Shorten G D, Uppington J, Comunale M E
Department of Anaesthesia and Critical Care, Beth Israel Hospital, Boston, USA.
Eur J Anaesthesiol. 1998 May;15(3):335-41. doi: 10.1046/j.1365-2346.1998.00302.x.
Rocuronium administration may cause tachycardia and an increase in cardiac index. Pancuronium, another steroidal non-depolarizing muscle relaxant, augments release of, and blocks re-uptake of catecholamines at adrenergic nerve endings. This study compared the haemodynamic effects of, and changes in catecholamine concentrations following administration of vecuronium (0.12 mg kg-1) or rocuronium (0.9 mg kg-1) to elderly patients. Thirty patients, 65 years or older, not receiving beta-blockers, were studied. During thiopentone, fentanyl, nitrous oxide anaesthesia, either rocuronium (0.9 mg kg-1) or vecuronium (0.12 mg kg-1) was administered, according to random allocation. In all 30 patients, blood pressure and heart rate were measured before induction of anaesthesia, immediately and 1 min after induction, 1 and 2 min after muscle relaxant administration, and immediately, 1 and 2 min after tracheal intubation. In the latter 20 patients, samples for plasma catecholamine estimation were obtained prior to, and 1 min after muscle relaxant administration and 1 min after tracheal intubation. Blood pressure and heart rate were similar in the two groups throughout the study. Plasma noradrenaline concentrations were similar in the vecuronium and rocuronium groups prior to muscle relaxant administration (589(SD240) and 444(SD213) pg mL-1, respectively), 1 min after muscle relaxant administration (602(SD220) and 520(SD392) pg mL-1, respectively) and 1 min after tracheal intubation (597(SD351) and 440(SD181) pg mL, respectively). There was no significant change in either plasma noradrenaline or adrenaline concentrations in either group following muscle relaxant administration or tracheal intubation. The use of rocuronium (0.9 mg kg-1) in elderly patients does not result in a clinically significant change in heart rate, blood pressure or plasma catecholamine concentration.
罗库溴铵的使用可能会导致心动过速和心脏指数增加。泮库溴铵，另一种甾体类非去极化肌松药，可增加肾上腺素能神经末梢儿茶酚胺的释放并阻止其再摄取。本研究比较了维库溴铵（0.12mg/kg）或罗库溴铵（0.9mg/kg）给药后对老年患者的血流动力学影响以及儿茶酚胺浓度的变化。研究了30例65岁及以上未接受β受体阻滞剂治疗的患者。在硫喷妥钠、芬太尼、氧化亚氮麻醉期间，根据随机分配给予罗库溴铵（0.9mg/kg）或维库溴铵（0.12mg/kg）。在所有30例患者中，于麻醉诱导前、诱导即刻和诱导后1分钟、肌松药给药后1和2分钟以及气管插管后即刻、1和2分钟测量血压和心率。在后面20例患者中，于肌松药给药前、给药后1分钟以及气管插管后1分钟采集血浆儿茶酚胺测定样本。在整个研究过程中，两组的血压和心率相似。在肌松药给药前，维库溴铵组和罗库溴铵组的血浆去甲肾上腺素浓度相似（分别为589（标准差240）和444（标准差213）pg/mL），肌松药给药后1分钟（分别为602（标准差220）和520（标准差392）pg/mL）以及气管插管后1分钟（分别为597（标准差351）和440（标准差181）pg/mL）。在肌松药给药或气管插管后，两组的血浆去甲肾上腺素或肾上腺素浓度均无显著变化。老年患者使用罗库溴铵（0.9mg/kg）不会导致心率、血压或血浆儿茶酚胺浓度出现具有临床意义的变化。
