Laurence A S, Norris S H
University Department of Anaesthetics, Sheffield University, United Kingdom.
Eur J Anaesthesiol. 1988 Mar;5(2):143-50.
Serum myoglobin concentrations were studied in 34 patients during tendon and nerve reconstruction operations that required the application of a pneumatic limb tourniquet. Seventeen patients received general anaesthesia without the use of suxamethonium, while the remaining 17 were given suxamethonium as part of the anaesthetic technique. Tourniquet times of up to 2.5 h were associated with negligible myoglobin release, but the use of suxamethonium administration resulted in a rise of serum myoglobin in some subjects, reaching a maximum of 300 micrograms litre-1 20-40 min after induction. No rise in serum myoglobin occurred in any patient following deflation of the tourniquet. Three of the four patients who required a re-application of the tourniquet (after a short reperfusion time) had rises of serum myoglobin up to 120 micrograms litre-1 following the second deflation. Pneumatic tourniquets appear to cause no detectable ischaemic damage for up to 2.5 h, with or without prior use of suxamethonium. Re-application after only a short period of reperfusion may be inadvisable.
在34例需要使用气动肢体止血带进行肌腱和神经重建手术的患者中，研究了血清肌红蛋白浓度。17例患者接受全身麻醉但未使用琥珀胆碱，其余17例患者在麻醉技术中使用了琥珀胆碱。长达2.5小时的止血带使用时间与可忽略不计的肌红蛋白释放相关，但使用琥珀胆碱给药导致一些受试者血清肌红蛋白升高，在诱导后20 - 40分钟达到最高300微克/升。止血带放气后，任何患者的血清肌红蛋白均未升高。在四名需要重新使用止血带（短时间再灌注后）的患者中，有三名在第二次放气后血清肌红蛋白升高至120微克/升。无论是否事先使用琥珀胆碱，气动止血带在长达2.5小时内似乎不会造成可检测到的缺血性损伤。仅在短时间再灌注后重新使用止血带可能是不可取的。
