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阿曲库铵前处理对琥珀胆碱胆松作用起效时间影响的临床研究 总被引:1,自引:0,他引:1
研究阿曲库铵作前处理对琥珀胆碱肌松作用的起效和持续时间的影响。20例患者分为对照组和前处理组。前处理组在注诱前5分钟预注阿曲库铵0.06mg/kg,观察Th降至T25.T10和%0的时间,T0的持续时间和Th恢复至T10、T25、T75的时间。结果表明,用阿曲库铵作前处理,既可缩短琥珀胆碱的起效时间,又不明显影响肌松持续时间,也能有效地防止琥珀胆碱肌震颤对患者可能造成的多种危害。 相似文献
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在临床麻醉中我们用小剂量非去极化肌松药 (阿曲库铵 )对抗去极化肌松药琥珀胆碱的不良反应 ,在气管插管中取得满意肌松效果 ,减少了不良反应 ,现报告如下。资料与方法76例ASAⅠ~Ⅱ级择期手术病人 ,年龄 2 0~ 6 5岁 ,其中男 45例 ,女 31例。随机均分为A组和B组。A组为对照组 ,B组为阿曲库铵 琥珀胆碱组 (治疗组 )。病人入手术室后 ,常规测眼内压、血清K 浓度 ,监测ECG、HR和BP。A组诱导用安定 10mg、芬太尼 0 1mg、2 5 %硫喷妥钠2 5 0mg、琥珀胆碱 1 5~ 2mg/kg ,经口腔明视下气管插管 ;B组诱导药和方法相… 相似文献
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复合小剂量阿曲库铵对顺苯磺酸阿曲库铵起效时间的影响 总被引:1,自引:0,他引:1
目的观察顺苯磺酸阿曲库铵同时复合阿曲库铵用于全凭静脉诱导的起效时间。方法择期全麻手术患者80例,随机均分为A、B、C、D四组。A组单用3ED95(0.15 mg/kg)顺苯磺酸阿曲库铵作为对照组;另三组分别用3ED95顺苯磺酸阿曲库铵复合阿曲库铵0.05 mg/kg(B组)、0.10 mg/kg(C组)或0.15 mg/kg(D组)。采用TOF-Watch SX肌松监测。静注咪唑安定0.05mg/kg、芬太尼5μg/kg、依托咪酯0.3 mg/kg及相应剂量肌松药,记录起效时间,进行气管插管条件评级。结果B、C、D组肌松起效时间依次加快,均明显短于A组(P<0.01),但B、C、D组之间差异无统计学意义。结论复合小剂量阿曲库铵能缩短3ED95顺苯磺酸阿曲库铵的起效时间。 相似文献
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哌库溴铵前处理对琥珀胆碱的肌震颤及肌松效应的影响 总被引:8,自引:1,他引:8
目的:观察哌库溴铵前处理对琥珀胆碱肌震颤的预防作用及对其肌松效应的影响。方法:36例择期手术病人随机分成三组,Ⅰ组静注琥珀胆碱1mg/kg(对照组)。Ⅱ、Ⅲ组静注哌库溴铵15μg/kg后3.5分钟分别注入琥珀胆碱1mg/kg和1.5mg/kg。结果:哌库溴铵前处理能有效地消除琥珀胆碱引起的肌震颤,但使1mg/kg琥珀胆碱的起效时间延长、阻滞程度降低、气管插管条件变差、肌松恢复时间缩短。当琥珀胆碱的剂量增至1.5mg/kg时,肌松效应恢复满意。结论:哌库溴铵前处理使琥珀胆碱的肌松效应减弱,故琥珀胆碱的插管剂量应增至1.5mg/kg,以获得满意的肌松。 相似文献
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维库溴铵对琥珀胆碱肌松效应的影响 总被引:2,自引:0,他引:2
研究维库溴铵(V)作用的不同的不同消退期给予琥珀胆碱的肌松效应。方法:55例全麻择期手术病人,按维库溴铵作用的不同消退期(50%或75%)和琥珀胆碱的剂量(1.0mg/kg或1.5mg/kg),随机分为六组。1-4组在维库溴铵作用消退50%或75%时,分别给予胆碱1.0mg/kg和1.5mg/kg;5、6组分别阳琥胆三1.mg/kg和1.5mg/kg作为对照。结果1-4组的琥珀胆碱使用时间比对照组 相似文献
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<正>支撑喉镜检查手术时间短,对肌松程度要求高,麻醉医师在其全身麻醉过程中更倾向于应用琥珀胆碱维持肌松。但琥珀胆碱可引起血清K+升高,肌颤及导致术后肌肉痛等不良反应,并非理想的肌松药。本研究拟比较顺苯磺酸阿曲库铵与琥珀胆碱在此类手术中的应用效果。1资料与方法1.1一般资料择期行支撑喉镜检查手术的成年患者46例,年龄21~60岁。术前心电图及肝肾功能均为正常。随机均分 相似文献
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目的 探讨近日节律对阿曲库铵肌松作用时间的影响.方法 全麻手术患者61例,年龄18~55岁,BMI 18~24 kg/m2,ASA分级Ⅰ或Ⅱ级.静脉注射异丙酚、芬太尼,意识消失后静脉注射阿曲库铵0.75 mg/kg.采用肌松监测仪监测拇内收肌的神经肌肉阻滞情况,试验时间8:00-23:00,分为5个时段:8:00-11:00、11:00-14:00、14:00-17:00、17:00-20:00和20:00-23:00,分别记录阿曲库铵临床作用时间.采用余弦分析法和广义线性模型分析近日节律对阿曲库铵肌松作用时间的影响.结果 53例患者完成本研究.广义线性模型分析得出20:00-23:00时段阿曲库铵临床作用时间最长,11:00-14:00时段最短;余弦法分析得到阿曲库铵临床作用时间(y)与给药时间刻(t)的余弦曲线方程为,y=48.05+15.54cos(15t+52.66).