Iwasaki H, Yamauchi M, Narimatsu E, Yamakage M, Tsuchida H, Namiki A
Department of Anesthesiology, Sapporo Medical University, School of Medicine, Japan.
Can J Anaesth. 1997 Nov;44(11):1208-10. doi: 10.1007/BF03013347.
To evaluate the onset of vecuronium neuromuscular blockade in the hand with an arterio-venous shunt for haemodialysis.
In 15 adult patients receiving haemodialysis for renal failure the onset of vecuronium-induced neuromuscular blockade after 0.08 mg-kg-1 vecuronium i.v. was measured. Using train-of-four mechanomyographic monitoring, the force of contraction of the adductor pollicis of both hands with and without arterio-venous shunt was measured simultaneously.
The times from the injection to the first depression of twitch response (latent onset) and 95% twitch depression (onset) in the hand with and without arterio-venous shunt were 114.7 +/- 33.4 and 218.7 +/- 59.9 and 117.3 +/- 34.3 and 208.7 +/- 60.9 sec respectively. No difference in the onset of vecuronium neuromuscular blockade in the hand an arterio-venous shunt was demonstrated.
The presence of an arteriovenous fistula does not modify the onset on neuromuscular blockade. Either arm can be used to monitor onset of neuromuscular blockade in chronic renal failure patients with an arterio-venous shunt in the hand for haemodialysis.
评估在有用于血液透析的动静脉分流的手部，维库溴铵神经肌肉阻滞的起效情况。
对15例因肾衰竭接受血液透析的成年患者，静脉注射0.08 mg·kg-1维库溴铵后，测量维库溴铵诱导的神经肌肉阻滞的起效情况。使用四个成串肌机械图监测，同时测量双手在有和没有动静脉分流情况下拇内收肌的收缩力。
在有和没有动静脉分流的手部，从注射到抽搐反应首次降低（潜伏起效）和95%抽搐降低（起效）的时间分别为114.7±33.4和218.7±59.9秒以及117.3±34.3和208.7±60.9秒。未显示有动静脉分流的手部维库溴铵神经肌肉阻滞起效有差异。
动静脉内瘘的存在不会改变神经肌肉阻滞的起效。对于手部有用于血液透析的动静脉分流的慢性肾衰竭患者，任一侧手臂均可用于监测神经肌肉阻滞的起效情况。
