Wulf H, Ledowski T, Linstedt U, Proppe D, Sitzlack D
Department of Anaesthesiology and Intensive Care, Hospital of the Christian-Albrechts-University, Kiel, Germany.
Can J Anaesth. 1998 Jun;45(6):526-32. doi: 10.1007/BF03012702.
To determine the magnitude of the potentiation of rocuronium by desflurane, isoflurane and sevoflurane 1.5 MAC anaesthesia.
In a prospective, randomised, study in 80 patients, the cumulative dose-effect curves for rocuronium were determined during anaesthesia with desflurane, sevoflurane and isoflurane (with N2O 70%, 15 min steady state) or total intravenous anaesthesia (TIVA) using propofol/fentanyl. Neuromuscular block was assessed by acceleromyography (TOF-Guard) after train-of-four (TOF) stimulation of the ulnar nerve (2 Hz every 12 sec, 200 microseconds duration). Rocuronium was administered in increments of 100 micrograms.kg-1 until first twitch (T1) depression > 95%.
Rocuronium led to more pronounced T1 depression with desflurane or sevoflurane anaesthesia than with TIVA. The ED50 and ED95 were lower during desflurane (95 +/- 25 and 190 +/- 80 micrograms.kg-1) and sevoflurane (120 +/- 30 and 210 +/- 40 micrograms.kg-1) than with TIVA (150 +/- 40 and 310 +/- 90 micrograms.kg-1) (P < .01), while the difference was not significant for isoflurane (130 +/- 40 and 250 +/- 90 micrograms.kg-1). Following equi-effective dosing (T1 > 95%) the duration to 25% T1 recovery, recovery index (25/75), and TOF0.70 was: 13.2 +/- 1.8, 12.7 +/- 3.4, and 26.9 +/- 5.7 min during anaesthesia with desflurane; 15.5 +/- 5.0, 11.4 +/- 3.8, and 31.0 +/- 6.0 min with sevoflurane; 13.9 +/- 4.7, 10.7 +/- 3.3, and 26.3 +/- 8.9 min with isoflurane; and 13.9 +/- 3.9, 11.3 +/- 5.7, and 27.5 +/- 8.2 min with TIVA anaesthesia (P: NS).
Interaction of rocuronium and volatile anaesthetics resulted in augmentation of the intensity of neuromuscular block but did not result in significant effects on duration of or recovery from the block.
确定在1.5倍最低肺泡有效浓度（MAC）麻醉下，地氟烷、异氟烷和七氟烷对罗库溴铵的增强作用程度。
在一项针对80例患者的前瞻性随机研究中，在使用地氟烷、七氟烷和异氟烷（氧化亚氮70%，15分钟稳态）或丙泊酚/芬太尼全静脉麻醉（TIVA）期间，测定罗库溴铵的累积剂量 - 效应曲线。在对尺神经进行四个成串刺激（TOF）（每12秒2赫兹，持续时间200微秒）后，通过加速度肌电图（TOF - Guard）评估神经肌肉阻滞。罗库溴铵以100微克·千克⁻¹的增量给药，直至第一个肌颤搐（T1）抑制>95%。
与TIVA相比，罗库溴铵在地氟烷或七氟烷麻醉下导致更明显的T1抑制。地氟烷（95±25和190±80微克·千克⁻¹）和七氟烷（120±30和210±40微克·千克⁻¹）麻醉下的半数有效剂量（ED50）和95%有效剂量（ED95）低于TIVA（150±40和310±90微克·千克⁻¹）（P <.01），而异氟烷（130±40和250±90微克·千克⁻¹）的差异不显著。在等效剂量给药（T1>95%）后，恢复至T1的25%、恢复指数（25/75）和强直后计数（TOF）0.70的时间分别为：地氟烷麻醉下13.2±1.8、12.7±3.4和26.9±5.7分钟；七氟烷麻醉下15.5±5.0、11.4±3.8和31.0±6.0分钟；异氟烷麻醉下13.9±4.7、10.7±3.3和26.3±8.9分钟；TIVA麻醉下13.9±3.9、11.3±5.7和27.5±8.2分钟（P：无显著性差异）。
罗库溴铵与挥发性麻醉药的相互作用导致神经肌肉阻滞强度增强，但对阻滞持续时间或恢复无显著影响。
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