Beauvoir C, Peray P, Daures J P, Peschaud J L, D'Athis F
Département d'Anesthésie-Réanimation A, Hôpital Lapeyronie, Montpellier, France.
Can J Anaesth. 1993 Aug;40(8):696-702. doi: 10.1007/BF03009763.
Eight trials comparing the effects of vecuronium in patients with either normal renal function or renal failure were subjected to a meta-analysis. Vecuronium doses were similar in the different trials, identical in the two patient groups of any given trial, and ranged from 0.05 to 0.14 mg.kg-1. Neuromuscular blockade was assessed by TOF or single twitch stimulation, and recorded by either mechanomyography or electromyography. Indices of blockade included onset time (from injection to maximal twitch depression), duration of action (from injection to recovery to 25% of control twitch) and 25-75% recovery index. Statistical analysis used Hedges method: effect size and variance were calculated for each relevant outcome, then the global effect size was estimated by pooling the effect sizes of each trial. Three separate meta-analyses were conducted. No differences were found either in onset time, or in recovery index between the two groups, whereas the duration of action was longer in the renal failure group. It is concluded that renal function is likely involved in the pharmacokinetic parameters of vecuronium.
八项比较维库溴铵在肾功能正常或肾衰竭患者中作用效果的试验进行了荟萃分析。不同试验中的维库溴铵剂量相似，在任何给定试验的两组患者中剂量相同，范围为0.05至0.14mg·kg-1。通过强直刺激后计数（TOF）或单次颤搐刺激评估神经肌肉阻滞，并通过肌机械图或肌电图记录。阻滞指标包括起效时间（从注射到最大颤搐抑制）、作用持续时间（从注射到恢复至对照颤搐的25%）和25%-75%恢复指数。统计分析采用Hedges方法：计算每个相关结局的效应大小和方差，然后通过汇总每个试验的效应大小来估计总体效应大小。进行了三项独立的荟萃分析。两组之间在起效时间或恢复指数方面均未发现差异，而肾衰竭组的作用持续时间更长。结论是肾功能可能参与了维库溴铵的药代动力学参数。
