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- Tracheal Intubation Condition-- a Comparison between One Minute after Rocuronium Alone, One Minute after Rocuronium Combined with Atracurium and One Minute after Atracurium with Rocuronium at One Minute Priming Interval
- Effectiveness and Safety of Rocuronium-hypnotic Sequence for Rapid-sequence Induction
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題名 | Tracheal Intubation Condition-- a Comparison between One Minute after Rocuronium Alone, One Minute after Rocuronium Combined with Atracurium and One Minute after Atracurium with Rocuronium at One Minute Priming Interval=單獨使用Rocuronium、Rocuronium與Atracurium混合或使用Rocuronium 1 分鐘後,再給Atracurium插管之比較 |
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作者姓名(中文) | 滿恬恬; 鄭仁坤; 黃家樂; 陳建全; 饒瑞泓; 吳國驊; 鄭清榮; | 書刊名 | 麻醉學雜誌 |
卷期 | 40:4 2002.12[民91.12] |
頁次 | 頁179-183 |
分類號 | 416.5 |
關鍵詞 | 非去極化肌肉鬆弛劑; 藥物協同作用; Neuromuscular nondepolarizing agents; Rocuronium bromide; Drug synergism; |
語文 | 英文(English) |
中文摘要 | 背景:Rocuronium,一種vecuronium的類固醇類似體,特別設計來縮短插管時間。實驗情形下,同理使用二種非去極化肌肉鬆弛劑,不是會産生加成作用(additive effect),就是會産生協合作用(synergistic effect)。實驗觀察中建議rocuronium剛開始時是以協合作用(synergistic effect)來加快其他的非雲極化肌肉鬆弛劑。方法:爲了探討rocuronium是否能加快atracrium的插管速度,我們使用120位需要插管的志願選擇性手術病人,平均劃分爲3組來接受以下三種方案:第一組2倍ED95的rocuronium(0.6mg/kg),第二組等強度混合ED95的rocuronium(0.3mg/kg)和artacurium(0.25mg/kg),第三組使用rocuronium(0.1mg/kg)1分鍾後,再給atracurium(0.42mg/kg)。在肌肉鬆弛劑給完1分鍾後,應用以下臨床標准給予計分並評估插管的困難度:(1)插管時之困難度(1-3分),(2)喉頭聲帶之鬆弛度(1-3分),(3)咳嗽的程度(1-3分),(4)有無四肢活動(1-3分)。評估後將所有分數加起來區分爲:好(4-5分)、尚可(6-7分)、不好(8-12分)。結果:第一組和第二組的插管情況雷同,可是前二組比第三組略佳。但在使用Pearson Chisquare Test下,並元達到統計學之差異。結論:在我們使用的劑量下,不管是單一使用rocuronium(0.6mg/kg),等強度混合rocuronium(0.3mg/kg)和atracurium(0.25mg/kg),或先給rocuronium(0.1mg/kg)1分鍾後,再給atracurium(0.42mg/kg, priming)所達成的滿意插管時間,在統計學上無明顯之不同。 |
英文摘要 | Background: Rocuronium, a monoquaternary steroid analogue of vecuronium, is designed to provide a rapid onset of action. Experimentally, it has been shown that two non-depolarizing neuromuscular relexants administered together can produce either a neuromuscular block of a size expected to be the sum of the individual doses (additive effect) or a larger neuromuscular block (synergistic effect). Experimental observations have suggested that during onset rocuronium acts synergistically with other nondepolarizing agents, but that at a steady state the combined action is additive. Methods: To investigate whether rocuronium can speed up the onset of atracurium for intubation, 120 patients who consented to receive elective surgery requiring tracheal intubation were randomly assigned to 3 equally divided groups to receive one of the following three different combinations of muscle relaxants: twice ED95 of rocuronium (0.6 mg/kg group 1), an equipotent mixture of ED of rocuronium and atracurium (0.3 mg/kg and 0.25 mg/ kg respectively, group 2), and rocuronium 0.1 mg/kg to prime atracurium 0.42 mg/kg at 1 mlii intervaL Intubation conditions were assessed 1 minute after intravenous muscle relexant injection, and scored as good, acceptable and poor based on four clinical evaluators: the ease of laryngoscopy (score of 1-3), the relexation of vocal cord (1-3), the degree of coughing (1-3), and movement of extremity (1-3). Adding up togethet; intubation condition that scored 4-5 was considered to be good, 6-7 acceptable, and 8-12 pool. Results: The conditions produced in the rocuronium and the mixture groups were similar and both were moderately better than those of the priming group. Good intubation conditions were achieved in 58% patients of the rocuronium group, 63% of the mixture group and 43% of the priming group. By Pearson Chi-square test, the comparisons did not show statistical significance between groups. Conclusions: Statistically, rocuronium alone, mixture of equipotent atracurium and rocuronium, and using rocuronium to prime atracurium all provided similar onset for satisfactory intubation. |
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