Diefenbach C, Abel M, Rump A F, Grond S, Korb H, Buzello W
Department of Anesthesiology, University of Koeln, Germany.
Anesth Analg. 1995 Jun;80(6):1088-91. doi: 10.1097/00000539-199506000-00004.
The effect of reduced plasma cholinesterase (ChE) activity in response to normothermic cardiopulmonary bypass (CPB) on mivacurium neuromuscular block was studied in nine patients anesthetized with propofol/fentanyl. Mivacurium was injected intravenously as an initial bolus of 150 micrograms/kg; repeat doses of 75 micrograms/kg were given when the evoked twitch tension attained 75% of control. With the institution of CPB, the previously normal ChE activity was reduced by 42% and remained low until the end of the procedure. The times of onset (time from the end of injection to maximum neuromuscular block) of the maintenance doses of mivacurium were 26% longer during than before or after CPB (P < 0.05). Their DUR25% (time from end of injection to recovery of neuromuscular transmission to 25% of control) were 13 +/- 3 min (means +/- SD) before, 14 +/- 4 min during, and 16 +/- 4 min (P < 0.05) after CPB. It is concluded, that, although markedly reducing the patient's previously normal ChE activity, normothermic CPB had little effect on the time characteristics of mivacurium neuromuscular block.
在9例接受丙泊酚/芬太尼麻醉的患者中，研究了常温体外循环（CPB）导致血浆胆碱酯酶（ChE）活性降低对米库氯铵神经肌肉阻滞的影响。静脉注射米库氯铵，初始推注剂量为150微克/千克；当诱发的抽搐张力达到对照值的75%时，给予75微克/千克的重复剂量。随着CPB的开始，先前正常的ChE活性降低了42%，并且在手术结束前一直保持较低水平。维持剂量的米库氯铵的起效时间（从注射结束到最大神经肌肉阻滞的时间）在CPB期间比CPB前或CPB后长26%（P<0.05）。它们的DUR25%（从注射结束到神经肌肉传递恢复到对照值的25%的时间）在CPB前为13±3分钟（均值±标准差），在CPB期间为14±4分钟，在CPB后为16±4分钟（P<0.05）。得出的结论是，尽管常温CPB显著降低了患者先前正常的ChE活性，但对米库氯铵神经肌肉阻滞的时间特征影响不大。
