Kim S Y, Hwang K H, Ok S Y, Kim S I, Kim S C, Park W
Department of Anesthesiology, School of Medicine, Soon Chun Hyang University and Hospital, Seoul, Korea.
Anaesthesia. 1995 Jun;50(6):507-9. doi: 10.1111/j.1365-2044.1995.tb06040.x.
Recovery from potent non-depolarising muscle relaxants is slower than from the less potent agents. However, recovery from mivacurium, which is more potent than atracurium, is faster than from atracurium following systemic administration. In an attempt to confirm this discrepancy we compared recovery times following simultaneous administration of equipotent doses of atracurium and mivacurium into the isolated forearms of human volunteers (n = 10). This method enabled us to study the interaction of muscle relaxants with receptors at the neuromuscular junction separated from the effects of plasma drug concentration. In these experiments, the recovery times from maximum block to 50% recovery of control twitch height were significantly longer with mivacurium than with atracurium (mean 25.2(SD 4.7) versus 22.6(3.1) min, p < 0.01). We found that the evidence that mivacurium has a slower recovery than the less potent atracurium may be true using the bilateral, isolated forearm technique and that the discrepancy might be due to a difference in the pharmacokinetic variables of the two drugs.
强效非去极化肌松药的恢复比低效肌松药慢。然而，米库氯铵比阿曲库铵效力更强，全身给药后其恢复却比阿曲库铵快。为了证实这种差异，我们将等效剂量的阿曲库铵和米库氯铵同时注入人类志愿者（n = 10）的离体前臂，比较恢复时间。这种方法使我们能够研究肌松药与神经肌肉接头处受体的相互作用，而不受血浆药物浓度影响。在这些实验中，米库氯铵从最大阻滞到对照抽搐高度恢复50%的恢复时间显著长于阿曲库铵（平均25.2(标准差4.7)对22.6(3.1)分钟，p < 0.01）。我们发现，使用双侧离体前臂技术，米库氯铵恢复比效力较低的阿曲库铵慢这一证据可能是真实的，这种差异可能是由于两种药物药代动力学变量不同所致。
