Chu Y C, Lin S M, Huang Y C, Hui K W, Tsai S K, Lee T Y
Department of Anesthesiology, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Acta Anaesthesiol Sin. 1997 Mar;35(1):15-20.
Mivacurium is considered a relaxant suitable for tracheal intubation in children due to its rapid onset. We compared the neuromuscular effects of mivacurium, with and without priming, in children undergoing elective surgery during halothane anesthesia.
Forty pediatric patients (2-10 yr, ASA class I) were randomly into 2 groups and studied under halothane anesthesia. The non-priming group (n = 20) received mivacurium 0.25 mg/kg, and the priming group (n = 20) received a priming dose of mivacurium 0.025 mg/kg, followed by an intubating dose of 0.225 mg/kg 3 min later. Thenar Electromyogram responsive to supramaximal train-of-four stimulation of the ulnar nerve at 12 s intervals was used as neuromuscular monitoring.
The onset time in the priming group was significantly faster than in the non-priming group (1.04 min vs. 1.7 min). The mean time from injection of intubating dose to spontaneous recovery to 25%, 50% and 75% twitch were not influenced by priming technique. Side effects, such as cutaneous flushing and hypotension, were unremarkable at this dose in children.
Priming technique can significantly accelerates the onset of mivacurium in the pediatric patients under halothane anesthesia.
米库氯铵起效迅速,被认为是适用于儿童气管插管的肌松药。我们比较了在氟烷麻醉下接受择期手术的儿童中,使用和不使用预注法时米库氯铵的神经肌肉效应。
40例儿科患者(2 - 10岁,ASA I级)随机分为2组,在氟烷麻醉下进行研究。非预注组(n = 20)给予米库氯铵0.25 mg/kg,预注组(n = 20)先给予预注剂量的米库氯铵0.025 mg/kg,3分钟后再给予插管剂量的0.225 mg/kg。以对尺神经每隔12秒进行一次超强四个成串刺激的拇短展肌肌电图作为神经肌肉监测指标。
预注组的起效时间明显快于非预注组(1.04分钟对1.7分钟)。从注射插管剂量到自主恢复至颤搐高度的25%、50%和75%的平均时间不受预注技术的影响。在此剂量下,儿童中诸如皮肤潮红和低血压等副作用不明显。
预注技术可显著加快氟烷麻醉下儿科患者米库氯铵的起效时间。