阿曲库铵和罗库溴铵量效关系和恢复时相的比较

A Comparative Study of Dose-Response and Time Course of Recovery of Atracurium and Rocuronium

目的:观察阿曲库铵和罗库溴铵的量效关系和恢复时相特征。方法:选择60例ASAⅠ级,择期腹部手术的患者,随机平均分成阿曲库铵组和罗库溴铵组。用60%NO2-O2-硫喷妥钠-芬太尼维持麻醉。用加速度仪监测神经肌肉功能,采用TOF刺激方式,以T1抑制的百分比为指标。用累计给药方法建立阿曲库铵和罗库溴铵的量效关系曲线。结果:阿曲库铵和罗库溴铵的作用强度比率为1∶1.2,两药的ED50、ED90和ED95均有明显差别。应用等效剂量(1.5×ED95)后,两药的高峰时间、临床肌松时间和体内作用时间具有明显差别,但恢复时间则无差别。结论:阿曲库铵和罗库溴铵均是弱效能的中效非去极化肌松药。阿曲库铵比罗库溴铵的作用强度高20%,且作用时间较短。

Objective： To compare the characteristics of the dose- response relations and the time- course of action between atracurium and rocuronium in healthy adult patients anesthetized with N2O-O2 - fentanyl - thiopental. Methods：Sixty patients, ASA grade Ⅰ, aged 18-50 years, scheduled for selective plastic surgery were studied. All the patients were randomly divided equally to either the atracurium or rocuronium group. General anesthesia was maintained with 60 % nitrous oxide in oxygen, thiopentone, and fentanyl. Neuromuscular function was assessed by using an accelerometer with train - offour （TOF） stimulation at the wrist every 12 s. The percentage depression of the first twitch （T1） was used as the study parameter. The dose- response relations of atracurium and rocuronium were determined by the cumulative dose - response technique. Results：According to the dose- response curves established by the least squares linear regression, the potency ratio of atracuriuna： rocuronium was 1 ： 1.2. There were significant differences in the ED50, ED90, and ED95 between the two drugs. After I.V. administration of equipotent doses of both drugs （1.5 ED95 ）, the duration of peak effect, clinical duration, and total duration were significantly different between the two drugs, but the recovery index of the two drugs were similar. Conclusions：Atracurium and rocuronium are the low- potency nondepolarizing relaxants with intermediate duration. As compared to atracurium, the neuromuscular blocking effect of rocuronium was about 20% less potent and its duration of action was shorter.