美维松前处理对琥珀胆碱的肌震颤及肌松效应的影响

Effects of Mivacurium Pretreatment on Succinylcholineinduced Fasciculation and Its Neuromuscular Blocking Action

目的与方法：３８例全麻病人随机分成三组，Ⅰ组（ｎ＝１２）：琥珀胆碱１ｍｇ／ｋｇ；Ⅱ组（ｎ＝１２）：美维松２５μｇ／ｋｇ、琥珀胆碱１ｍｇ／ｋｇ和Ⅲ组（ｎ＝１４）：美维松２５μｇ／ｋｇ、琥珀胆碱１．３ｍｇ／ｋｇ。注射美维松和琥珀胆碱的间隔时间为３．５ｍｉｎ。结果：美维松（２５μｇ／ｋｇ）前处理能基本消除琥珀胆碱引起的肌震颤，但使琥珀胆碱（１ｍｇ／ｋｇ）的起效时间延长、阻滞程度降低、气管插管条件变差、肌松恢复时间缩短。当琥珀胆碱的剂量增加到１．３ｍｇ／ｋｇ后，起效时间和阻滞程度与单独注射１ｍｇ／ｋｇ琥珀胆碱（Ⅰ组）相似，但肌松恢复时间仍明显缩短。结论：建议美维松前处理时适当增加琥珀胆碱的插管剂量。

bjective and Methods:The effects of mivacurium pretreatment on succinylcholineinduced fasciculation and its neuromuscular blockade were studied.Thirtyeight patients scheduled for selective surgery under thiopentonefentanyl anesthesia were randomly allocated to one of three groups,groupⅠ:Succinylcholine 1mg/kg;group Ⅱ:mivacurium 25 μg/kg,succinylcholine 1mg/kg and group Ⅲ:mivacurium 25μg/kg,succinylcholine13mg/kg.The interval of administration between mivacurium and succinylcholine was 35min.Results:the fasciculation induced by 1 or 13mg/kg succinylcholine was suppressed in most patients and the neuromuscular blocking action of 1mg/kg succinylcholine was compromised obviously by prior administration of mivacurium,while its dosage increased to 13mg/kg,the onset time,maximum block and intubating condition of succinylcholine were as same as those in group Ⅰ,but the recovery time was still shortened significantly.Conclusion:It is suggested that the intubating dose of succinylcholine should be increased appropriately following pretreatment with mivacurium.