Doenicke A, Moss J, Lorenz W, Mayer M, Rau J, Jedrzejewski A, Ostwald P
Institute of Anaesthesiology, Ludwig Maximilians-University, Munich, Germany.
Br J Anaesth. 1996 Sep;77(3):421-3. doi: 10.1093/bja/77.3.421.
In this randomized, double-blind, placebo-controlled study, we have examined histamine release, haemodynamic and cutaneous effects of mivacurium administered in low (0.105 mg kg-1 = 1.5 x ED95) and high (0.21 mg kg-1 = 3 x ED95) doses and assessed if oral pretreatment with H1/H2 antagonists would blunt the effects of mivacurium-induced histamine release. Patients received either ranitidine 300 mg and dimethindene 0.1 mg kg-1 (H1 blocker) or placebo, orally 1 h before induction of anaesthesia. Twelve patients were allocated to each group. Although plasma concentrations of histamine increased significantly in three patients in the placebo group given low-dose mivacurium, the mean value for the group was unchanged. Plasma concentrations of histamine increased significantly in five patients in the placebo group after high-dose mivacurium and the mean value was increased. There was no consistent correlation between haemodynamic changes, cutaneous manifestations and histamine concentrations. Significant cardiovascular reactions occurred in six patients in the placebo groups and in only one patient treated with antihistamines.
在这项随机、双盲、安慰剂对照研究中，我们研究了低剂量（0.105mg/kg = 1.5倍ED95）和高剂量（0.21mg/kg = 3倍ED95）米库氯铵的组胺释放、血流动力学及皮肤效应，并评估了术前口服H1/H2拮抗剂是否会减弱米库氯铵诱导的组胺释放效应。患者在麻醉诱导前1小时口服雷尼替丁300mg和二甲茚定0.1mg/kg（H1阻滞剂）或安慰剂。每组分配12例患者。虽然在给予低剂量米库氯铵的安慰剂组中有3例患者血浆组胺浓度显著升高，但该组平均值未变。高剂量米库氯铵后，安慰剂组有5例患者血浆组胺浓度显著升高，且平均值增加。血流动力学变化、皮肤表现与组胺浓度之间无一致的相关性。安慰剂组有6例患者发生显著的心血管反应，而抗组胺药治疗组仅有1例患者发生。
