轻至中度肝功能损害对万可罗宁作用时效的影响

The Prolonged Effect of Vecuronium in Patients with Abnormal Liver Function

本实验选择20例择期手术病人,其中10例肝功能轻至中度损害,另10例肝功正常。通过采用尺神经刺激仪监测拇指颤搐反应(TH),探讨此类病人应用万可罗宁的药物作用时效的变化。结果:实验组第1次给药后(0.08mg/kg)起效时间、高峰期及临床有效时间与对照组比较无明显差异。但TH25％～75％恢复时间及恢复到95％时间显著延长。第2次给药后(量同第1次)实验组起效时间明显缩短,其余各时间均较第1次给药显著延长。其中恢复时间延长尤为突出,是正常组300％;注药至TH恢复到95％时间亦延长168％。此结果提示,肝功能轻至中度损害对万可罗宁作用时效的影响主要是使肌松作用恢复时间延长,重复用药时更加明显。

10 patients with abnormal liver function were compared with the control. 0. 08mg/kg vecuronium was injected intravenously after tracheal intubation. Peripheral nerve stimulator was used to monitor the degree of nerve blocking. The second dose of vecuronium (0. 08mg/kg) was given when a TH (twitch hight) of 95% was recovered. Result: after the first dose, the onset time, peak duration and effective clinic lasting time were no different in both groups. But the TH from 25% to 75% revovering time and the time from drug administration to TH up to 95% were markedly prolonged in study group. After the second dose the onset time was significantly shorter, the other parameters were longer than that after the first dose. The changes were of no significance in the control group. It is concluded that the prolonged effect of vecuronium was determined by abnormal liver function patients.