阿曲库铵和维库溴铵量-效关系和恢复时相的比较性研究

A Comcparative Study of Pharmacody namic Characteristics of Atracurium with Vecuronium

目的 :比较观察阿曲库铵和维库溴铵的量 效关系和恢复时相特征。方法 :选择 60例ASAⅠ级 ,年龄 17～5 0岁 ,施择期整形外科手术的患者 ,随机平均分成阿曲库铵组和维库溴铵组。用 60 %N2 O O2 吸入辅以静注硫喷妥钠和芬太尼维持麻醉。用加速度仪监测神经肌肉功能。采用累计给药方法建立阿曲库铵和维库溴铵的量 效关系曲线。结果 :根据用最小二乘法建立的量 效关系曲线 ,阿曲库铵的作用强度仅为维库溴铵的 1/6。应用等效剂量的阿曲库铵和维库溴铵 (1 5×ED95)后 ,两药的高峰作用时间、临床肌松时间、恢复时间和体内作用时间无明显差别。结论 :阿曲库铵是一弱效能的中效非去极化肌松药 ,其神经肌肉阻滞强度仅为维库溴铵的 17%。

Objective :Tocomparethepharmacodynamiccharacteristicsofatracuriumwithvecuronium .Methods :Sixty patients,ASAgradeI,aged 17 5 0 years,scheduledforelectivesurgery .Thepatientswererandomlydividedintotwogroupsofatracuriumandvecuronium .Generalanesthesiawasmaintainedwith 60 %N2 Oinoxygen ,andi.v .incrementsofthiopental 2mg/kgorfentanyl 2 μg/kgasrequired .NeuromuscularfunctionwasassessedbyTOFstimulationofaccelerometryandthepercentagedepressionofT1responsewasusedasthestudyparameter .Thedose responserelationsofatracuriumandvecuroni umweredeterminedbythecumulativedose responsetechnique .Results:TakenfromED95,calculatedbylinearregression ,the ratioofpotencyatracuriumtovecuroniumwas 1∶6.Followingequipotentdosesoftwodrugs(1 5×ED95)wereused ,the time courseofrecoverywasnotsignificantlydifferentbetweenthetwodrugs .Conclusions:Atracuriumisalowpotencydepo larizingrelaxantwithintermediatedurationofactionanditsneuromuscularblockingpotencyisapproximately 17%ofvecuro niuminadultpatientsanesthetizedwithnitrousoxideandfentanyl.