Ciobotaru Oana Roxana, Stoleriu Gabriela, Ciobotaru Octavian Catalin, Grigorovici Alexandru, Voinescu Doina Carina, Matei Madalina Nicoleta, Cobzaru Roxana Gabriela, Manolache Nicuta, Lupu Mary-Nicoleta
Clinical Department, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800008 Galati, Romania.
Department of Surgery, Faculty of Medicine and Pharmacy, 'Dunărea de Jos' University, 800008 Galati, Romania.
Exp Ther Med. 2020 Sep;20(3):2368-2372. doi: 10.3892/etm.2020.8792. Epub 2020 May 26.
Intraoperative anaphylactic reactions may range from mild, erythema-like to anaphylactic shock, with tension crash and bronchospasm. The substances considered to be most responsible for the occurrence of intraoperative allergic reactions are neuromuscular blocking agents, antibiotics and latex. Recent studies have identified a new receptor, Mas-Related G-Protein-coupled Receptor X2 (MRGPRX2), considered as a target for some neuromuscular blockers such as atracurium, rocuronium or fluoroquinolone, resulting in pseudoallergic or anaphylactoid reactions. Induction of anesthesia can use both depolarizing myorelaxants, useful especially in emergency situations, in the patient with gastric plenitude or at high risk of intubation, and non-depolarizing myorelaxants such as atracurium, cisatracurium and rocuronium. Succinylcholine has a short time of action and it is rapidly metabolized. Atracurium, although having a slightly longer time to action, has the benefit of a low risk of increased levels of potassium in blood, which is extremely important in patients with cardiac pathology or associated kidney diseases. The present study compared the side effects of systemic anesthesia with succinylcholine vs. atracurium.
术中过敏反应的范围可能从轻微的红斑样反应到过敏性休克,伴有张力性虚脱和支气管痉挛。被认为是术中过敏反应发生最主要原因的物质是神经肌肉阻滞剂、抗生素和乳胶。最近的研究发现了一种新的受体,即Mas相关G蛋白偶联受体X2(MRGPRX2),它被认为是某些神经肌肉阻滞剂(如阿曲库铵、罗库溴铵或氟喹诺酮)的靶点,会导致假过敏或类过敏反应。麻醉诱导可使用去极化肌松药,这在紧急情况下、胃扩张患者或插管高风险患者中特别有用,也可使用非去极化肌松药,如阿曲库铵、顺阿曲库铵和罗库溴铵。琥珀酰胆碱作用时间短,且迅速代谢。阿曲库铵虽然作用时间稍长,但具有血中钾水平升高风险低的优点,这对患有心脏疾病或相关肾脏疾病的患者极为重要。本研究比较了使用琥珀酰胆碱与阿曲库铵的全身麻醉的副作用。