscular and cardiovascular effects of atracurium during nitrous oxide-fentanyl and nitrous oxide-isoflurane anaesthesia.阿曲库铵在氧化亚氮-芬太尼及氧化亚氮-异氟烷麻醉期间对神经肌肉和心血管系统的影响。
Br J Anaesth. 1983;55 Suppl 1:67S-70S.
3
Safety and efficacy of atracurium (BW33A) in surgical patients receiving balanced or isoflurane anesthesia.阿曲库铵(BW33A)在接受平衡麻醉或异氟烷麻醉的外科手术患者中的安全性和有效性。
Can J Anaesth. 1990 Jul;37(5):543-8. doi: 10.1007/BF03006323.
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The use of muscle relaxants in the intensive care unit.重症监护病房中肌肉松弛剂的使用。
Can J Anaesth. 1992 Nov;39(9):949-62. doi: 10.1007/BF03008345.
Anesthesiology. 1983 May;58(5):450-5. doi: 10.1097/00000542-198305000-00010.
4
Histamine-releasing potencies of atracurium, dimethyl tubocurarine and tubocurarine.阿曲库铵、二甲筒箭毒碱和筒箭毒碱的组胺释放效能。
Br J Anaesth. 1983;55 Suppl 1:105S-106S.
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Vecuronium in renal failure.肾衰竭中的维库溴铵。
Can Anaesth Soc J. 1984 Sep;31(5):491-6. doi: 10.1007/BF03009532.
6
Comparison of vecuronium, atracurium and tubocurarine in normal patients and in patients with no renal function.维库溴铵、阿曲库铵和筒箭毒碱在正常患者和无肾功能患者中的比较。
Br J Anaesth. 1984 Sep;56(9):941-51. doi: 10.1093/bja/56.9.941.
7
Vecuronium-induced neuromuscular blockade during enflurane, isoflurane, and halothane anesthesia in humans.维库溴铵在人体氟烷、异氟烷和恩氟烷麻醉期间引起的神经肌肉阻滞。
Anesthesiology. 1984 Feb;60(2):102-5. doi: 10.1097/00000542-198402000-00004.
8
Renal and biliary elimination of vecuronium (ORG NC 45) and pancuronium in rats.大鼠体内维库溴铵(ORG NC 45)和泮库溴铵的肾和胆汁排泄情况。
Anesth Analg. 1982 Apr;61(4):313-6.
9
Pharmacokinetics of Org NC45 (norcuron) in patients with and without renal failure.Org NC45(诺库溴铵)在有和没有肾衰竭的患者中的药代动力学。
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