Luo X, Yie T, Luo A, Ren H, Jin Y
Department of Anesthesiology, Peking Union Medical College Hospital, Beijing.
Chin Med Sci J. 1994 Mar;9(1):56-8.
Myasthenia gravis patients are hypersensitive to nondepolarizing relaxants, such as alcuronium, an intermediate-long nondepolarizing agent. This study observed the effects of alcuronium treatment in myasthenia gravis patients as compared with non-MG patients during operation. Ten MG patients (Ossermann class I-IV, scheduled for thymectomy) and 10 non-MG patients (ASA class I-II, scheduled for operation) were selected. An induction dose of alcuronium 0.2 mg/kg and thiopental 4-6 mg/kg was given, followed by intubation and ventilation with 50% nitrous oxide in oxygen and 0.5-1.5% ethrane. Neuromuscular transmission was monitored using an accelerograph and degrees of neuromuscular function at different depths were recorded. There were statistically significant differences between the two groups. The effect of alloferin in the MG group was quicker and deeper. This study also found a relation between MG class and the recovery of respiration: Respiratory recovery was quicker in classes I-II than in classes III-IV.
重症肌无力患者对非去极化肌松药高度敏感,如阿库氯铵,一种中长效非去极化剂。本研究观察了在手术期间阿库氯铵治疗重症肌无力患者与非重症肌无力患者相比的效果。选取了10例重症肌无力患者(Ossermann I - IV级,计划行胸腺切除术)和10例非重症肌无力患者(ASA I - II级,计划行手术)。给予诱导剂量的阿库氯铵0.2mg/kg和硫喷妥钠4 - 6mg/kg,随后进行插管,并使用50%氧化亚氮与氧气混合及0.5 - 1.5%恩氟烷进行通气。使用加速度仪监测神经肌肉传递,并记录不同深度的神经肌肉功能程度。两组之间存在统计学显著差异。阿库氯铵在重症肌无力组的作用更快且更深。本研究还发现重症肌无力分级与呼吸恢复之间存在关联:I - II级患者的呼吸恢复比III - IV级患者更快。