Maddineni V R, Mirakhur R K, Cooper R, McCoy E
Department of Anaesthetics, Queen's University of Belfast.
Br J Anaesth. 1993 Jun;70(6):694-5. doi: 10.1093/bja/70.6.694.
We have assessed the potency of mivacurium, a new non-depolarizing neuromuscular blocker, using two different modes of nerve stimulation in patients anaesthetized with thiopentone, fentanyl and nitrous oxide in oxygen. The force of contraction of adductor pollicis was measured after single twitch stimulation at 0.1 Hz or train-of-four stimulation (TOF) at 2 Hz every 10 s. Dose-response curves were constructed using a single-dose method for each mode of stimulation. The ED50 and ED95 were 43 micrograms kg-1 and 83 micrograms kg-1, respectively, for the single twitch responses and 34 micrograms kg-1 and 66 micrograms kg-1, respectively, for the first response of the TOF stimulation. The difference between the ED95 doses was not significant (P = 0.051), but the difference between the ED50 doses was significant (P = 0.03), suggesting greater sensitivity of the neuromuscular junction using TOF stimulation. The results show that the information obtained using single twitch stimulation at 0.1 Hz is not the same as that obtained from the first response of the TOF stimulation.
我们在接受硫喷妥钠、芬太尼和氧化亚氮-氧气麻醉的患者中，采用两种不同的神经刺激模式，评估了一种新型非去极化神经肌肉阻滞剂米库氯铵的效能。每隔10秒，在0.1Hz的单次颤搐刺激或2Hz的四个成串刺激（TOF）后，测量拇内收肌的收缩力。针对每种刺激模式，采用单剂量法构建剂量-反应曲线。单次颤搐反应的ED50和ED95分别为43微克/千克和83微克/千克，TOF刺激首次反应的ED50和ED95分别为34微克/千克和66微克/千克。ED95剂量之间的差异不显著（P = 0.051），但ED50剂量之间的差异显著（P = 0.03），这表明使用TOF刺激时神经肌肉接头的敏感性更高。结果表明，0.1Hz单次颤搐刺激获得的信息与TOF刺激首次反应获得的信息不同。
