Ostergaard D, Engbaek J, Ording H, Viby-Mogensen J
Eur J Anaesthesiol. 1987 Mar;4(2):87-92.
An infusion technique, designed to reduce the duration of period of no response to nerve stimulation following atracurium (Group I) and vecuronium (Group 2), was studied in 30 patients during neurolept anaesthesia. For intubation a combination of a small bolus injection of the relaxant (ED50) and a continuous infusion were administered. The tactile response to nerve stimulation was used to quantify the degree of relaxation and to adjust the speed of infusion. On the other arm the mechanical twitch was recorded blindly for control. Good to excellent intubation conditions were obtained in 4.3 min with atracurium and in 4.0 min with vecuronium. The total dose given for intubation was 0.36 mg kg-1 atracurium (0.24-0.49 mg kg-1) and 0.064 mg kg-1 vecuronium (0.046-0.084 mg kg-1). The period of no response was zero in seven patients in Group I and in four patients in Group 2. In the remaining patients in Group I the period of no response ranged from 5.0-25.0 min, median 10.9 min, and in Group 2 from 2.5-15.6 min, median 9.5 min. At the time of extubation the train-of-four ratio was 0.71 and 0.72 in Group I and 2, respectively. It is concluded that it is possible to achieve a stable, adjustable, and easily reversible block with this technique, even during surgery of short duration.
在30例接受神经安定麻醉的患者中，研究了一种旨在缩短阿曲库铵（第1组）和维库溴铵（第2组）用药后对神经刺激无反应期时长的输注技术。插管时，给予小剂量推注松弛剂（ED50）并持续输注。通过对神经刺激的触觉反应来量化松弛程度并调整输注速度。在另一只手臂上，盲目记录机械性抽搐用于对照。使用阿曲库铵时，4.3分钟内可获得良好至极佳的插管条件，使用维库溴铵时为4.0分钟。插管的总剂量分别为阿曲库铵0.36 mg·kg-1（0.24 - 0.49 mg·kg-1）和维库溴铵0.064 mg·kg-1（0.046 - 0.084 mg·kg-1）。第1组7例患者和第2组4例患者的无反应期为零。第1组其余患者的无反应期为5.0 - 25.0分钟，中位数为10.9分钟，第2组为2.5 - 15.6分钟，中位数为9.5分钟。拔管时，第1组和第2组的四个成串刺激比值分别为0.71和0.72。得出的结论是，即使在短时间手术期间，使用该技术也有可能实现稳定、可调节且易于逆转的阻滞。
