Goudsouzian N G, Liu L M, Coté C J
Anesth Analg. 1981 Dec;60(12):862-6.
The neuromuscular effects of equipotent doses of non-depolarizing muscle relaxants used for endotracheal intubation were studied in 27 children anesthetized with thiopental, nitrous oxide/oxygen, and narcotic. Equipotent doses of d-tubocurarine (0.8 mg/kg), metocurine (0.5 mg/kg), and pancuronium (0.13 mg/kg) were used. At these doses conditions for intubation were satisfactory in all children and the twitch was completely abolished in 26 of the 27 patients. The twitch height recovered to 5% of control values in 54 +/- 6 minutes, and 29 +/- 2 minutes later recovered to 25% of control values. The time from injection of the drug to maximum effect, the conditions for intubation, and recovery times among the three drugs were not significantly different. Train-of-four values correlated (p less than 0.001) with the twitch heights. When the twitch height at 0.1 Hz was 21% of control values, only three contractions were detected following train-of-stimulation. At 14% of control twitch height, two contractions were detected; at 7% of control twitch height, one contraction was detected. The most frequent reason for administering an incremental dose of relaxant was the beginning of respiratory movements, corresponding to a twitch height of 24% of control values (train-of-four 3%). The second most common reason was unsatisfactory abdominal wall relaxation (twitch height 31% of control values, train-of-four 11%.
在27例接受硫喷妥钠、氧化亚氮/氧气和麻醉性镇痛药麻醉的儿童中，研究了用于气管插管的等效剂量非去极化肌松药的神经肌肉效应。使用了等效剂量的右旋筒箭毒碱（0.8mg/kg）、美库氯铵（0.5mg/kg）和泮库溴铵（0.13mg/kg）。在这些剂量下，所有儿童的插管条件均令人满意，27例患者中有26例的颤搐完全消失。颤搐高度在54±6分钟时恢复至对照值的5%，29±2分钟后恢复至对照值的25%。三种药物从注射药物到达到最大效应的时间、插管条件和恢复时间无显著差异。四个成串刺激值与颤搐高度相关（p<0.001）。当0.1Hz时的颤搐高度为对照值的21%时，四个成串刺激后仅检测到三次收缩。当颤搐高度为对照值的14%时，检测到两次收缩；当颤搐高度为对照值的7%时，检测到一次收缩。给予追加剂量肌松药的最常见原因是开始出现呼吸运动，此时颤搐高度为对照值的24%（四个成串刺激为3%）。第二个最常见的原因是腹壁松弛不满意（颤搐高度为对照值的31%，四个成串刺激为11%）。
