Kim K S, Chun Y S, Chon S U, Suh J K
Department of Anaesthesiology, Hanyang University Hospital, Seoul, South Korea.
Anaesthesia. 1998 Sep;53(9):872-8. doi: 10.1046/j.1365-2044.1998.00492.x.
We compared the dose-response relationships of cisatracurium, mivacurium, atracurium, vecuronium and rocuronium and examined the interactions of cisatracurium with mivacurium, atracurium, vecuronium and rocuronium in humans by isobolographic and fractional analyses. We studied 180 adult patients during nitrous oxide-fentanyl-propofol anaesthesia. Neuromuscular block was monitored using mechanomyography to detect the twitch response of the ulnar nerve at the wrist. The dose-response curves were determined by probit analysis. The calculated ED50 values and their 95% confidence intervals were 40.9 (38.1-43.7), 49.8 (47.0-52.6), 187.2 (175.1-199.3), 36.6 (34.7-38.5) and 136.4 (129.2-143.6) micrograms.kg-1 for cisatracurium, mivacurium, atracurium, vecuronium and rocuronium, respectively. Corresponding ED95 values were 57.6 (53.5-61.7), 91.8 (88.1-95.5), 253.1 (238.9-267.3), 52.9 (49.1-56.7) and 288.7 (276.2-301.2) micrograms.kg-1, respectively. The interaction between cisatracurium and mivacurium, vecuronium or rocuronium was found to be synergistic, but the interaction between cisatracurium and atracurium was found to be additive. Synergy between cisatracurium and vecuronium or rocuronium was greater than between cisatracurium and mivacurium.
我们比较了顺式阿曲库铵、米库氯铵、阿曲库铵、维库溴铵和罗库溴铵的剂量-反应关系，并通过等效应线图和分数分析研究了顺式阿曲库铵与米库氯铵、阿曲库铵、维库溴铵和罗库溴铵在人体中的相互作用。我们在氧化亚氮-芬太尼-丙泊酚麻醉期间研究了180例成年患者。使用肌动描记法监测神经肌肉阻滞，以检测手腕处尺神经的抽搐反应。通过概率分析确定剂量-反应曲线。顺式阿曲库铵、米库氯铵、阿曲库铵、维库溴铵和罗库溴铵的计算ED50值及其95%置信区间分别为40.9（38.1-43.7）、49.8（47.0-52.6）、187.2（175.1-199.3）、36.6（34.7-38.5）和136.4（129.2-143.6）微克·千克-1。相应的ED95值分别为57.6（53.5-61.7）、91.8（88.1-95.5）、253.1（238.9-267.3）、52.9（49.1-56.7）和288.7（276.2-301.2）微克·千克-1。发现顺式阿曲库铵与米库氯铵、维库溴铵或罗库溴铵之间的相互作用是协同的，但顺式阿曲库铵与阿曲库铵之间的相互作用是相加的。顺式阿曲库铵与维库溴铵或罗库溴铵之间的协同作用大于顺式阿曲库铵与米库氯铵之间的协同作用。
