Scheiber G, Ribeiro F C, Marichal A, Bredendiek M, Renzing K
Department of Anesthesiology, University Hospital, Essen, Germany.
Anesth Analg. 1996 Aug;83(2):320-4. doi: 10.1097/00000539-199608000-00020.
To evaluate muscle relaxant onset times and tracheal intubating conditions, 60 children (ASA physical status I or II) aged 18 to 72 mo were randomly assigned to receive a bolus of either rocuronium 0.6 mg/kg, vecuronium 0.1 mg/kg, or atracurium 0.5 mg/kg. After induction of anesthesia with etomidate 0.2-0.4 mg/kg and fentanyl 1-3 mg/kg, lungs were ventilated with 50% nitrous oxide in oxygen via a face mask. The evoked electromyogram of the adductor pollicis to a train-of-four stimulation every 20 s was monitored. After administration of the muscle relaxant, endotracheal intubation was attempted every 30 s, beginning 30 s after drug administration, until intubation could be achieved with good or excellent conditions. Rocuronium produced acceptable intubating conditions significantly faster (all tracheas intubated within 60 s) compared with vecuronium (120 s) and atracurium (180 s). The quality of intubating conditions at the time of completed intubation was rated significantly better with rocuronium than with vecuronium or atracurium. However, onset to 95% block at the adductor pollicis muscle was not significantly different after rocuronium (92 +/- 46.9 s), vecuronium (112 +/- 33.3 s), or atracurium (134 +/- 57.1 s), and mean neuromuscular block achieved at the point of successful intubation was not complete in all groups. We conclude that clinically acceptable intubating conditions are produced more rapidly with rocuronium than with atracurium or vecuronium.
为评估肌肉松弛剂的起效时间和气管插管条件，将60名年龄在18至72个月的儿童（ASA身体状况I或II级）随机分组，分别给予0.6 mg/kg罗库溴铵、0.1 mg/kg维库溴铵或0.5 mg/kg阿曲库铵静脉推注。在使用0.2 - 0.4 mg/kg依托咪酯和1 - 3 μg/kg芬太尼诱导麻醉后，经面罩用含50%氧化亚氮的氧气进行肺通气。每20秒监测一次拇内收肌对四个成串刺激的诱发肌电图。给予肌肉松弛剂后，在给药后30秒开始，每隔30秒尝试进行气管插管，直至能在良好或极佳条件下完成插管。与维库溴铵（120秒）和阿曲库铵（180秒）相比，罗库溴铵能显著更快地产生可接受的插管条件（所有气管在60秒内完成插管）。完成插管时，罗库溴铵组的插管条件质量评分显著优于维库溴铵组或阿曲库铵组。然而，罗库溴铵（92±46.9秒）、维库溴铵（112±33.3秒）或阿曲库铵（134±57.1秒）使拇内收肌达到95%阻滞的起效时间无显著差异，且所有组在成功插管时达到的平均神经肌肉阻滞均未完全。我们得出结论，与阿曲库铵或维库溴铵相比，罗库溴铵能更快地产生临床上可接受的插管条件。