结论 近日节律可影响阿曲库铵肌松作用时间,表现为20:00--23:00时段阿曲库铵临床作用时间最长,11:00-14:00时段最短.Abstract: Objective To investigate the effect of circadian rhythm on the duration of neuromuscular blockade (NMB) elicited by atracurium. Methods Sixty-one ASA Ⅰ or Ⅱ patients aged 18-55 yr with body mass index of 18-24 kg/m2 undergoing general anesthesia were enrolled in this study. Anesthesia was induced with fentanyl 2 μg/kg and propofol 2 mg/kg. Atracurium 0.75 mg/kg was injected iv as soon as the patients lost consciousness . NMB was assessed by TOF-stimulation of ulnar nerve using TOF-Watch(R) SX. Tracheal intubation was performed as soon as the first twitch (T1) disappeared. The patients were mechanically ventilation (VT 6-8 ml/kg, RR 12 bpm, I ∶ E 1.0 ∶1.5). PETCO2 was maintained at 35-45 mm Hg. Anesthesia was maintained with continuous infusion of propofol 6-8 mg·kg-1·-1·-1and remifentanil 0.25-0.50 μg·kg-1·min-1 . Anesthesia was performed at 5 time periods: (1) 8:00-11:00, (2) 11:00-14:00, (3) 14:00-17:00, (4) 17:00-20:00 and (5) 20:00-23:00. The duration of NMB produced by atracurium was defined as the interval between the end of atracurium injection and 3% recovery of T2 . The data were analysed using generalised linear models (GLMs) and cosinor method. Results Fifty-three cases completed the study. GLM analysis showed that the duration of NMB was longest at 20:00-23:00 (53 min (95% confidence interval 50-56 min)) and shortest at 11:00-14:00 (43 min (95% confidence interval 39-46 min)), suggesting that there is a significant diurnal variation in the duration of NMB elicited by atracurium. Cosinor method analysis showed that equation of the duration of NMB and time point of atracurium administration was y = 48.05 + 15cos( 15t + 52.66). Conclusion Circadian rhythm can affect the duration of NMB elicited by atracurium, which shows that the duration of NMB is longest at 20:00-23:00 and shortest at 11:00-14:00. 相似文献
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目的比较顺式阿曲库铵与琥珀胆碱用于患儿气管异物取出术的效果。方法择期气管异物取出术患儿40例,随机分为两组,每组20例。C组诱导时给予顺式阿曲库铵0.2mg/kg,S组给予琥珀胆碱2 mg/kg;C组静注顺式阿曲库铵0.05 mg/kg维持肌松,S组静注琥珀胆碱0.4mg/kg。记录支气管镜置入条件评分、肌松药追加次数、气管导管拔除时间及术后24h肌肉酸痛发生率。结果两组患儿支气管镜置入条件差异无统计学意义。C组无一例追加肌松药,S组所有患儿均需追加肌松药(P0.01)。气管导管拔除时间C组明显长于S组(P0.05)。S组所有患儿均有肌肉酸痛发生,C组无一例肌肉酸痛发生(P0.01)。结论患儿气管异物取出术中顺式阿曲库铵及琥珀胆碱均可提供良好的肌松效果,但前者拔管时间延长,后者术后肌肉酸痛较多。 相似文献
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罗库溴铵和琥珀胆碱临床药效比较 总被引:4,自引:1,他引:3
目的:比较罗库溴铵和琥珀胆碱的药效动力学以及用于气管内插管的效果。方法;成年全麻手术患者60例随机分为四组。分别给予2或3倍ED_(95)罗库溴铵(Ⅰ组和Ⅱ组)和2或3倍ED_(95)琥珀胆碱(Ⅱ组和Ⅳ组),记录拇收肌诱发颤搐反应的抑制和恢复过程,分析各组插管效果。结果:Ⅱ组插管评级均为优·Ⅲ组仅占20%。注药后T_1达到最大抑制程度四组基本相同,作用显效时间和T_1达到最大抑制时间,Ⅱ、Ⅲ和Ⅳ组组间比较无明显差异,比Ⅰ组明显短。T_1显现及恢复到25%和95%的时间。Ⅱ组和Ⅳ组都分别比Ⅰ组和Ⅲ组明显长。结论:3倍ED_(95)罗库溴铵的作用起效时间和2或3倍ED_(95)琥珀胆碱相似,插管效果最佳,但临床作用时间明显延长。 相似文献
