Withington D E, Davis G M, Vallinis P, Del Sonno P, Bevan J C
Department of Anaesthesia, Montreal Children's Hospital, Québec, Canada.
Paediatr Anaesth. 1998;8(1):41-7. doi: 10.1046/j.1460-9592.1998.00711.x.
Residual neuromuscular blockade is a major risk factor for respiratory insufficiency. We examined the relationship between neuromuscular and respiratory function in 18 ASA I or II children aged 2-4 years. Lung function was measured by pneumotachography and transpulmonary pressure, neuromuscular transmission by first twitch response ratio (T1:T1) and train-of-four ratio (TOFR), before and at specific points in recovery from vecuronium paralysis. The tidal volume was directly related to maximal inspiratory pressure at occlusion (PIOCC), P < 0.001, whereas the minute ventilation (VE) was related to the respiratory drive (P0.1), P < 0.001. The best predictors of minute ventilation were the P0.1 (r = 0.57), and the TOFR (r = 0.62). PIOCC and P0.1 correlated closely (r = 0.889, P = 0.002) but TOFR and T1:T1 did not correlate with either. Our results show that the occlusion pressure measurements, P0.1 and PIOCC, were good predictors of both VE.kg-1 and respiratory work.
残余神经肌肉阻滞是呼吸功能不全的主要危险因素。我们研究了18名年龄在2至4岁的美国麻醉医师协会（ASA）I或II级儿童的神经肌肉功能与呼吸功能之间的关系。在维库溴铵麻痹恢复前及恢复过程中的特定时间点，通过呼吸流速仪和跨肺压测量肺功能，通过单刺激颤搐反应比值（T1:T1）和四个成串刺激比值（TOFR）测量神经肌肉传递。潮气量与吸气末阻断压（PIOCC）直接相关，P<0.001，而分钟通气量（VE）与呼吸驱动相关（P0.1），P<0.001。分钟通气量的最佳预测指标是P0.1（r=0.57）和TOFR（r=0.62）。PIOCC和P0.1密切相关（r=0.889，P=0.002），但TOFR和T1:T1与二者均无相关性。我们的结果表明，阻断压测量值P0.1和PIOCC是VE.kg-1和呼吸功的良好预测指标。
