Rupp S M, Miller R D, Gencarelli P J
Anesthesiology. 1984 Feb;60(2):102-5. doi: 10.1097/00000542-198402000-00004.
To determine the effect of the commonly used volatile anesthetics on a vecuronium-induced neuromuscular blockade, the authors studied 54 patients anesthetized with 1.2 MAC or 2.2 MAC enflurane, isoflurane, or halothane (MAC value includes contribution from 60% nitrous oxide). During 1.2 MAC enflurane, isoflurane, and halothane, the ED50S (the doses depressing twitch tension 50%) for vecuronium were 12.8, 14.7, and 16.9 micrograms/kg, respectively. During 2.2 MAC enflurane, isoflurane, and halothane, the ED50S for vecuronium were 6.3, 9.8, and 13.8 micrograms/kg, respectively (P less than 0.05). Time from injection to peak effect was the same for each anesthetic group (6.5 +/- 0.5 min, mean +/- SD), except for the group given 2.2 MAC enflurane (9.7 +/- 0.6 min) (P less than 0.05). The duration of a 50% block from injection to 90% recovery was the same for each group (mean 20 +/- 4 min), except for the group given 2.2 MAC enflurane (46.5 min) (P less than 0.05). The authors conclude that enflurane is the most potent volatile anesthetic, followed by isoflurane and then halothane, in augmenting a vecuronium-induced neuromuscular blockade. Increasing the concentration of volatile anesthetic has less effect on a neuromuscular blockade produced by vecuronium than on one produced by other nondepolarizing relaxants (e.g., pancuronium and d-tubucurarine).
为确定常用挥发性麻醉药对维库溴铵所致神经肌肉阻滞的影响，作者研究了54例接受1.2 MAC或2.2 MAC安氟醚、异氟醚或氟烷麻醉的患者（MAC值包括60%氧化亚氮的作用）。在1.2 MAC安氟醚、异氟醚和氟烷麻醉期间，维库溴铵的ED50（使颤搐张力降低50%的剂量）分别为12.8、14.7和16.9微克/千克。在2.2 MAC安氟醚、异氟醚和氟烷麻醉期间，维库溴铵的ED50分别为6.3、9.8和13.8微克/千克（P<0.05）。除接受2.2 MAC安氟醚的组（9.7±0.6分钟）外，各麻醉组从注射到达到最大效应的时间相同（6.5±0.5分钟，均值±标准差）（P<0.05）。除接受2.2 MAC安氟醚的组（46.5分钟）外，各组从注射到恢复至50%阻滞的持续时间相同（平均20±4分钟）（P<0.05）。作者得出结论，在增强维库溴铵所致神经肌肉阻滞方面，安氟醚是最有效的挥发性麻醉药，其次是异氟醚，然后是氟烷。增加挥发性麻醉药的浓度对维库溴铵所致神经肌肉阻滞的影响比对其他非去极化肌松药（如泮库溴铵和d-筒箭毒碱）所致神经肌肉阻滞的影响小。
