Baker T, Stanec A
Department of Anesthesiology, St. Joseph's Hospital and Medical Center, Paterson, New Jersey 07503.
Anesthesiology. 1987 Dec;67(6):942-7. doi: 10.1097/00000542-198712000-00011.
The occurrence of fasciculations following administration of agents is a well-known pharmacologic phenomenon. Using the cat soleus nerve-muscle preparation, intravenous neostigmine doses between 20-200 micrograms/kg evoked fasciculations in a dose-related manner. The data demonstrate that the fasciculations were the result of the direct effect of neostigmine acting at the motor nerve endings. Vecuronium in a dose-related manner (3 and 5 micrograms/kg iv) suppressed this prejunctional activity of neostigmine. The prejunctional effect of vecuronium explains its effectiveness in preventing succinylcholine-induced fasciculations. In the presence of isoflurane (end-tidal concentration 0.20-0.25%), the suppressant effect of vecuronium on motor nerve endings was enhanced. The prejunctional action of isoflurane may be a major contribution to the additive effects of non-depolarizing muscle relaxants and potent inhalation agents.
用药后出现肌束震颤是一种众所周知的药理现象。使用猫比目鱼肌神经-肌肉标本，静脉注射新斯的明剂量在20 - 200微克/千克之间时，会以剂量相关的方式诱发肌束震颤。数据表明，肌束震颤是新斯的明作用于运动神经末梢的直接效应的结果。维库溴铵以剂量相关的方式（静脉注射3和5微克/千克）抑制了新斯的明的这种节前活性。维库溴铵的节前效应解释了其预防琥珀酰胆碱诱导的肌束震颤的有效性。在异氟烷（呼气末浓度0.20 - 0.25%）存在的情况下，维库溴铵对运动神经末梢的抑制作用增强。异氟烷的节前作用可能是对非去极化肌松药和强效吸入剂相加作用的主要贡献。
