Department of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Department of Anesthesia, Surgical Intensive Care and Pain Management, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Rev Esp Anestesiol Reanim (Engl Ed). 2024 Jun-Jul;71(6):438-444. doi: 10.1016/j.redare.2024.04.004. Epub 2024 Apr 12.
Some studies investigating the effect of calcium on neostigmine-induced recovery of neuromuscular blockade have shown that this combination promotes neuromuscular recovery, but does not significantly affect the incidence of postoperative residual curarization and time to extubation. This study aimed to evaluate the effects of 10 mg/kg calcium chloride co-administered with neostigmine on early recovery and time to extubation.
This prospective, randomized, double-blinded, placebo-controlled study included 88 ASA I-II patients aged between 18 and 65 years who were scheduled for elective surgery lasting at least 1 h under general anaesthesia in which 10 mg/kg of calcium chloride or the same volume of normal saline was co-administered with 5 μg/kg of neostigmine at the end of surgery. Time to extubation (time from neostigmine administration to extubation), time from neostigmine administration to TOF ratio (TOFr) 0.9 (neuromuscular recovery), and the incidence of residual neuromuscular blockade (RNMB) and other adverse effects were recorded.
Median (Q1, Q3) extubation time was significantly shorter in the calcium group vs. the placebo group (6.5 min [5.52-7.43] vs. 9.78 min [8.35-11]), P < .001. Median neuromuscular recovery time in the calcium group was 5 min vs. 7.1 min in the placebo group, P < .001. Patients in the calcium group had significantly higher TOFr and lower incidence of RNMB at 5 and 10 min vs. the placebo group, and no significant side effects.
Calcium chloride at a dose of 10 mg/kg co-administered with neostigmine promotes early neuromuscular recovery and reduces time to extubation by about 32%.
一些研究调查了钙对新斯的明诱导的神经肌肉阻滞恢复的影响，这些研究表明，这种组合促进了神经肌肉恢复，但对术后残余肌松和拔管时间没有显著影响。本研究旨在评估 10mg/kg 氯化钙与新斯的明联合应用对早期恢复和拔管时间的影响。
这是一项前瞻性、随机、双盲、安慰剂对照研究，纳入了 88 名 ASA I-II 级、年龄在 18 至 65 岁之间的患者，这些患者计划接受全身麻醉下至少 1 小时的择期手术，在手术结束时，将 10mg/kg 氯化钙或等量生理盐水与 5μg/kg 新斯的明联合使用。记录拔管时间（新斯的明给药至拔管时间）、新斯的明给药至 TOFr（TOFr 0.9，神经肌肉恢复）时间和残余神经肌肉阻滞（RNMB）发生率及其他不良反应。
与安慰剂组相比，钙组的拔管时间中位数（Q1，Q3）明显更短（6.5min[5.52-7.43]vs.9.78min[8.35-11]，P<0.001）。钙组的神经肌肉恢复时间中位数为 5min，而安慰剂组为 7.1min，P<0.001。钙组患者在 5 分钟和 10 分钟时的 TOFr 更高，RNMB 发生率更低，与安慰剂组相比，差异有统计学意义，且无明显不良反应。
10mg/kg 氯化钙与新斯的明联合应用可促进早期神经肌肉恢复，使拔管时间缩短约 32%。
