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米库氯铵与阿曲库铵神经肌肉阻滞作用的比较

[Comparison of neuromuscular blockade by mivacurium and atracurium].

作者信息

Hofmockel R, Benad G, Jantschulev S

机构信息

Klinik für Anaesthesiologie und Intensivtherapie der Universität Rostock.

出版信息

Anaesthesiol Reanim. 1995;20(1):4-11.

PMID:8526957
Abstract

The aim of our randomized controlled study was to compare the neuromuscular characteristics of mivacurium and atracurium by evaluating the intubation conditions, intubation times, onset times and the duration of action of these two muscle relaxants using two different dosing principles. Forty-eight patients were included in this study. All patients were premedicated orally with 0.2 mg/kg diazepam. Anaesthesia was induced with 2.0 mg/kg propofol and 0.02 mg/kg alfentanil and maintained with 6 mg/kg/h propofol and 60% nitrous oxide in oxygen. Neuromuscular monitoring was carried out with supramaximal TOF-stimulation (2 HZ) of the ulnar nerve every 10 seconds and recording of the mechanomyogram (MMG) (Myograph 2000, Biometer) at the adductor pollicis muscle. The patients of group 1 (n = 12) received an intubation dose of 0.15 mg/kg mivacurium (2 x ED95) and the patients of group 2 (n = 12) received a priming dose of 0.015 mg/kg mivacurium (20% of ED95) followed by an intubation dose of only 0.07 mg/kg mivacurium (ED95) two minutes later. The patients of group 3 (n = 12) were intubated with 0.46 mg/kg atracurium (2 x ED95) and the patients of group 4 (n = 12) received a priming dose of 0.046 mg/kg atracurium (20% of ED95) and an intubation dose of 0.23 mg/kg atracurium (ED95) four minutes later. The patients were intubated under normocapnic conditions and following stabilisation of the palmar skin temperature after a 90% neuromuscular block (T1) had occurred. The intubation conditions were measured semiquantitatively using an intubation score.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们随机对照研究的目的是通过使用两种不同的给药原则,评估米库氯铵和阿曲库铵的插管条件、插管时间、起效时间和作用持续时间,以比较这两种肌肉松弛剂的神经肌肉特性。本研究纳入了48例患者。所有患者均口服0.2mg/kg地西泮进行术前用药。采用2.0mg/kg丙泊酚和0.02mg/kg阿芬太尼诱导麻醉,并用6mg/kg/h丙泊酚和60%氧化亚氮-氧气维持麻醉。每隔10秒对尺神经进行超强强直刺激(2Hz),并在拇收肌记录机械肌电图(MMG)(Myograph 2000,Biometer),进行神经肌肉监测。第1组(n = 12)患者接受0.15mg/kg米库氯铵(2倍ED95)的插管剂量,第2组(n = 12)患者先接受0.015mg/kg米库氯铵(ED95的20%)的预充剂量,两分钟后再接受仅0.07mg/kg米库氯铵(ED95)的插管剂量。第3组(n = 12)患者用0.46mg/kg阿曲库铵(2倍ED95)插管,第4组(n = 12)患者先接受0.046mg/kg阿曲库铵(ED95的20%)的预充剂量,4分钟后再接受0.23mg/kg阿曲库铵(ED95)的插管剂量。患者在正常二氧化碳分压条件下,且在90%神经肌肉阻滞(T1)出现后手掌皮肤温度稳定后进行插管。使用插管评分对插管条件进行半定量测量。(摘要截断于250字)

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