Ribeiro F C, Scheiber G, Marichal A
Department of Anaesthesiology, Clinic Volmarstein, University Witten-Herdecke, Ruhr, Germany.
Eur J Anaesthesiol. 1998 May;15(3):310-3. doi: 10.1046/j.1365-2346.1998.00294.x.
In order to compare the neuromuscular effects following rocuronium 0.6 mg kg-1 and atracurium 0.5 mg kg-1 30 children aged from 18 to 67 months were studied under the same anaesthetic conditions. After induction of anaesthesia with etomidate and fentanyl, neuromuscular blockade was monitored by recording the electromyographic response of the adductor pollicis muscle to a supramaximal train-of-four (TOF) stimulation of the ulnar nerve at 2 Hz for 2 s at 20-s intervals. Intubation was performed when more than 90% muscle relaxation was achieved, thereafter anaesthesia was maintained with 70% nitrous oxide in oxygen and isoflurane 0.5% end-tidal. Mean onset of action was significantly faster following rocuronium (86 +/- 44.9 s) (mean +/- SD) compared with atracurium (126.3 +/- 61.0 s). Clinical duration with rocuronium was 22.8 +/- 5.31 min and thus significantly shorter than that of atracurium, which was 31.5 +/- 6.01 min. A statistically significant difference between rocuronium and atracurium also had been found for recovery of T1 to 50%, 75% and 90% as well as for the time taken to a TOF ratio of 70%. The recovery index for rocuronium and atracurium was not significantly different with 9.2 +/- 3.43 min and 10.9 +/- 2.65 min, respectively. Thus, rocuronium may be more advantageous than atracurium for short-lasting surgical procedures in young children.
为比较0.6 mg/kg罗库溴铵和0.5 mg/kg阿曲库铵的神经肌肉效应，在相同麻醉条件下对30名年龄在18至67个月的儿童进行了研究。在依托咪酯和芬太尼诱导麻醉后，通过记录拇收肌对尺神经以2 Hz频率进行2 s的超强四个成串刺激（TOF）的肌电图反应，间隔20 s进行神经肌肉阻滞监测。当肌肉松弛超过90%时进行插管，此后用70%氧化亚氮和0.5%呼气末异氟烷维持麻醉。与阿曲库铵（126.3±61.0 s）相比，罗库溴铵的平均起效时间（86±44.9 s）（平均值±标准差）明显更快。罗库溴铵的临床作用时间为22.8±5.31分钟，因此明显短于阿曲库铵的31.5±6.01分钟。在罗库溴铵和阿曲库铵之间，T1恢复到50%、75%和90%以及达到TOF比值70%所需的时间也存在统计学显著差异。罗库溴铵和阿曲库铵的恢复指数分别为9.2±3.43分钟和10.9±2.65分钟，无显著差异。因此，对于幼儿的短期外科手术，罗库溴铵可能比阿曲库铵更具优势。
