Debaene B, Lieutaud T, Billard V, Meistelman C
Department of Anesthesia, Institut Gustave Roussy, Villejuif, France.
Anesthesiology. 1997 Jun;86(6):1300-5; discussion 7A. doi: 10.1097/00000542-199706000-00011.
ORG 9487 is a new steroidal nondepolarizing muscle relaxant with a rapid onset of action. This study was designed to determine the neuromuscular blocking profile of ORG 9487 at the adductor muscles of the larynx and the adductor pollicis.
In 30 adults, anesthesia was induced with propofol (2-5 mg/kg) and fentanyl (2-3 microg/kg). After train-of-four stimulation, the block of the laryngeal adductor muscles was evaluated by measuring the pressure changes in the cuff of the tracheal tube placed between the vocal cords, and the force of the contraction of the adductor pollicis was measured with a force transducer. Patients were randomly allocated to receive ORG 9487 at intravenous bolus doses of 0.75, 1.5 or 2 mg/kg (n = 10 in each group).
Time to peak effect was significantly shorter at the vocal cords than at the adductor pollicis muscle (P < 0.001). Onset time at the vocal cords was 62 +/- 16 s, 62 +/- 13 s, and 52 +/- 14 s (mean +/- SD) after doses of 0.75, 1.5, and 2 mg/kg, respectively (not significant). Onset time at the adductor pollicis muscle was 126 +/- 33 s, 96 +/- 20 s, and 82 +/- 21 s after 0.75, 1.5, and 2 mg/kg doses, respectively (P < 0.001). Maximum block was significantly less intense at the vocal cords than at the adductor pollicis muscle (69 +/- 15% vs. 94 +/- 4% after 0.75 mg/kg; 86 +/- 7% vs. 97 +/- 4% after 1.5 mg/kg; and 91 +/- 5% vs. 99 +/- 1% after 2 mg/kg). After 1.5 mg/kg duration to 25%, recovery was 3.7 +/- 2.2 min versus 10.2 +/- 2.5 min at the vocal cords and the adductor pollicis muscle, respectively, and 75% recovery occurred at 9.7 +/- 3.7 min at the vocal cords and at 18.3 +/- 5.2 min at the adductor pollicis muscle.
ORG 9487 has a rapid onset of action at the laryngeal adductor and the adductor pollicis muscles. Onset and duration of action are faster at the vocal cords than at the adductor pollicis muscle. However, the maximum block obtained at the laryngeal muscles was less than at the adductor pollicis, regardless of the dose of ORG 9487.
ORG 9487是一种新型甾体类非去极化肌肉松弛剂，起效迅速。本研究旨在确定ORG 9487在喉内收肌和拇内收肌的神经肌肉阻滞特征。
30例成年患者，采用丙泊酚（2 - 5mg/kg）和芬太尼（2 - 3μg/kg）诱导麻醉。在四个成串刺激后，通过测量置于声带间气管导管套囊内的压力变化来评估喉内收肌的阻滞情况，并用测力传感器测量拇内收肌的收缩力。患者被随机分配接受静脉推注剂量为0.75、1.5或2mg/kg的ORG 9487（每组n = 10）。
声带处达到峰值效应的时间显著短于拇内收肌（P < 0.001）。在剂量分别为0.75、1.5和2mg/kg后，声带处的起效时间分别为62±16秒、62±13秒和52±14秒（均值±标准差）（无显著差异）。在剂量为0.75、1.5和2mg/kg后，拇内收肌的起效时间分别为126±33秒、96±20秒和82±21秒（P < 0.001）。声带处的最大阻滞程度显著低于拇内收肌（0.75mg/kg后分别为69±15%对94±4%；1.5mg/kg后分别为86±7%对97±4%；2mg/kg后分别为91±5%对99±1%）。在1.5mg/kg剂量后，恢复至25%时，声带处为3.7±2.2分钟，拇内收肌处为10.2±2.5分钟；恢复至75%时，声带处为9.7±3.7分钟，拇内收肌处为18.3±5.2分钟。
ORG 9487在喉内收肌和拇内收肌起效迅速。声带处的起效和作用持续时间比拇内收肌更快。然而，无论ORG 9487剂量如何，喉肌获得的最大阻滞程度均低于拇内收肌。
