Bevan D R, Donati F, Gyasi H, Williams A
Can Anaesth Soc J. 1984 Sep;31(5):491-6. doi: 10.1007/BF03009532.
Neuromuscular blockade during surgery was provided with vecuronium in 24 adult patients in end-stage renal failure and in 21 normal patients who served as controls. Dose response curves were constructed which showed that the effective doses required to produce 50, 90 and 95 per cent neuromuscular blockade in patients with renal failure were 27.5, 43 and 49 micrograms X kg-1 respectively. These were not significantly different from the doses of 31, 49 and 57 micrograms X kg-1 in the normal patients. Repeated small doses of 0.01 mg X kg-1 had a significantly longer duration of action and were associated with some cumulation in the renal failure group. Recovery from the block occurred rapidly after neostigmine, was no different in renal failure and was not associated with recurarization. It is concluded that, when given to subjects in renal failure, vecuronium offers advantages over established agents such as shorter duration of action and easy reversibility.
在24例终末期肾衰竭成年患者以及21例作为对照的正常患者的手术过程中，使用维库溴铵进行神经肌肉阻滞。构建了剂量反应曲线，结果显示，肾衰竭患者产生50%、90%和95%神经肌肉阻滞所需的有效剂量分别为27.5、43和49微克/千克。这些剂量与正常患者的31、49和57微克/千克无显著差异。肾衰竭组中重复给予0.01毫克/千克的小剂量药物，其作用持续时间显著延长，且有一定的蓄积作用。新斯的明使用后神经肌肉阻滞迅速恢复，肾衰竭患者与正常患者无异，且未出现再箭毒化现象。结论是，对于肾衰竭患者，维库溴铵比现有药物具有优势，如作用持续时间较短且易于逆转。
