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轻度术中低温不会改变维库溴铵在人体中的药效学(浓度-效应关系)。

Mild intraoperative hypothermia does not change the pharmacodynamics (concentration-effect relationship) of vecuronium in humans.

作者信息

Heier T, Caldwell J E, Sharma M L, Gruenke L D, Miller R D

机构信息

Department of Anesthesia, University of California, San Francisco 94143-0648.

出版信息

Anesth Analg. 1994 May;78(5):973-7. doi: 10.1213/00000539-199405000-00024.

Abstract

To investigate the effect of mild hypothermia on the neuromuscular junction sensitivity to vecuronium, we determined the pharmacodynamics (concentration-effect relationship) of vecuronium in 10 patients (ASA physical class I or II; age range, 21-46 yr; weight range, 54-104 kg), during isoflurane-nitrous oxide-fentanyl anesthesia. Five were cooled to a mean temperature of 34.4 degrees C and five were maintained normothermic at a mean temperature of 36.8 degrees C. Neuromuscular function was monitored by measuring the evoked mechanical response of the adductor pollicis muscle after supramaximal train-of-four stimulation of the ulnar nerve at the wrist. Vecuronium, 3 micrograms.kg-1.min-1, was infused for 10 min, venous blood sampled for 60 min, and twitch tension and plasma concentration data were used to determine pharmacodynamic variables in each patient. Results for the hypothermic and normothermic groups were compared by Mann-Whitney U-test. There were no differences in any pharmacodynamic variable between the hypothermic and normothermic patients. For the hypothermic and normothermic patients, respectively, steady-state plasma concentrations of vecuronium producing 50% neuromuscular block (Css50) were 73 +/- 13 ng/mL (mean +/- SD) and 79 +/- 31 ng/mL; the rate constants for equilibration of vecuronium between the plasma and the neuromuscular junction (Keo) were 0.27 +/- 0.14 per min-1 and 0.26 +/- 0.11 per min, and the power functions representing the slope of the concentration-effect relationship (gamma) were 5.7 +/- 1.9 and 4.4 +/- 1.8.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为研究轻度低温对神经肌肉接头处维库溴铵敏感性的影响,我们在异氟烷-氧化亚氮-芬太尼麻醉期间,测定了10例患者(美国麻醉医师协会身体状况分级为I或II级;年龄范围21 - 46岁;体重范围54 - 104 kg)体内维库溴铵的药效学(浓度-效应关系)。5例患者被冷却至平均体温34.4摄氏度,另5例维持正常体温,平均体温为36.8摄氏度。通过测量腕部尺神经给予超强成串刺激后拇内收肌的诱发机械反应来监测神经肌肉功能。以3微克·千克⁻¹·分钟⁻¹的速率输注维库溴铵10分钟,采集静脉血60分钟,利用抽搐张力和血浆浓度数据来确定每位患者的药效学变量。低温组和正常体温组的结果采用曼-惠特尼U检验进行比较。低温患者和正常体温患者在任何药效学变量上均无差异。对于低温患者和正常体温患者,产生50%神经肌肉阻滞的维库溴铵稳态血浆浓度(Css50)分别为73±13纳克/毫升(平均值±标准差)和79±31纳克/毫升;维库溴铵在血浆与神经肌肉接头之间的平衡速率常数(Keo)分别为0.27±0.14每分钟⁻¹和0.26±0.11每分钟,代表浓度-效应关系斜率的幂函数(γ)分别为5.7±1.9和4.4±1.8。(摘要截选至250字)

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