Kitajima T, Ishii K, Ogata H
Department of Anaesthesiology, Dokkyo University School of Medicine, Tochigi, Japan.
Anaesthesia. 1995 Apr;50(4):359-61. doi: 10.1111/j.1365-2044.1995.tb04618.x.
Train-of-four stimuli were applied to the ulnar nerve using an accelograph in 10 elderly patients (aged 70-82 years) and 10 younger patients (aged 27-54 years). Anaesthesia was induced with thiopentone 5 mg.kg-1 and was maintained with nitrous oxide (66%) oxygen and sevoflurane (1 MAC). Vecuronium 0.1 mg.kg-1 was used for paralysis, and reversed with intravenous edrophonium 0.75 mg.kg-1 and atropine 0.015 mg.kg-1 when the train-of-four ratio returned to 25%. The times from initial administration of vecuronium to completion of maximal block were 211.5 (SD 66.9) s and 154.0 (SD 39.7) s in the elderly and younger patients, respectively (p < 0.05). The times from maximal block to 25% recovery of train-of-four ratio were 64.8 (SD 36.3) min and 61.8 (SD 36.3) min in the elderly and younger patients, respectively. There was no statistically significant difference between them. The reversal times from 25% to 75% of the train-of-four ratio after the administration of edrophonium were 210.0 (SD 136.7) s and 177.0 (SD 100.4) s in the elderly and younger patients, respectively. There was no statistically significant difference between them. The authors were unable to show that healthy elderly patients differ significantly from younger patients in the neuromuscular blocking effect of vecuronium and the reversal effect of edrophonium.
使用加速度描记器对10名老年患者（年龄70 - 82岁）和10名年轻患者（年龄27 - 54岁）的尺神经施加四个成串刺激。用硫喷妥钠5mg·kg⁻¹诱导麻醉，并用氧化亚氮（66%）、氧气和七氟醚（1MAC）维持麻醉。使用维库溴铵0.1mg·kg⁻¹进行肌松，当四个成串刺激比值恢复到25%时，静脉注射依酚氯铵0.75mg·kg⁻¹和阿托品0.015mg·kg⁻¹进行拮抗。老年患者和年轻患者从最初给予维库溴铵到达到最大阻滞的时间分别为211.5（标准差66.9）秒和154.0（标准差39.7）秒（p<0.05）。老年患者和年轻患者从最大阻滞到四个成串刺激比值恢复25%的时间分别为64.8（标准差36.3）分钟和61.8（标准差36.3）分钟。两者之间无统计学显著差异。给予依酚氯铵后，老年患者和年轻患者从四个成串刺激比值25%恢复到75%的拮抗时间分别为210.0（标准差136.7）秒和177.0（标准差100.4）秒。两者之间无统计学显著差异。作者未能表明健康老年患者在维库溴铵的神经肌肉阻滞作用和依酚氯铵的拮抗作用方面与年轻患者有显著差异。
