Moore G P, Pace S A, Busby W
Department of Emergency Medicine, Madigan Army Medical Center, Tacoma, Washington 98431-5382.
Pediatr Emerg Care. 1989 Dec;5(4):209-10. doi: 10.1097/00006565-198912000-00001.
The intraosseous route of vascular access has been popularized recently for resuscitation of children. Intraosseous succinylcholine use has been anecdotally reported for airway management. This drug could be utilized for control of the airway in pediatric burns, status epilepticus, or combative head-injured patients. No series quantifying the efficacy of the intraosseous route has been reported for succinylcholine. To accomplish this goal, six sheep serving as their own controls were anesthetized with halothane and subsequently intubated. Succinylcholine (1 mg/kg) was given. The time to respiratory arrest and 100% loss of the forefoot twitch upon stimulation of the anterior tibial nerve were noted. Each animal was successively studied using the intravenous (IV), intraosseous (IO), and intramuscular (IM) routes of administration, with a minimum of seven days separating trials. The average time from administration to respiratory arrest in seconds was 30.8 +/- 7.3 (IV), 57.5 +/- 10.3 (IO), and 230 +/- 106 (IM). The average time from administration to 100% loss of forefoot twitch in seconds was 93.3 +/- 34.0 (IV), 100.8 +/- 24.2 (IO), and 291 +/- 109 (IM). All groups were statistically significantly different using the t-test for the difference of means, with a p value less than 0.0015. We conclude that the intraosseous route of administration of succinylcholine in this series of sheep is comparable to the intravenous route and superior to the intramuscular route.
骨内血管通路最近在儿童复苏中得到了推广。骨内使用琥珀酰胆碱用于气道管理已有个案报道。这种药物可用于小儿烧伤、癫痫持续状态或有攻击性的头部受伤患者的气道控制。尚未有系列研究对骨内途径给予琥珀酰胆碱的疗效进行量化报道。为实现这一目标，选用6只绵羊作为自身对照，用氟烷麻醉后进行气管插管。给予琥珀酰胆碱（1mg/kg）。记录呼吸停止时间以及刺激胫前神经后前足抽搐完全消失的时间。每只动物依次采用静脉（IV）、骨内（IO）和肌肉内（IM）给药途径进行研究，试验间隔至少7天。给药至呼吸停止的平均时间（秒）为：静脉给药30.8±7.3，骨内给药57.5±10.3，肌肉内给药230±106。给药至前足抽搐完全消失的平均时间（秒）为：静脉给药93.3±34.0，骨内给药100.8±24.2，肌肉内给药291±109。采用t检验比较均值差异，所有组间差异均具有统计学意义，p值小于0.0015。我们得出结论，在这一系列绵羊中，骨内途径给予琥珀酰胆碱与静脉途径相当，且优于肌肉内途径。
