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芬太尼麻醉期间罗库溴铵的血流动力学效应:与维库溴铵的比较。

Haemodynamic effects of rocuronium during fentanyl anaesthesia: comparison with vecuronium.

作者信息

McCoy E P, Maddineni V R, Elliott P, Mirakhur R K, Carson I W, Cooper R A

机构信息

Department of Anaesthesia, Queen's University, Belfast, Northern Ireland.

出版信息

Can J Anaesth. 1993 Aug;40(8):703-8. doi: 10.1007/BF03009764.

Abstract

Haemodynamic variables were measured following administration of rocuronium 0.6 mg.kg-1 or vecuronium 0.08 mg.kg-1 (approximately equivalent to 2 x ED95 doses) in patients anaesthetized with fentanyl 50 micrograms.kg-1 and scheduled to undergo elective coronary artery bypass grafting. There were increases in stroke volume index (+15%) and cardiac index (+11%), and a decrease in pulmonary capillary wedge pressure (-25%) following administration of rocuronium (P < 0.05). The changes in heart rate (+7%), mean arterial pressure (-5%), systemic vascular resistance (-12%) and other measured or derived indices were insignificant. In comparison the administration of vecuronium was associated with decreases in heart rate (-7%), mean pulmonary artery pressure (-17%), central venous pressure (-15%) and the rate-pressure product (-9%) (P < 0.05). The changes in mean arterial pressure (-7%), cardiac index (-6%) and systemic vascular resistance (-8%) following vecuronium were insignificant. There were no differences in any of the variables between rocuronium and vecuronium. The absolute values of all variables were, however, within acceptable clinical limits. There was no evidence of histamine release in any patient. The present study shows that rocuronium 0.6 mg.kg-1 is associated with changes of only small magnitude in haemodynamic variables.

摘要

在接受50微克/千克芬太尼麻醉且计划进行择期冠状动脉搭桥术的患者中,静脉注射0.6毫克/千克罗库溴铵或0.08毫克/千克维库溴铵(约相当于2倍ED95剂量)后,测量血流动力学变量。注射罗库溴铵后,每搏量指数增加(+15%)、心脏指数增加(+11%),肺毛细血管楔压降低(-25%)(P<0.05)。心率增加(+7%)、平均动脉压降低(-5%)、全身血管阻力降低(-12%)以及其他测量或推导指标的变化均无统计学意义。相比之下,注射维库溴铵后心率降低(-7%)、平均肺动脉压降低(-17%)、中心静脉压降低(-15%)以及心率-血压乘积降低(-9%)(P<0.05)。注射维库溴铵后平均动脉压降低(-7%)、心脏指数降低(-6%)和全身血管阻力降低(-8%)无统计学意义。罗库溴铵和维库溴铵之间的任何变量均无差异。然而,所有变量的绝对值均在可接受的临床范围内。未发现任何患者有组胺释放的证据。本研究表明,0.6毫克/千克罗库溴铵仅引起血流动力学变量的微小变化。

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