Haraldsted V Y, Nielsen J W, Joensen F, Dilling-Hansen B, Hasselstrøm L
Department of Anaesthesia and Intensive Care, Randers Centralsygehus, Denmark.
Br J Anaesth. 1988 Oct;61(4):479-81. doi: 10.1093/bja/61.4.479.
In 15 patients (ASA I-II) undergoing intraabdominal gynaecological surgery, muscle paralysis for tracheal intubation and surgery was achieved by a combined bolus and demand infusion of vecuronium. The initial loading dose of 67 micrograms kg-1 and the rate of subsequent infusion were determined by evaluation of the tactile twitch response to train-of-four (TOF) stimulation of the ulnar nerve while the neuromuscular blockade obtained was recorded blindly for control on the contralateral arm. A maintenance dose of 4.9 mg h-1 (2.0-7.6 mg h-1) produced a smooth course of blockade with minimum and maximum values of twitch height during infusion of 2% and 12%, respectively. A period of 15.9 min elapsed from the end of infusion to a TOF-ratio of 0.7, when neostigmine 2.5 mg was administered at the point of two palpable twitches to TOF-stimulation. Simple tactile evaluation of peripheral nerve stimulation is sufficient to determine the infusion rate of vecuronium required to produce stable and appropriate neuromuscular blockade during intra-abdominal surgery.
在15例（ASA I-II级）接受腹腔内妇科手术的患者中，通过维库溴铵的单次推注和按需输注实现气管插管和手术时的肌肉麻痹。初始负荷剂量为67微克/千克，随后的输注速率通过评估尺神经四个成串刺激（TOF）的触觉颤搐反应来确定，同时对侧手臂盲目记录所获得的神经肌肉阻滞情况以进行对照。维持剂量为4.9毫克/小时（2.0 - 7.6毫克/小时），在输注期间产生了平稳的阻滞过程，颤搐高度的最小值和最大值分别为2%和12%。从输注结束到TOF比值为0.7经过了15.9分钟，此时在对TOF刺激有两个可触及颤搐时给予新斯的明2.5毫克。在腹腔内手术期间，对外周神经刺激进行简单的触觉评估足以确定产生稳定且适当的神经肌肉阻滞所需的维库溴铵输注速率。