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BACKGROUND: The aim of this study was to evaluate the effect of ephedrine administered prior to induction of anaesthesia on the onset time of succinylcholine for endotracheal intubation. METHODS: Patients were randomly assigned to receive intravenously (i.v.) either 70 microg kg(-1) of ephedrine (Group I; n = 25) or saline (Group II; n = 25) 3 min before induction of anaesthesia. Induction of anaesthesia was provided with propofol 2 mg kg(-1) plus remifentanil 1 microg kg(-1). Onset time and duration of muscle fasciculation and onset time of succinylcholine were recorded. Intubation was attempted after establishment of 100% thumb relaxation and difficulties were recorded. Heart rate, pulse oxymetry (SpO2) and mean arterial pressure (MAP) were also recorded. RESULTS: The onset time of succinylcholine were significantly (P < 0.001) shorter in Group I (26 +/- 4 s), when compared with Group II (43 +/- 6 s). Patients in Group I were intubated at 49 +/- 7 s compared with 68 +/- 10 s in Group II. The score of intubation was similar in both groups. Duration of muscle fasciculation was longer in Group II. Heart rate and MAP increased significantly (P < 0.05) after ephedrine injection, compared with the baseline value in Group I. CONCLUSIONS: The onset time of succinylcholine can be shortened with ephedrine pretreatment. 相似文献
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Belyamani L Azendour H Elhassouni A Zidouh S Atmani M Kamili ND 《Annales fran?aises d'anesthèsie et de rèanimation》2008,27(4):292-296
Objective
The goal of this study was to determine if ephedrine could improve intubating conditions when it is administered before the muscle relaxant (rocuronium and succinylcholine).Patients and methods
In this prospective randomized double-blind study, 80 patients ASA I- II, scheduled for elective surgery, were allocated randomly to receive: succinylcholine 1 mg/kg + ephedrine 70 μg/kg (Group I, n = 20); rocuronium 0.6 mg/kg + ephedrine 70 μg/kg (Group II, n = 20); succinylcholine 1 mg/kg + 0.9% saline (Group III, n = 20); rocuronium 0.6 mg/kg + 0.9% saline (Group IV, n = 20). Induction of anaesthesia started with administration of the first syringe containing either ephedrine or saline, then 30 s later propofol 2.5 mg/kg and fentanyl 3 μg/kg, were administered followed by the contents of the second syringe containing either rocuronium or succinylcholine. Thirty seconds after injection of the muscle relaxant, another blinded staff anaesthetist performed intubation of the patient. Intubating conditions were evaluated according to criteria's of the conference of Copenhagen. Heart rate, systolic blood pressure and diastolic were also noted. Kruskall-Wallis test for non-parametric variable and Student t test for quantitative variables were used for statistical analysis.Results
