Latorre F, Stanek A, Gervais H W, Kleemann P P
Klinik für Anästhesiologie, Johannes-Gutenberg-Universität Mainz.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1996 Oct;31(8):470-3. doi: 10.1055/s-2007-995961.
Rocuronium is a new non-depolarising steroidal muscle relaxant with a short onset time. The present study was undertaken to compare intubating conditions as well as onset and clinical duration of a single dose of 0.6 mg/kg (2 x ED95) with a single dose of 1 mg/kg suxamethonium (3 x ED95).
After obtaining informed consent and approval of the Ethics Committee, 40 adult patients (ASA I-III) participated in this study. After premedication with oxazepam, anaesthesia was induced with fentanyl and propofol and maintained with propofol, N2O and supplements of fentanyl as needed. Muscular relaxation was assessed by EMG recording of adductor pollicis muscle after supramaximal single twitch stimulation of the ulnar nerve every 10 s. Patients were allocated randomly to receive either rocuronium 0.6 mg/kg or suxamethonium 1 mg/kg. The following parameters were measured: intubating conditions 60 s after injection, onset time and clinical duration of neuromuscular block, % block at intubation, heart rate, blood pressure and arterial oxygen saturation.
(mean +/- SD). Intubating conditions after rocuronium and suxamethonium were found to be clinically acceptable (excellent or good) in 90% of patients, though there was only a partial blockade of the adductor pollicis muscle with rocuronium (71 +/- 23%) compared to suxamethonium (95 +/- 14%) (p < 0.05). The onset time and clinical duration of relaxation was shorter after suxamethonium (p < 0.05) and occurred at 0.8 +/- 0.2, 7 +/- 2.1 and 3.2 +/- 1.3, 29 +/- 11 min after suxamethonium and rocuronium respectively.
At a dosage of 0.6 mg/kg, rocuronium has an onset time of about 3 min and a clinical duration of relaxation of nearly half an hour. These data are supported by various studies, while others show shorter times, probably due to different monitoring techniques. In spite of the pharmacodynamic differences between suxamethonium and rocuronium, the intubating conditions after administration of both compounds are comparable and develop at the same rate.
罗库溴铵是一种起效时间短的新型非去极化甾体类肌肉松弛剂。本研究旨在比较单剂量0.6mg/kg（2倍ED95）罗库溴铵与单剂量1mg/kg琥珀胆碱（3倍ED95）的插管条件以及起效时间和临床作用持续时间。
在获得知情同意并经伦理委员会批准后，40例成年患者（ASA I - III级）参与本研究。用奥沙西泮进行术前用药后，用芬太尼和丙泊酚诱导麻醉，并根据需要用丙泊酚、N2O和芬太尼补充维持麻醉。每隔10秒对尺神经进行超强单刺激后，通过拇收肌的肌电图记录评估肌肉松弛情况。患者随机分配接受0.6mg/kg罗库溴铵或1mg/kg琥珀胆碱。测量以下参数：注射后60秒的插管条件、神经肌肉阻滞的起效时间和临床持续时间、插管时的阻滞百分比、心率、血压和动脉血氧饱和度。
（均值±标准差）。罗库溴铵和琥珀胆碱给药后的插管条件在90%的患者中被认为临床上可接受（优或良），尽管与琥珀胆碱（95±14%）相比，罗库溴铵对拇收肌只有部分阻滞（71±23%）（p<0.05）。琥珀胆碱后的起效时间和肌肉松弛临床持续时间较短（p<0.05），分别在琥珀胆碱和罗库溴铵给药后0.8±0.2、7±2.1分钟和3.2±1.3、29±11分钟出现。
剂量为0.6mg/kg时，罗库溴铵的起效时间约为3分钟，肌肉松弛临床持续时间近半小时。这些数据得到了各种研究的支持，而其他研究显示时间更短，可能是由于监测技术不同。尽管琥珀胆碱和罗库溴铵之间存在药效学差异，但两种化合物给药后的插管条件相当，且发展速度相同。
