Kumar N, Mirakhur R K, Symington M J, McCarthy G J
Department of Anaesthetics, Queen's University of Belfast.
Br J Anaesth. 1996 Oct;77(4):488-91. doi: 10.1093/bja/77.4.488.
We have studied the potency and onset and duration of action of rocuronium in patients anaesthetized with 1 MAC of desflurane or isoflurane (in 66% nitrous oxide). Potency was estimated using the single bolus dose technique. Neuromuscular block was measured by stimulation of the ulnar nerve and recording the force of contraction of the adductor pollicis muscle. The ED50 and ED95 of rocuronium were estimated as 138 (95% confidence limits 117-162) micrograms kg-1 and 281 (241-328) micrograms kg-1, and 126 (105-151) micrograms kg-1 and 283 (236-339) micrograms kg-1 during desflurane and isoflurane anaesthesia, respectively. The mean times to onset of maximum block after rocuronium 0.6 mg kg-1 were 1.0 (SD 0.10) min and 1.1 (0.15) min, respectively, during anaesthesia with desflurane and isoflurane. The respective times to recovery of T1 (the first response in the train-of-four (TOF) stimulation) to 25% and 90% were 36 (8.3) min and 54 (15.4) min during desflurane anaesthesia and 31 (8.2) min and 45 (12.7) min during isoflurane anaesthesia. The times to recovery of the TOF ratio to 0.7 were 66 (13.4) min and 52 (16.3) min and the 25-75% recovery indices 14 (5.3) min and 10 (3.2) min, respectively, in the desflurane and isoflurane groups. There were no differences in the estimated potency or onset of action of rocuronium during desflurane and isoflurane anaesthesia. However, duration of action tended to be longer curing desflurane anaesthesia although only the differences in times to TOF ratio of 0.7 and the recovery indices were close to being significantly different (P = 0.0503 and 0.0560).
我们研究了在接受1 MAC地氟烷或异氟烷(含66%氧化亚氮)麻醉的患者中罗库溴铵的效价、起效时间和作用持续时间。采用单次推注剂量技术评估效价。通过刺激尺神经并记录拇内收肌收缩力来测量神经肌肉阻滞。罗库溴铵的ED50和ED95在接受地氟烷麻醉时分别估计为138(95%置信区间117 - 162)微克/千克和281(241 - 328)微克/千克,在接受异氟烷麻醉时分别为126(105 - 151)微克/千克和283(236 - 339)微克/千克。在给予0.6毫克/千克罗库溴铵后,达到最大阻滞的平均起效时间在接受地氟烷麻醉时为1.0(标准差0.10)分钟,在接受异氟烷麻醉时为1.1(0.15)分钟。在接受地氟烷麻醉时,T1(四个成串刺激(TOF)中的第一个反应)恢复到25%和90%的相应时间分别为36(8.3)分钟和54(15.4)分钟,在接受异氟烷麻醉时分别为31(8.2)分钟和45(12.7)分钟。在接受地氟烷和异氟烷麻醉的两组中,TOF比值恢复到0.7的时间分别为66(13.4)分钟和52(16.3)分钟,25 - 75%恢复指数分别为14(5.3)分钟和10(3.2)分钟。在接受地氟烷和异氟烷麻醉期间,罗库溴铵的估计效价或起效时间没有差异。然而,虽然只有TOF比值恢复到0.7的时间和恢复指数的差异接近显著水平(P = 0.0503和0.0560),但在接受地氟烷麻醉期间作用持续时间往往更长。