Harper N J, Bradshaw E G, Healy T E
Br J Anaesth. 1984 Oct;56(10):1089-94. doi: 10.1093/bja/56.10.1089.
The reversal of alcuronium by edrophonium 1 mg kg-1 or neostigmine 35.7 micrograms kg-1 was compared in 23 patients undergoing elective ophthalmic surgery. Neuromuscular transmission was assessed by measuring the force of contraction of the adductor pollicis muscle in response to train-of-four supramaximal stimuli (2 Hz, 0.2 ms duration) delivered via surface electrodes to the ulnar nerve every 10 s. Anaesthesia was induced and maintained with Althesin, and patients were ventilated to normocarbia with 67% nitrous oxide in oxygen. Neuromuscular blockade was induced with alcuronium 0.2-0.3 mg kg-1 and antagonism was attempted when the train-of-four ratio had recovered spontaneously to 0.1. Recovery of the first contraction response of the train-of-four and of fade were more rapid after edrophonium. Although most patients were monitored for at least 30 min no re-curarization was seen. Comparison of the relative rates of recovery of the first contraction, and the response to train-of-four stimuli, suggests that edrophonium has a greater prejunctional effect than neostigmine.
在23例接受择期眼科手术的患者中，比较了1 mg/kg依酚氯铵或35.7 μg/kg新斯的明对阿库氯铵的逆转作用。通过测量拇收肌对每隔10秒经表面电极施加于尺神经的四个成串超强刺激（2 Hz，持续时间0.2 ms）的收缩力来评估神经肌肉传递。用阿法沙龙诱导并维持麻醉，患者用67%氧化亚氮和氧气进行通气以维持正常碳酸血症。用0.2 - 0.3 mg/kg阿库氯铵诱导神经肌肉阻滞，当四个成串刺激比值自发恢复至0.1时尝试进行拮抗。依酚氯铵给药后，四个成串刺激中第一个收缩反应和衰减的恢复更快。尽管大多数患者至少监测了30分钟，但未观察到再箭毒化现象。对第一个收缩反应的相对恢复率以及对四个成串刺激的反应进行比较，表明依酚氯铵比新斯的明具有更强的接头前效应。