There was no significant difference between the groups concerning age, sex, BMI and ASA status. Pretreatment by ephedrine improved significantly (p < 0.0001) intubating conditions after succinylcholine and rocuronium.Conclusion
Use of ephedrine 30 seconds before induction with propofol, fentanyl followed by rocuronium or succinylcholine provides faster good conditions of intubation. 相似文献14.
西咪替丁对普鲁卡因复合麻醉下琥珀胆碱时—量和阻滞性质的影响 总被引:1,自引:0,他引:1
20例普胸、脊柱外科手术患者,配对分为西咪替了组(1组)和对照组(2组)。 1组麻醉诱导前45分钟肌注西咪替了4mg·kg-1,用加速度仪监测两组患者用普鲁卡因、琥珀胆碱复合液时琥珀胆碱的时-量和阻滞性质的变化,并采血做血清胆碱酯酶活性测定。结果:两组患者静滴流琥珀碱后时-量无显著差异。Ⅰ组转相过程、Ⅱ相阻滞发生时间较2组迟。Ⅰ组诱导时血清胆碱酯酶活性下降33.37%,差异显著。 相似文献
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The effects of succinylcholine and calcium (Ca2+), alone and together, on membrane-bound acetylcholinesterase (true-type cholinesterase) were examined using human erythrocyte ghosts to elucidate the combined pharmacological activity of succinylcholine and calcium in in vivo system. Succinylcholine inhibited the acetylcholinesterase by a mixed style. Calcium alone exhibited an inhibitory effect on the enzyme, but a biphasic effect together with succinylcholine: marked restoration of the enzyme activity at calcium concentrations lower than 6mM and depression at its higher concentrations. It is suggested that calcium induces a conformational change of the enzyme protein leading to the altered binding capacity of succinylcholine. In anesthetic practice, therefore, the use of calcium may not be indicated for the treatment of SCh phase II block.(Wakamatsu M et al.: Combined effects of succinylcholine and calcium on membrane-bound acetylcholinesterase activity. J Anesth 1: 15–21, 1987) 相似文献
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Kato M Shiratori T Yamamuro M Haga S Hoshi K Matsukawa S Jalal IM Hashimoto Y 《Journal of anesthesia》1999,13(4):189-192
Purpose. To compare the in vivo and in vitro pharma-cokinetics of succinylcholine (SCh) in humans.
Methods. A bolus of SCh 1 mg·kg−1 (n = 7) or 2 mg·kg−1 (n = 11) was given to 18 patients anesthetized with thiopental. Arterial blood samples for determination of in vivo SCh concentrations
were collected every 30 s for 5 min. Another 20-ml blood sample was obtained before induction of anes-thesia for determination
of in vitro SCh. Concentrations of SCh were measured by high-performance liquid chromato-graphy. In vivo and in vitro concentrations
of SCh vs time data were analyzed by the one-compartment model.
