Doxacurium的临床肌松及心血管效应

Neuromuscular blockade and cardiovascular effects of doxacurium

将16例患者根据Doxacurium(BW A938U)剂量的不同分成两组,组1(8例)0.03mg/kg,组2(8例)0.05mg/kg,观察该药的肌松和心血管效应。结果起效时间分别为242±42秒、196±37秒,T_125%恢复时间为67.3±266分、116.5±32.4分,恢复指数为58.0±21.3分、69.5±25.5分。提出组2比组1起效时间短、作用时间长。两组患者均未观察到心血管及其他副反应。

To determine the neuromuscular blockade (NMB) and cardiovascular effects of doxacurium (DOX). 16 adult patients, ASA grade Ⅰ to Ⅱ, scheduled for elective surgery. served as subjects. Anesthesia was induced with intravenous valium, thiopental and suecinycholine and maintained whh inhalation of nitrous oxide and intravenoas fentanyl. Train-of-four (TOF) and post-tetanic stimulations were applied to ulnar nerve at the wrist. and the force of constraction of the adductor pollicis was measured as parameter for NMB. After the succinycholine-induced NMB recovered completely with SpO_2 and P_(ET)CO_2 remaining normal. all subjects were assigned to receiving intravenously DOX at dose of 0.03 (group Ⅰ, n=8) or 0.05mg/kg (group Ⅱ, n=8). respectively. As compared with those in group Ⅰ. onset time was shorten (242±42 seconds vs 196±37 seconds. P<0.05), duration of no response (35.6±24.8 mins vs 66.4±30.7 mins), time to 25% recovery of T_1(67.3±26.6 mins vs 116.5±32.4 mins). time to PTC recovery (24.6±8.2 mins vs 48.14±27.3 mins). time to TOF response recovery(39.6±21.8 mins vs 69.7±27.3mins) and interval between the recoveries of PTC and TOF response (15.0 mins vs 21.6 mins), all of them were prolonged (P<0.05), but time from 25% to 75% recovery of T_1 did not differ markedly (58.0±21.3 mins vs 69.5±25.5 mins, P>0.05). Following DOX administration, HR, mean arterial pressure and myocardial consumpation oxygen index kept statistically stable in both groups (P>0.05). The signs related to the release of histamine did not occur in all subjects. Therefore, we suggest that bolus injection of DOX at clinical doses can produce a dose-related long duration of NMB without cardiovascular side effects, but it's longer onset time of NMB may not he appropriate for induction of tracheal intubation.