Thomareis O, Triantaphyllidis C, Giala M
Department of Anesthesiology, School of Medicine, Aristotelian University of Thessaloniki, Greece.
Methods Find Exp Clin Pharmacol. 1994 Jul-Aug;16(6):413-7.
An expected response in a hypoglycemic patient to a muscle relaxant formed the basis for the research presented in this study. There was no information available in the accessible literature and references gave no data on this subject. But because perioperative hypoglycemia is not unusual, we scheduled this experimental work. Four groups of 6 white adult Wistar albino rats were used in the study. Group A was the normoglycemia control group, with blood glucose levels of 80-120 mg/dl. Groups B, C and D were made hypoglycemic by i.v. injection of insulin 1 IU/100 g b.w. Blood glucose levels were reduced to 50% of the control values in hypoglycemic animals, which were sacrificed 40 min later. Phrenic nerve-hemidiaphragm preparations were placed in a 100 ml bath containing Paradelis-Zaimis solution, 37 degrees C, pH 7.2, aerated with O2/CO2:95/5%. After stabilization and recording of neuromuscular activity, pancuronium bromide was administered in doses of 1.5 x 10(-9) M in groups A and B, 3 x 10(-9) M in group D. Statistical analysis between A-B, A-C, A-D groups was done with Student's paired t test. Results showed that under hypoglycemic conditions the amount of pancuronium bromide needed for complete neuromuscular blockade was 2.5-fold greater than that needed in normoglycemic conditions. These findings suggest that the integrity of the neuromuscular junction is altered during hypoglycemia.
低血糖患者对肌肉松弛剂的预期反应构成了本研究中所呈现研究的基础。在可获取的文献中没有相关信息,参考文献也未给出关于该主题的数据。但由于围手术期低血糖并不罕见,我们安排了这项实验工作。本研究使用了四组,每组6只成年白色Wistar白化大鼠。A组为血糖正常对照组,血糖水平为80 - 120mg/dl。B、C和D组通过静脉注射胰岛素1IU/100g体重使血糖降低。低血糖动物的血糖水平降至对照值的50%,40分钟后处死。将膈神经 - 半膈肌标本置于含有帕拉代利斯 - 扎伊米斯溶液的100ml浴槽中,温度37℃,pH7.2,用O₂/CO₂:95/5%通气。在稳定并记录神经肌肉活动后,A组和B组以1.5×10⁻⁹M的剂量给予泮库溴铵,D组给予3×10⁻⁹M。A - B、A - C、A - D组之间的统计分析采用学生配对t检验。结果表明,在低血糖条件下,实现完全神经肌肉阻滞所需的泮库溴铵量比血糖正常条件下所需量高2.5倍。这些发现表明低血糖期间神经肌肉接头的完整性发生了改变。