Saarnivaara L, Lindgren L
Acta Anaesthesiol Scand. 1983 Apr;27(2):126-30. doi: 10.1111/j.1399-6576.1983.tb01921.x.
QT interval was studied in 156 adults and in 127 children during the induction of anaesthesia. Both in adults and in children, QT interval was prolonged statistically significantly after thiopentone 5 mg/kg and the most marked prolongation occurred after suxamethonium 1 to 1.5 mg/kg. In adults, d-tubocurarine 0.06 mg/kg, but not alcuronium 0.03 mg/kg or pancuronium 0.01 mg/kg, prevented statistically significantly the prolongation of the QT interval after suxamethonium 1.5 mg/kg. In children, all three muscle relaxants prevented statistically significantly the effect of suxamethonium 2 mg/kg and pancuronium also prevented the effect of thiopentone. The most common ECG changes were ventricular ectopic beats (VEB) which occurred in 26% of the adults and in 22% of the children who were not pretreated with the muscle relaxants. After pretreatment with d-tubocurarine, the incidence of VEB was 3% in both groups. In adults, alcuronium was as effective as d-tubocurarine in the prevention of VEB but in the alcuronium group supraventricular ectopic beats and junctional rhythm occurred in 6% and 9% of the patients, respectively. Pancuronium did not significantly prevent the incidence of VEB. On the basis of the present results, d-tubocurarine is the relaxant of choice for the prevention of the prolongation of QT interval as well as ECG changes during the induction of anaesthesia.
在156名成年人和127名儿童麻醉诱导期间对QT间期进行了研究。在成年人和儿童中，静脉注射5mg/kg硫喷妥钠后QT间期均有统计学意义的延长，而静脉注射1至1.5mg/kg琥珀胆碱后QT间期延长最为明显。在成年人中，静脉注射0.06mg/kg右旋筒箭毒碱可在统计学意义上显著防止静脉注射1.5mg/kg琥珀胆碱后QT间期的延长，但静脉注射0.03mg/kg阿库氯铵或0.01mg/kg泮库溴铵则无此作用。在儿童中，这三种肌肉松弛剂均可在统计学意义上显著防止静脉注射2mg/kg琥珀胆碱的影响，泮库溴铵还可防止硫喷妥钠的影响。最常见的心电图变化是室性早搏（VEB），在未预先使用肌肉松弛剂的成年人中发生率为26%，在儿童中为22%。预先使用右旋筒箭毒碱后，两组的室性早搏发生率均为3%。在成年人中，阿库氯铵在预防室性早搏方面与右旋筒箭毒碱效果相当，但在阿库氯铵组中，分别有6%和9%的患者出现室上性早搏和交界性心律。泮库溴铵未能显著预防室性早搏的发生率。根据目前的结果，右旋筒箭毒碱是麻醉诱导期间预防QT间期延长以及心电图变化的首选肌肉松弛剂。
