Dose response of succinylcholine at the adductor pollicis of children with cerebral palsy during propofol and nitrous oxide anesthesia.
Dose response of succinylcholine at the adductor pollicis of children with cerebral palsy during propofol and nitrous oxide anesthesia.
复制标题
脑瘫儿童丙泊酚和笑气麻醉期间拇内收肌琥珀胆碱的剂量反应。
作者：
M. Theroux;B. Brandom;M. Zagnoev;R. Kettrick;F. Miller;C. Ponce
脑瘫儿童可能对非去极化神经肌肉阻滞药物引起的瘫痪有抵抗力。此前尚未研究过推注琥珀胆碱对脑瘫儿童的功效。因此，我们测量了用异丙酚和笑气麻醉的脑瘫儿童的拇内收肌对琥珀胆碱的反应。 40 名年龄在 2 岁至 10.2 岁之间的痉挛性四肢瘫痪脑瘫儿童被随机分配，在异丙酚和一氧化二氮麻醉期间接受 100、175、250 或 375 微克/千克的琥珀胆碱。每 10 秒用四组超最大刺激刺激尺神经，并由 Datex NMT 监视器记录拇内收肌的复合肌电图。使用三种不同底物（丙酰硫胆碱、苯甲酰胆碱和琥珀酰胆碱）测量所有患者的血浆胆碱酯酶活性。还通过抑制苯甲酰胆碱降解来测定丁卡因数。琥珀胆碱的 ED50 为 146.8 微克/千克，95% 置信区间为 111.4-193.7 微克/千克。琥珀胆碱的 ED95 为 360.5 微克，95% 置信区间为 273.3-475.5 微克/千克。我们的结论是，脑瘫儿童对琥珀胆碱轻微敏感，但可能不足以具有临床重要性。
Children with cerebral palsy may be resistant to paralysis induced by nondepolarizing neuromuscular blocking drugs. Potency of a bolus of succinylcholine in children with cerebral palsy has not been studied previously. Therefore, we measured the response of the adductor pollicis to succinylcholine in children with cerebral palsy anesthetized with propofol and nitrous oxide. Forty children between the ages of 2 and 10.2 yr with spastic quadriplegic cerebral palsy were randomly assigned to receive 100, 175, 250, or 375 micrograms/kg of succinylcholine during anesthesia with propofol and nitrous oxide. The ulnar nerve was stimulated with a train-of-four supramaximal stimulus every 10 s and the compound electromyogram of the adductor pollicis recorded by a Datex NMT monitor. Plasma cholinesterase activity was measured in all patients with three different substrates (propionylthiocholine, benzoylcholine, and succinylcholine). Dibucaine number was also determined using inhibition of benzoylcholine degradation. ED50 of succinylcholine was 146.8 micrograms/kg with 95% confidence intervals of 111.4-193.7 micrograms/kg. ED95 of succinylcholine was 360.5 micrograms with 95% confidence intervals of 273.3-475.5 micrograms/kg. We conclude that children with cerebral palsy are slightly sensitive to succinylcholine, but probably not sufficiently to be clinically important.
长期苯妥英治疗期间对美托库林的敏感性降低可能归因于蛋白质结合和乙酰胆碱受体的变化。
影响因子：
8.8
作者：
Kim,CS;Arnold,FJ;Itani,MS;Martyn,JA
通讯作者：
Martyn,JA