Results. The respective in vivo and in vitro pharmacokinetic parameters (SCh 1 mg·kg−1
vs SCh 2 mg·kg−1) were as follows: Plasma clearance was 4.17 ± 2.37 and 1.85 ± 0.28 l·min−1, P < 0.05, vs 2.91 ± 2.01 and 1.27 ± 0.43 l·min−1, P < 0.05. Elimination half-life was 25.4 ± 10.6 and 47.4 ± 5.4 s, P < 0.002 vs 26.3 ± 10.0 and 75.2 ± 21.8 s, P < 0.00005.
Conclusion. These results suggest that the rapid disap-pearance of SCh from the circulation is due to diffusion out of the blood vessels
rather than to enzymatic hydrolysis.
Received for publication on August 31, 1998; accepted on May 11, 1999 相似文献
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Effect of d-tubocurarine pretreatment on succinylcholine twitch augmentation and neuromuscular blockade 总被引:2,自引:0,他引:2
Subparalyzing doses of d-tubocurarine (dTC) given before succinylcholine decrease the duration of neuromuscular blockade. In animal preparations, they also abolish succinylcholine-induced twitch augmentation, defined as a greater-than-maximal contraction in response to a single stimulus. To determine quantitatively the effect of dTC on succinylcholine potency and on twitch augmentation in humans, 60 adult patients, ASA physical status I or II, were assigned randomly to receive either 0.05 mg/kg of dTC or saline 2 min before induction of anesthesia with fentanyl and thiopental. Train-of-four stimulation was applied every 12 s to the ulnar nerve and the force of contraction of the adductor pollicis muscle was measured. One minute after induction of anesthesia, 0.15, 0.20, 0.25, 0.35, or 0.50 mg/kg of succinylcholine was given. The height of the first twitch (T1) reached 121% +/- 6% (mean +/- SEM) of control without dTC, and was virtually abolished by dTC pretreatment (105% +/- 1%, P less than 0.01). Twitch augmentation was more noticeable with lower doses of succinylcholine, and was not observed in the response to the fourth stimulus of the train of four (T4). The potency of succinylcholine was decreased by approximately one-half in the dTC-pretreated groups. The ED50 was 0.27 +/- 0.04 mg/kg without dTC and 0.50 +/- 0.06 mg/kg with dTC (P less than 0.002). The corresponding values for ED90 were 0.51 +/- 0.07 and 1.02 +/- 0.12 mg/kg, respectively (P less than 0.02). The ED95 values were 0.63 +/- 0.09 and 1.28 +/- 0.15 mg/kg, respectively (P less than 0.02). The slopes of the regression lines did not deviate significantly from parallelism.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
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依托咪酯和丙泊酚对罗库溴铵插管条件和起效时间的影响 总被引:5,自引:0,他引:5
目的 比较依托咪酯和丙泊酚对罗库溴铵插管条件和起效时间的影响。方法 60例ASA Ⅰ~Ⅱ级拟行择期上腹部手术的病人,随机均分为依托咪酯诱导组(E组)和丙泊酚诱导组(P组)。两组术前及其他术中用药相同,采用TOF-WATCH加速度仪监测肌松,并记录诱导前后的血压、心率。结果两组的插管条件无显著性差异(P>0.05)。E组的起效时间明显快于P组(P<0.05),P组诱导后的MAP明显低于E组(P<0.05)。结论 依托咪酯和丙泊酚均可提高罗库溴铵的插管条件。相对于丙泊酚,依托咪酯可缩短罗库溴铵的起效时间。 相似文献
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卡肌宁前处理对琥珀胆碱Ⅱ相阻滞的影响 总被引:1,自引:0,他引:1
研究卡肌宁前处理对长时间反复静注琥珀胆碱效应的影响。结果:前处理对单次静注琥珀胆碱的起效时间、作者持续时间和恢复时间无明显影响。但牟显著地降低由琥珀胆碱引起的肌颤增强现象;对长时间反复静注琥珀胆碱能明显地延缓Ⅱ相阻滞的发生时间,提高神经肌肉的自然恢复率。由此可见,卡肌宁为一种良好的前处理药物。 相似文献