依托咪酯影响琥珀胆碱肌松时效的研究

Effect of etomidate on the time-response relationships of succinylcholine in rat and human.

依托咪酯和琥珀胆碱均是麻醉中常用的药物。通过14只Wistar大鼠坐骨神经-胫前肌在体实验研究和ASA Ⅰ～Ⅱ级择期手术患者24例的临床观察,发现在大鼠依托咪酯(0.6mg/kg)能显著延长琥珀胆碱(1.0mg/kg)的肌松维持时间和肌松总时间(分别P<0.01和P<0.05);在临床上依托咪酯(0.3mg/kg)对琥珀胆碱(1.5mg/kg)肌松时效无明显影响。提示依托咪酯对琥珀胆碱肌松时效的影响在大鼠与人之间存在差异,原因可能为依托咪酯在大鼠能明显竞争与抑制血浆假性胆碱酯酶,而在人则否。

To investigate the experimental and clinical effects of etomidate (Eto)on the time-response relationships of succinylcholine (Suc), 14 Wistar rats and 24 adult patients of ASA grade Ⅰ-Ⅱ were randomly divided into control group and Eto group,Suc (1.0mg/kg to rat, 1.5mg/kg to patient) was given after intravenous administration of normal saline in control group or Eto (0.6mg/kg to rat, 0.3mg/kg to patient) in Eto group. Onset time,maintenance duration,total duration and recovery index of neuromuscular blockade of Suc were measured by the force of contraction of the tibialis anterior muscle after single-twitch stimulation to the sciatic nerve at 0.2Hz in rat,or by the T_1 height of adductor pollicis muscle after TOF stimulations to ulnar nerve with accelograph in patient. Maintenance duration was 8.3±2.0 mins in control group and 16.7±4.0 mins in Eto group (P<0.01),and total duration 14.2±3.9 mins in control group and 24.9±2.4 mins in Eto group (P<0.05) in rat. However,time-response relationship of Suc was no signficant difference between control group and Eto group in patient. The results indicate that Eto 0.6mg/kg significantly prolonged maintenance duration and total duration of Suc 1.0mg/kg in rat,but Eto 0.3mg/kg had no remarkable influence on the time response relationship of Sue 1.5mg/kg in human. Routine clinical dose of Suc can be used after administration of Eto in anaesthesia.