稳态麻醉和快速序列诱导时阿曲库铵对眼压的影响:与琥珀酰胆碱的比较。

G G Lavery, J N McGalliard, R K Mirakhur, W F Shepherd
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引用次数: 12

摘要

研究了10例稳常氧化亚氮-氧-芬太尼麻醉时阿曲库铵0.5 mg X kg-1或琥珀胆碱1.0 mg X kg-1对眼压的影响。服用阿曲库铵后IOP没有变化,但在服用琥珀胆碱1分钟后,IOP从5.6 mmHg显著升高(p < 0.025)至13.2 mmHg,并在3分钟内显著高于对照组。另外20名患者接受了阿曲库铵0.75 mg X kg-1或琥珀胆碱1.0 mg X kg-1,作为快速序列诱导的一部分,阿曲库铵在硫贲妥之前使用,琥珀胆碱在之后使用。两组患者插管条件均可接受。硫喷妥与IOP显著降低相关(p < 0.025)。虽然两组的IOP都因喉镜检查和插管而增加(阿曲库铵组从8.0 mmHg增加到12.1 mmHg,琥珀胆碱组从7.5 mmHg增加到14.5 mmHg),但前者没有超过诱导前的IOP。在琥珀胆碱组,插管后IOP超过诱导前值2分钟,尽管仅在插管后立即读数时这种增加是显著的(p < 0.05)。结论:0.75 mg X kg-1剂量的阿曲库铵是一种适合用于快速序列诱导的松弛剂。
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The effects of atracurium on intraocular pressure during steady state anaesthesia and rapid sequence induction: a comparison with succinylcholine.

The effects of atracurium 0.5 mg X kg-1 or succinylcholine 1.0 mg X kg-1 on intraocular pressure (IOP) were studied in ten patients during steady state nitrous oxide-oxygen-fentanyl anaesthesia. IOP was unchanged following atracurium but, one minute after succinylcholine, it had increased significantly (p less than 0.025) from 5.6 mmHg to 13.2 mmHg and remained significantly above control for 3 min. Twenty additional patients received either atracurium 0.75 mg X kg-1 or succinylcholine 1.0 mg X kg-1 as part of a rapid sequence induction, atracurium being administered prior to, and succinylcholine after, thiopentone. Intubating conditions were acceptable in all patients in both groups. Administration of thiopentone was associated with a significant (p less than 0.025) decrease in IOP. Although IOP increased in both groups as a result of laryngoscopy and intubation (from 8.0 mmHg to 12.1 mmHg in the atracurium Group and from 7.5 mmHg to 14.5 mmHg in the succinylcholine group) it did not exceed pre-induction IOP in the former. In the succinylcholine group, IOP after intubation exceeded pre-induction values for 2 min, although this increase was significant (p less than 0.05) only at the immediate post-intubation reading. It is concluded that atracurium in a dose of 0.75 mg X kg-1 is a suitable relaxant for use in rapid sequence induction.

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