Keneally J P, Goonetilleke P H, Ramzan I M
Department of Anaesthesia, Children's Hospital, Camperdown, NSW.
Anaesth Intensive Care. 1993 Apr;21(2):197-200. doi: 10.1177/0310057X9302100211.
The effect of alcuronium dichloride (0.3 mg/kg) was studied in seven normal children (Group A), nine with acyanotic congenital heart disease (Group B) and eight with cyanotic disease (Group C). The onset of action was recorded using an integrated electromyograph and blood samples taken for later estimation of plasma concentrations of the drug. The mean time (SD) taken to 75% suppression of twitch height was 1.3(0.8), 1.7(1.0) and 3.8(2.8) minutes, respectively, in each of the three groups. This was significantly slower in Group C compared with both other groups (P < 0.05). While six of the Group A patients and seven from Group B reached 95% paralysis within ten minutes, only two of the cyanosed children achieved this level of relaxation. However, if times to 95% relaxation were extrapolated, there was no significant difference between the groups at 4.5(3.9), 5.8(5.7) and 10.9(6.5) minutes respectively. There was a weak but statistically significant relationship between haematocrit and time to 75% blockade. Maximum twitch depression was similar in all three groups with plasma concentrations at this time being 1.6(0.7), 1.8(0.5) and 2.3(1.4) micrograms/ml respectively. Again, there was no statistically significant difference between these values. These results confirm that the clinical onset of relaxation is delayed in children with cyanotic congenital heart disease, possibly because of delayed distribution of alcuronium.
在七名正常儿童（A组）、九名无青紫型先天性心脏病儿童（B组）和八名青紫型疾病儿童（C组）中研究了二氯阿库氯铵（0.3mg/kg）的作用。使用集成肌电图记录起效时间，并采集血样用于随后测定药物的血浆浓度。三组中达到颤搐高度抑制75%的平均时间（标准差）分别为1.3（0.8）、1.7（1.0）和3.8（2.8）分钟。与其他两组相比，C组明显更慢（P<0.05）。A组六名患者和B组七名患者在十分钟内达到95%的麻痹状态，而青紫型儿童中只有两名达到了这种松弛程度。然而，如果外推至95%松弛的时间，三组分别为4.5（3.9）、5.8（5.7）和10.9（6.5）分钟，无显著差异。血细胞比容与达到75%阻滞的时间之间存在微弱但具有统计学意义的关系。三组最大颤搐抑制相似，此时血浆浓度分别为1.6（0.7）、1.8（0.5）和2.3（1.4）微克/毫升。同样，这些值之间无统计学显著差异。这些结果证实，青紫型先天性心脏病儿童临床松弛起效延迟，可能是因为阿库氯铵分布延迟。
