等效罗库溴铵、美维松和琥珀胆碱用于气管内插管及临床药效分析

Comparison of Rocuronium, Mivacurium and Succinylcholine in Endotracheal Intubationand Clinical Pharmacodynamics

成年手术患者45例。静注异丙酚和芬太尼诱导后,给予罗库溴铵0.6mg/kg(Ⅰ组),美维松0.16mg/kg(Ⅱ组)或琥珀胆碱0.6mg/kg(Ⅲ组),每组15例。待拇收肌诱发颤搐反应的T_1达到最大抑制时,行气管内插管,插管评级达到1级者,Ⅰ、Ⅱ和Ⅲ组分别为11、8和3例;2级为4、7和9例。Ⅲ组3级2例和4级1例。Ⅲ组插管评级比Ⅰ、Ⅱ组差(P<0.01)。三组T_1最大抑制程度相同,但是达到最大抑制时间Ⅲ组最快(1.50分),Ⅰ组其次(2.68分),Ⅱ组最慢(5.32分)(P<0.01)。T_1恢复到25％的时间分别为28.0分、16.9分和5.6分(P<0.01);T_1恢复到95％的时间分别为42.05分、26.75分和7.95分(P<0.01)。恢复指数分别为9.30分、7.04分和1.56分。

Neuromuscular blockade performance of rocuronium, mivacurium and succinylcholine were studied in 45 cases during propofol - fentanyl - N2O - O2 anesthesia. The TOFr and T, were measured by Accelography in addutor pollicis. Patients were allocated to three groups according to which muscle relaxants received, the dosage of these drugs was 2 x EDM, and 15 cases in each: Group I rocuronium 0.6 mg/kg, group n mivacurium 0.16 mg/kg and group III succinylcholine 0.6 mg/kg. The endotracheal intubation was performed after the maximal depression of T, achieved. The onset time, duration of blockade, recovery of TOFr and recovery index, were observed. Endotracheal intubation condition in three groups, excellent and good were 11, 8, 3 cases and 4, 7, 9 cases respectively. In group IE , 1 cases were poor and 1 case was impossible. So that, intubation condition of group I and n was better than group m (P<0.01). The time of maximal depression of T, occurred at 2.68, 5.32 and 1.50 min respectively (P<0.01). The time of T, 25% recovery was 28.0, 16.9 and 5.6 min and the recovery index was 9.30, 7.04 and 1.56 min these three groups respectively (P<0.01). We conclude that the onset time of rocuronium is longer than succinylcholine but shorter than mivacurium. The intubation condition is similar both in rocuronium and mivacurium, but the effect time of rocuronium is two times longer than mivacurium.