Naguib M, Samarkandi A H, Ammar A, Elfaqih S R, Al-Zahrani S, Turkistani A
Department of Anesthesiology, King Saud University, College of Medicine at King Khalid University Hospital, Riyadh, Saudi Arabia.
Anesthesiology. 1998 Nov;89(5):1116-24. doi: 10.1097/00000542-199811000-00011.
The comparative clinical pharmacology of cisatracurium and rocuronium and their combinations has not been reported. In this study, the authors compared the relative potency and the clinical profile and characterized the interaction of both drugs.
Two hundred twenty adults classified as American Society of Anesthesiologists physical status I and anesthetized with propofol-fentanyl-nitrous oxide were studied. In part 1, the neuromuscular-blocking effects of cisatracurium and rocuronium were assessed after administration of bolus doses of 20-50 microg/kg and 100-300 microg/kg, respectively. In part 2, we compared the time course of 1xED50, 1, 1.5, and 2xED95 doses of both drugs (where ED50 and ED95 are, respectively, the doses producing 50% and 95% depression of the first twitch height [T1]). In part 3, equieffective combinations of both drugs were studied to characterize their interaction.
The calculated ED50 values and their 95% confidence intervals were 111 (107-115) and 26.2 (25.8-26.5) microg/kg [corrected] for rocuronium and cisatracurium, respectively. Compared with equipotent doses of cisatracurium, rocuronium had a faster onset, and a faster spontaneous T1 and train-of-four recovery times that were significant except at maximum recovery with the 2xED95 dose. The interaction between rocuronium and cisatracurium was synergistic, and the time profile of the combination group was different from that of the single-dose groups.
Cisatracurium is four to five times more potent than rocuronium. Rocuronium had a faster onset of action, a shorter clinical duration, and a faster spontaneous recovery rate compared with equipotent doses of cisatracurium.
尚未有关于顺式阿曲库铵与罗库溴铵及其联合用药的比较临床药理学报道。在本研究中，作者比较了两者的相对效价和临床特征，并对两种药物的相互作用进行了表征。
研究对象为220名美国麻醉医师协会身体状况I级的成年人，采用丙泊酚-芬太尼-氧化亚氮麻醉。在第1部分中，分别给予20 - 50μg/kg和100 - 300μg/kg的单次推注剂量后，评估顺式阿曲库铵和罗库溴铵的神经肌肉阻滞作用。在第2部分中，我们比较了两种药物1倍半数有效量（ED50）、1倍、1.5倍和2倍95%有效量（ED95）（其中ED50和ED95分别是使第一个肌颤搐高度[T1]降低50%和95%的剂量）的时间过程。在第3部分中，研究了两种药物的等效组合以表征其相互作用。
罗库溴铵和顺式阿曲库铵的计算ED50值及其95%置信区间分别为111（107 - 115）μg/kg和26.2（25.8 - 26.5）μg/kg[校正后]。与等效剂量的顺式阿曲库铵相比，罗库溴铵起效更快，自发T1恢复时间和四个成串刺激恢复时间更快，但在2倍ED95剂量达到最大恢复时除外。罗库溴铵和顺式阿曲库铵之间的相互作用是协同的，联合用药组的时间过程与单剂量组不同。
顺式阿曲库铵的效价比罗库溴铵高4至5倍。与等效剂量的顺式阿曲库铵相比，罗库溴铵起效更快，临床持续时间更短，自发恢复率更快。
