Graham G G, Morris R, Pybus D A, Torda T A, Woodey R
Anesthesiology. 1986 Dec;65(6):579-83. doi: 10.1097/00000542-198612000-00003.
The relationship of train-of-four (TOF) ratio to the depression of the first twitch (TD) was investigated in 16 patients given pancuronium in doses insufficient to eliminate the fourth response in the train. In ten patients the block was allowed to spontaneously recover (Group 1) and in six it was reversed with neostigmine (Group 2) once maximum depression of TOF ratio had occurred. Maximum depression of the first response occurred in 6.5 +/- 4.3 min (mean +/- SD). Maximum depression of the TOF ratio was not present until 28.0 +/- 11.0 min. TOF ratio was usually still decreasing when recovery of TD had begun. However, once the TOF ratio began to recover, the recovery rates for TD and TOF ratio were similar in both the spontaneously recovering and the reversed groups. TOF ratio at complete TD recovery was 74.9 +/- 15.7 and 86.2 +/- 15.4% for the two groups. A kinetic analysis yielded significantly different elimination rate constants for the two effects from the "effect compartment." These findings suggest that these two effects of pancuronium are exerted at different sites.
在16例接受潘库溴铵治疗且剂量不足以消除成串刺激中第四个反应的患者中，研究了四个成串刺激（TOF）比率与第一个肌颤搐抑制（TD）之间的关系。在10例患者中，让肌松阻滞自行恢复（第1组），在另外6例患者中，当TOF比率出现最大程度抑制后，用新斯的明进行逆转（第2组）。第一个反应的最大抑制在6.5±4.3分钟（平均值±标准差）出现。直到28.0±11.0分钟才出现TOF比率的最大抑制。当TD开始恢复时，TOF比率通常仍在下降。然而，一旦TOF比率开始恢复，在自行恢复组和逆转组中，TD和TOF比率的恢复率相似。两组在TD完全恢复时的TOF比率分别为74.9±15.7%和86.2±15.4%。动力学分析得出两种效应从“效应室”的消除速率常数有显著差异。这些发现表明潘库溴铵的这两种效应作用于不同部位。
