Astley B A, Hackett H, Hughes R, Payne J P
Br J Anaesth. 1986;58 Suppl 1:75S-79S. doi: 10.1093/bja/58.suppl_1.75s.
Eleven fit unpremedicated patients took part in the study. Group I (five patients) received atracurium 0.3 mg kg-1 and group II (six patients) received alcuronium 0.2 mg kg-1. The simultaneous recovery of respiration, judged by serial measurements of the tidal volume and blood-gas values, and peripheral neuromuscular function, judged by the response of the adductor pollicis muscle, were studied. Anaesthesia was maintained with 66% nitrous oxide in oxygen, supplemented by 0.5% halothane. The tetanic response reappeared 17.6 +/- 0.92 min (group I) and 19.2 +/- 2.6 min (group II) after the administration of the drug, and spontaneous breathing at 24.0 +/- 2.08 min (group I) and 23.6 +/- 2.1 min (group II). Adequate recovery of respiratory muscle function was present in group I within 15 min of the onset of spontaneous respiration, whereas in group II this recovery took 30 min. At this time there was marked peripheral neuromuscular blockade with the peak tetanic height value less than 25% of control in both groups. It was concluded that recovery of the respiratory muscles from neuromuscular block by atracurium and alcuronium occurred more rapidly than the recovery of the small muscles of the hand, but that adequate tidal volume, in the absence of other clinical signs, should not be regarded as a reliable indication of complete return of neuromuscular function.
11名健康且未用药的患者参与了该研究。第一组（5名患者）接受了0.3毫克/千克阿曲库铵，第二组（6名患者）接受了0.2毫克/千克阿库氯铵。通过连续测量潮气量和血气值来判断呼吸的同时恢复情况，并通过拇收肌的反应来判断外周神经肌肉功能的恢复情况。麻醉维持采用66%氧化亚氮与氧气混合，并辅以0.5%氟烷。给药后，第一组和第二组的强直反应分别在17.6±0.92分钟和19.2±2.6分钟时重现，自主呼吸分别在24.0±2.08分钟和23.6±2.1分钟时恢复。第一组在自主呼吸开始后15分钟内呼吸肌功能得到充分恢复，而第二组则需要30分钟。此时两组均存在明显的外周神经肌肉阻滞，强直峰值高度值低于对照值的25%。得出的结论是，阿曲库铵和阿库氯铵所致神经肌肉阻滞的呼吸肌恢复比手部小肌肉的恢复更快，但在没有其他临床体征的情况下，充足的潮气量不应被视为神经肌肉功能完全恢复的可靠指标。
