阿曲库铵与维库溴铵复合应用的药效学研究  

Pharmacodynamics of combination of atracurium and vecuronium

作　　者：叶照君[1] 陈锡明[2] 杭燕南[2] 孙大金[2] 

机构地区：[1]上海市静安区中心医院,200040 [2]上海第二医科大学附属仁济医院

出　　处：《中华麻醉学杂志》1998年第11期649-651,共3页Chinese Journal of Anesthesiology

摘　　要：目的:将结构不同的维库溴铵(VEC)与阿曲库铵(ATC)复合应用,观测肌松效果和判断其作用类型。方法:54例择期手术病人(ASA Ⅰ～Ⅱ级)分三组,静注咪唑安定-依托咪酯-芬太尼麻醉诱导后,以单次静注给药方式,采用"四个成串"(TOF)刺激尺神经,监测拇内收肌肌颤搐变化。观察起效时间和T_1达到最大抑制,得出ATC或VEC单用和ATC+VEC合用时的量-效曲线,求得各自ED_(50)、ED_(95)值。并运用等效图法和代数法对相互作用进行分析。结果:复合用药后ATC、VEC的ED_(50)值分别为56.26和11.71μg/kg,复合用药时ED_(50)的合用代数值等于0.75<1。结论:维库溴铵与阿曲库铵复合应用时产生协同作用,表现为量-效曲线左移。Objective: To observe the effects of neuromuscular blockade after combining atracurium (ATC) with veeuronium (VEC). Method: Fifty-four patients undergoing elective abdominal surgery(ASA grade Ⅰ-Ⅱ) were allocated randomly into 3 groups. After induction with intravenous midazolam-etomidate-fentanyl, neuromuscular blockade was measured with the train of four (TOF) to the ulnar nerve by monitoring the contraction of musculus adductor pollicis. The onset time and the peak effect were observed. According to the dose-effect relationships of the combination of ATC and VEC and that of either ATC or VEC given alone,the ED_(50) and ED_(95) were caeulated. The isogram and algebraic methods were used to analyse interaction between them. Result: The fraction ED_(50) values of ATC and VEC in combination were 52.26 and 11.71μg/kg respectively, The algebraic subtotal of combinations was 0.75<1. Conclusion: The combination of atracurium and vecuronium produces synergism, with dose-effect relationship line being shifted to left.

关 键 词：维库溴铵 阿曲库铵 协同作用 药理学 

分 类 号：R971.8[医药卫生—药品] R969.2[医药卫生—药学]