Meretoja O A, Olkkola K T
Department of Anaesthesia, Children's Hospital University of Helsinki, Finland.
Br J Anaesth. 1993 Aug;71(2):232-7. doi: 10.1093/bja/71.2.232.
A computerized infusion system was used to determine requirement for a mivacurium infusion to maintain a 95% and a 50% neuromuscular block in 21 children aged 1-15 yr. Neuromuscular block was measured by adductor pollicis EMG and anaesthesia maintained with 66% nitrous oxide in oxygen and alfentanil 50-100 micrograms kg-1 h-1. The targeted neuromuscular block was reached within mean 5 (SD 3) min from initiation of an infusion. Mivacurium requirement for 95% neuromuscular block was 950 (350) micrograms kg-1 h-1, which represented an hourly requirement of 6.8 (1.6) individual ED95 doses. Infusion requirement for 50% neuromuscular block averaged 350 (150) micrograms kg-1 h-1. There was a significant negative correlation between infusion rate and age of a patient. Great individual variation of the infusion rate makes a computerized infusion an easy method to achieve and maintain a desired level of neuromuscular block. No side effects of mivacurium were noticed.
采用计算机化输注系统，测定21例1至15岁儿童维持95%和50%神经肌肉阻滞所需的米库氯铵输注量。通过拇收肌肌电图测定神经肌肉阻滞，并采用66%氧化亚氮与氧气混合气体及50 - 100微克/千克/小时的阿芬太尼维持麻醉。从开始输注起，平均5（标准差3）分钟内达到目标神经肌肉阻滞。维持95%神经肌肉阻滞所需的米库氯铵量为950（350）微克/千克/小时，相当于每小时6.8（1.6）个ED95个体剂量。维持50%神经肌肉阻滞的输注量平均为350（150）微克/千克/小时。患者的输注速率与年龄之间存在显著负相关。输注速率的个体差异很大，使得计算机化输注成为实现和维持所需神经肌肉阻滞水平的简便方法。未观察到米库氯铵的副作用。
