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[维库溴铵对人体的血流动力学影响]

[Hemodynamic effects of vecuronium in man].

作者信息

Lienhart A, Guggiari M, Tauvent A, Maneglia R, Cousin M T, Viars P

出版信息

Ann Fr Anesth Reanim. 1983;2(1):7-16. doi: 10.1016/s0750-7658(83)80043-4.

Abstract

The cardiovascular effects of vecuronium (Organon NC 45 or Norcuron) in man were determined through different protocols using continuous recording of heart rate, arterial blood pressure and parameters obtained by a Swan-Ganz catheter. In healthy anaesthetized patients (n = 23), the effects of a dose of 0.1 mg X kg-1 pancuronium (group A) were compared to those of two doses of vecuronium: 0.1 mg X kg-1 (group B) and 0.3 mg X kg-1 (group C). Pancuronium induced an increase in heart rate (+12%), arterial pressure (+16%) and cardiac index (+8%). No change occurred with vecuronium. In patients under mechanical ventilation in an intensive care unit, we compared the effects of pancuronium 0.1 mg X kg-1 (group D; n = 10), d-tubocurarine (group E; n = 11), vecuronium 0.1 mg X kg-1 (group F; n = 9) and 0.3 mg X kg-1 (group G; n = 10). Pancuronium induced an increase in heart rate (+12%), arterial pressure (+8%) and cardiac index (+9%). d-Tubocurarine induced an increase in heart rate (+6%), a decrease in arterial pressure (-24%) and cardiac index (-17%). No change was observed after vecuronium 0.1 mg X kg-1. After vecuronium 0.3 mg X kg-1, the changes were minimal: a slight decrease in arterial pressure (-5%), a very slight (+3%) and transient (3 min) increase in heart rate were observed. The doses were approximately equipotent in groups A, B and C, whereas the dose of 0.3 mg X kg-1 in group G is about 10 times the 90% effective dose of vecuronium. In geriatric patients with per- or postoperative circulatory deficiency (group H; n = 10, mean age 83 yr), no hemodynamic side effects were observed. Vecuronium seems to be a non-depolarizing neuromuscular blocking agent devoid of cardiovascular side-effects at the generally usual doses.

摘要

通过不同方案,持续记录心率、动脉血压以及用Swan - Ganz导管获得的参数,来确定维库溴铵(Organon NC 45或Norcuron)对人体心血管系统的影响。在健康麻醉患者(n = 23)中,将0.1 mg/kg潘库溴铵(A组)的效果与两种剂量的维库溴铵进行比较:0.1 mg/kg(B组)和0.3 mg/kg(C组)。潘库溴铵可使心率增加(+12%)、动脉压升高(+16%)以及心脏指数增加(+8%)。维库溴铵则无变化。在重症监护病房接受机械通气的患者中,我们比较了0.1 mg/kg潘库溴铵(D组;n = 10)、右旋筒箭毒碱(E组;n = 11)、0.1 mg/kg维库溴铵(F组;n = 9)和0.3 mg/kg维库溴铵(G组;n = 10)的效果。潘库溴铵可使心率增加(+12%)、动脉压升高(+8%)以及心脏指数增加(+9%)。右旋筒箭毒碱可使心率增加(+6%)、动脉压降低(-24%)以及心脏指数降低(-17%)。0.1 mg/kg维库溴铵后未观察到变化。0.3 mg/kg维库溴铵后,变化极小:动脉压轻微降低(-5%),心率有非常轻微的(+3%)且短暂的(3分钟)增加。A、B和C组中的剂量大致等效,而G组中0.3 mg/kg的剂量约为维库溴铵90%有效剂量的10倍。在患有术前或术后循环功能不全的老年患者(H组;n = 10,平均年龄83岁)中,未观察到血流动力学副作用。在通常常用剂量下,维库溴铵似乎是一种无心血管副作用的非去极化神经肌肉阻滞剂。

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