罗库溴铵和维库溴铵在终末期肾衰竭病人临床药效的比较

A clinical comparison of neuromuscular blocking effects of rocuronium and vecuronium in patients with end-stage renal failure

目的 比较罗库溴铵和维库溴铵在终末期肾衰竭病人中的肌松效应。方法 2 5例ASAⅢ级行肾移植术病人随机分为罗库溴铵组 (R组 ,15例 )和维库溴铵组 (V组 ,10例 )。麻醉诱导后分别给予 2×ED95剂量的罗库溴铵 (0 6mg/kg)或维库溴铵 (0 1mg/kg)。术中当T1恢复至 2 5 %时 ,追加 0 5×ED95剂量的罗库溴铵 (0 15mg/kg)或维库溴铵 (0 0 2 5mg/kg)。末次剂量后 ,使肌张力自然恢复或给予新斯的明拮抗。结果 初量罗库溴铵的起效时间为 (1 98± 0 4 7)min ,明显短于维库溴铵的 (3 2 5±0 82 )min。初量和追加量的罗库溴铵的肌松维持时间分别为 (4 6 87± 14 6 0 )min和 (34 86± 15 5 7)min,与维库溴铵相似。两组应用拮抗药后 ,恢复指数均显著缩短。结论 对于终末期肾衰竭病人 ,罗库溴铵的起效快于维库溴铵 ,肌松作用维持时间和恢复指数与维库溴铵相似。

Objective To investigate the neuromuscular blocking effects of rocuronium and vecuronium in patients with end-stage renal failure. Methods Twenty-five ASAⅢ patients undergoing renal transplantation were randomly divided into rocuronium (.n=.15) and vecuronium (.n=.10) group. A bolus dose of 2×ED 95 rocuronium(0.6 mg/kg)or vecuronium(0.1 mg/kg)was injected after anesthesia induction and followed by maintenance doses of 0.5 ED 95 rocuronium or vecuronium when T 1 returned to 25% of the control. The neuromuscular blocking effects were allowed to recover spontaneously or antagonized by neostigmine.Results The onset time of rocuronium was (1.98±0.47) min,which was faster than that of vecuronium (3.25±0.82) min. The mean duration of block of rocuronim after the initial dose and maintenance doses was (46.87±14.60) min and (34.86±15.57) min respectively. There were no significant differences between the duration time of block of rocuronium and vecuronium. The use of antagnism reduced the recovery indices of both rocuronium and vecuronium. Conclusions Onset of rocuronium is faster than that of vecuronium and duration of action and recovery indices of rocuronium and vecuronium are similar in patients with end-stage renal failure.