Beaufort A M, Wierda J M, Belopavlovic M, Nederveen P J, Kleef U W, Agoston S
Research Group for Experimental Anesthesiology and Clinical Pharmacology, University of Groningen, The Netherlands.
Eur J Anaesthesiol Suppl. 1995 Sep;11:95-106.
Hypothermia prolongs the time-course of action of non-depolarizing neuromuscular blocking agents. The mechanism, however, is unknown. We studied the influence of hypothermia (by surface cooling, nasopharyngeal temperature < or = 31 degrees C) on the time-course of action and on the pharmacokinetics of rocuronium in humans. Nineteen neurosurgical patients were divided into hypothermic and normothermic groups. Hypothermia (30.4 +/- 0.8 degrees C (mean +/- SD)) increased the duration of action, temperature dependently, and delayed the recovery. Hypothermia reduced the plasma clearance significantly (2.17 +/- 0.62 vs. 4.26 +/- 0.50 mL kg-1 min-1, P = 0.004), did not change the volume of distribution (224 +/- 64 vs. 232 +/- 60 mL kg-1 min-1, P = 1.0), and prolonged the mean residence time (108 +/- 39 vs. 56 +/- 19 mL kg-1 min-1, P = 0.01). We conclude that hypothermia prolongs the duration of action of rocuronium and delays spontaneous recovery and that altered pharmacokinetics, such as a decreased clearance, play an important role in this.
体温过低会延长非去极化神经肌肉阻滞剂的作用时间。然而，其机制尚不清楚。我们研究了体温过低（通过体表降温，鼻咽温度≤31℃）对罗库溴铵在人体中的作用时间和药代动力学的影响。19例神经外科患者被分为体温过低组和正常体温组。体温过低（30.4±0.8℃（均值±标准差））依温度依赖性增加了作用持续时间，并延迟了恢复。体温过低显著降低了血浆清除率（2.17±0.62对4.26±0.50 mL·kg⁻¹·min⁻¹，P = 0.004），未改变分布容积（224±64对232±60 mL·kg⁻¹·min⁻¹，P = 1.0），并延长了平均驻留时间（108±39对56±19 mL·kg⁻¹·min⁻¹，P = 0.01）。我们得出结论，体温过低会延长罗库溴铵的作用持续时间并延迟自主恢复，药代动力学改变，如清除率降低，在其中起重要作用。
