阿曲库铵与哌库溴铵在预注法中的复合应用  

Neuromuscular blocking effects of atracurium after pipecuronium priming

作　　者：吴嘉宾[1] 刘斌[2] 陈斌[3] 徐德军[4] 

机构地区：[1]重庆市急救医疗中心麻醉科,400014 [2]四川大学华西医疗中心麻醉科 [3]川北医学院附属医院麻醉科 [4]北京大学第三医院麻醉科

出　　处：《临床麻醉学杂志》2005年第1期4-6,共3页Journal of Clinical Anesthesiology

摘　　要：目的　观察阿曲库铵和哌库溴铵在预注法中的复合应用。方法　选择平衡麻醉下择 期手术病人70例。研究分两部分:第一部分,将30例病人随机均分为阿曲库铵组和哌库溴铵组,采 用累计给药法建立两药量 效关系曲线,计算ED50和ED95;第二部分,根据两药ED95将另40例病人 随机均分为单纯阿曲库铵预注组和复合哌库溴铵预注组。观察预注期间肌颤搐抑制值、起效时间和 临床作用时间。结果　阿曲库铵ED50和ED95分别为117.5μg/kg和272.8μg/kg,哌库溴铵ED50和 ED95分别为23.7μg/kg和42.6μg/kg;复合哌库溴铵预注组起效快于单纯阿曲库铵预注组;复合哌 库溴铵预注组临床作用时间长于单纯阿曲库铵预注组。结论　在预注法中采用化学结构不同的肌 松药可进一步加快起效,延长临床作用时间。Objective To study the synergism of neuromuscular blockade produced by atracurium after pipecuronium priming. Methods Seventy patients undergoing elective surgery served as the experimental subjects. All patients were induced and maintained with balanced anesthesia. The study consisted of two parts according to the purpose of the study. In part Ⅰ,30 patients were randomly divided equally to the atracurium group and pipecuronium group. The dose-response relations of atracurium and pipecuronium were determined by the cumulative dose-response technique, and ED 50 and ED 95 were calculated. In part Ⅱ,40 patients were divided into two groups and given a priming dose of atracurium or pipecuronium respectively before atracurium for intubation.The percentage depression after priming doses and the onset time as well as duration of action were obtained. Results ED 50 and ED 95 of atracurium were 117.5μg/kg and 272.8μg/kg respectively. ED 50 and ED 95 of pipecuronium were 23.7μg/kg and 42.6μg/kg respectively. The priming dose of pipecuronium accelerated the onset time of intubation dose of atracurium more than that of atracurium. Priming with pipecuronium prolonged the duration of atracurium-induced neuromuscular block compared priming with atracurium.Conclusion Priming injection of relaxant with different chemical structure accelerates the onset time and prolongs the duration of action of the latter.

关 键 词：阿曲库铵 哌库溴铵 预注法 复合应用 

分 类 号：R614[医药卫生—麻醉学]