Leroy B, Baclet L, Sonnenfeld H, Scherpereel P
Ann Fr Anesth Reanim. 1985;4(6):489-91. doi: 10.1016/s0750-7658(85)80246-x.
Hepatic function influences the action of muscle relaxants. Among these drugs, the elimination of atracurium does not depend on liver function. The clinical effects of atracurium were studied in ten patients with portal hypertension and some degree of liver dysfunction and in ten normal patients. The cirrhotic patients underwent resection of oesophageal varices while control patients underwent abdominal surgery. All patients received 0.6 mg X kg-1 atracurium as a first intravenous bolus injection and 0.2 mg X kg-1 incremental doses. The delay of action, the degree of neuromuscular block and the delay of reversal of the block were compared. No statistically significant differences were observed. It is suggested that non significant differences observed could be attributed to an increased volume of distribution of drugs in the cirrhotic patient. These results would suggest that atracurium may be the best relaxant in patients with severe liver failure.
肝功能会影响肌肉松弛剂的作用。在这些药物中，阿曲库铵的消除不依赖于肝功能。对10例门静脉高压且有一定程度肝功能障碍的患者和10例正常患者进行了阿曲库铵的临床效果研究。肝硬化患者接受食管静脉曲张切除术，而对照组患者接受腹部手术。所有患者均静脉注射首剂负荷剂量0.6mg/kg的阿曲库铵，并给予0.2mg/kg的递增剂量。比较了起效延迟、神经肌肉阻滞程度和阻滞恢复延迟情况。未观察到统计学上的显著差异。有人认为观察到的无显著差异可能归因于肝硬化患者药物分布容积增加。这些结果表明，阿曲库铵可能是重症肝衰竭患者的最佳松弛剂。
