维库溴铵和阿曲库铵预处理对琥珀胆碱的肌震颤及肌松效应的影响

Effects of Vecuronium and Atracurium Pretreatment Used for Preventing Muscular Fasciculation Induced by Succinylcholine

目的:观察维库溴铵和阿曲库铵预处理对琥珀胆碱肌震颤的预防及对其肌松效应的影响。方法:30例全麻病人根据不同预处理药分成3组,即0.9%生理盐水(对照组);0.01mg/kg维库溴铵组和0.05mg/kg阿曲库铵组,每组10例。预处理4分后静注琥珀胆碱1.5mg/kg。采用ParaGraph监测肌松。结果:阿曲库铵预处理能基本消除琥珀胆碱引起的肌震颤,维库溴铵只能减轻或部分消除琥珀胆碱引起的肌震颤。但它们均使1.5mg/kg剂量的琥珀胆碱的起效时间延长,阻滞程度降低,而对气管插管条件的影响无甚差别。其中以阿曲库铵预处理对琥珀胆碱的起效时间影响较小。结论:与维库溴铵相比,阿曲库铵预处理能基本消除琥珀胆碱引起的肌震颤,并对其肌松效应影响较小,是较好的预处理肌松药。

Purpose: To observe the effects of vecuronium and atracurium pretreatment used for preventing muscular fasciculations induced by succinylcholine and neuromuscular blocking effect of succinylcholine. Methods:Thirty adult patients under gener-al anesthesia were randomly divided into three groups according to the pretreatment agent used:0.9% NaCl (control) ,0.01 mg/kg vecuronium and 0.05 mg/kg atracurium. Four minutes after the pretreatment, 1.5 mg/kg succinylcholine was in-jected intravenously. A Paragraph neuromuscular transmission monitor was used to evaluate the neuromuscular block. Re-sults: 0.05 mg/kg atracurium could prevent the muscular fasciculations following succinylcholine administration on the whole,but 0.01 mg/kg vecuronium did partly. Influence of atracurium on the onset of action following succinylcholine ad-ministration was less significant than that of vecuronium. Both of them prolonged the onset of action and decreased the ex-tent of block induced by succinylcholine. There was no difference among the three groups in the conditions of tracheal intu-bation. Conclusion:Compared with vecuronium,atracurium was a better pretreatment agent, which prevented muscular fas-ciculations induced by succinylcholine and had less influence on neuromuscular block effects of succinylcholine.