The immediate cardiovascular effects of pancuronium, alcuronium and tubocurarine in man
The immediate cardiovascular effects of pancuronium, alcuronium and tubocurarine in man
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泮库溴铵、阿库溴铵和筒箭毒碱对人类的直接心血管作用
DOI：
10.1111/j.1365-2044.1972.tb08247.x
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发表时间：
1972
期刊：
影响因子：
10.7
通讯作者：
M. Styles
中科院分区：
文献类型：
--
作者：
A. J. Coleman;John W. Downing;W. P. Leary;D. G. Moyes;M. Styles
以前的研究在人的心血管作用的肌肉松弛剂泮库溴铵一直相互矛盾。Kelman & Kennedy 1发现心率、血压和心输出量显著增加。McDowell & Clark2和Kolliker3报告血压下降，心率无变化。Baird & Reid4和Fastner & Agostons发现对心率和血压没有显著影响，Loh6发现泮库溴铵增加血压和心率。他们的报告之间的差异可以合理地归因于研究方法的差异。术前用药和手术刺激程度存在差异。有时在气管内插管期间进行测量，这是一种众所周知的导致心动过速的手术，几名患者正在接受洋地黄治疗。动脉二氧化碳水平并不总是得到控制，一些研究是对接受挥发性麻醉剂的患者进行的。出于类似的原因，在关于筒箭毒碱和阿库铵对心血管影响的报告中也存在差异13。在评价一种新药时，将其与在临床实践中发挥类似作用的已确立药物进行比较是有用的。在这项研究中，潘库溴铵，一个相对较新的药物，已与筒箭毒碱和阿库溴铵在类似的情况下管理。据作者所知，之前没有此类性质的报告，据我们所知，文献研究未显示肌肉松弛剂给药后人体心输出量绝对水平的数据。
Previous studies in man on the cardiovascular effects of the muscle relaxant pancuronium have been conflicting. Kelman & Kennedy 1 found a significant increase in heart rate, blood pressure and cardiac output. McDowell & Clark2 and Kolliker3, reported a fall in blood pressure with no change in heart rate. Baird & Reid4 and Fastner & Agostons, found no significant effect on the heart rate and blood pressure and Loh6 found that pancuronium increased both blood pressure and heart rate. The discrepancies between their reports can be reasonably attributed to differences in methods of study. There were differences in premedication and in the degree of surgical stimulation. Measurements were sometimes made during endotrachea1 intubation7, which is a procedure well known to cause tachycardias and several patients were receiving digitalis. Arterial carbon dioxide levels were not always controlled and some studies were performed upon patients receiving volatile anaesthetic agents. There have also been discrepancies too, for similar reasons, in reports on the cardiovascular effects of tubocurarine and alcuroniumg13. In evaluating a new drug it is useful to compare it with established agents which fulfil similar roles in clinical practice. In this study pancuronium, a relatively new drug, has been compared with tubocurarine and alcuronium administered in similar circumstances. There are no previous reports of this nature so far as the authors are aware and, to our knowledge, no data on the absolute level of cardiac output in man following the administration of muscle relaxants has been revealed by a study of the literature.