Mirakhur R K, Lavery G G, Gibson F M, Clarke R S
Acta Anaesthesiol Scand. 1986 Jul;30(5):347-50. doi: 10.1111/j.1399-6576.1986.tb02428.x.
Intubating conditions have been assessed at 60 s following administration of vecuronium 0.1 mg kg-1 or atracurium 0.5 mg kg-1 given either as a single dose after induction of anaesthesia with thiopentone or in divided doses; vecuronium 0.015 mg kg-1 followed 4 or 6 min later by 0.085 mg kg-1, or atracurium 0.075 mg kg-1 followed 4 or 6 min later by 0.425 mg kg-1. In the divided dose groups the smaller initial (priming) dose was given prior to induction of anaesthesia. Onset and duration of clinical relaxation were assessed using a peripheral nerve stimulator. The intubating conditions at 60 s improved significantly, with the use of relaxants in divided doses being acceptable in 80 and 70% of patients, respectively, with vecuronium and atracurium, but the conditions are not as good as those commonly found using suxamethonium. Priming at 6 min has no advantage over priming at 4 min. The onset of complete block was accelerated with priming, but the difference was not significant. The duration of clinical relaxation of vecuronium was significantly prolonged by giving it in divided doses. Unpleasant awareness of muscle weakness was observed in 15 patients, requiring early induction of anaesthesia in five of them.
在给予0.1mg/kg维库溴铵或0.5mg/kg阿曲库铵后60秒评估插管条件，药物给药方式为硫喷妥钠诱导麻醉后单次给药或分次给药；维库溴铵先给予0.015mg/kg，4或6分钟后再给予0.085mg/kg，或阿曲库铵先给予0.075mg/kg，4或6分钟后再给予0.425mg/kg。在分次给药组中，较小的初始（预充）剂量在麻醉诱导前给予。使用外周神经刺激器评估临床肌肉松弛的起效时间和持续时间。60秒时的插管条件显著改善，分别使用维库溴铵和阿曲库铵分次给药时，80%和70%的患者可接受，但条件不如使用琥珀胆碱时常见的情况。6分钟预充与4分钟预充相比没有优势。预充可加速完全阻滞的起效，但差异不显著。维库溴铵分次给药显著延长了临床肌肉松弛的持续时间。15名患者出现了令人不适的肌肉无力感，其中5人需要提前诱导麻醉。
