RELATIONSHIPS OF DIFFERENT PARAMETERS USED FOR THE MEASUREMENT OF NEUROMUSCULAR BLOCKADE
用于测量神经肌肉阻滞的不同参数的关系
基本信息
- 批准号:05671250
- 负责人:
- 金额:$ 1.34万
- 依托单位:
- 依托单位国家:日本
- 项目类别:Grant-in-Aid for General Scientific Research (C)
- 财政年份:1993
- 资助国家:日本
- 起止时间:1993 至 1994
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
Monitoring of the action of neuromuscular blocking agents is becoming more important in their rational and safe administration. In order to know the concentrations and the action of these agents and their active metabolites, it is necessary to evaluate various parameters as a whole. In this project, first we developed two types of transducers incorporated in the hand, which are practical and resistant to external disturbances. Tetanic fade and and TOF fade are considered to reflect the presynaptic effect of neuromuscular blocking agents. But it is not certain if these two parameters reflect the same phenomenon. We compared the tetanic contraction of the adductor pollicis muscle and the TOF of EEG of the hypothenar muscle. Tetanic contraction showed presynaptic stimulating effect during the recovery from the neuromuscular blockade, but TOF did not show this phenomenon. EMG of the foot muscle is often used for the measurement of neuromuscular blockade when the monitoring of the adductor pollicis is not possible. We compared the single twitch of the adductor pollicis and the TOF of the EMG of the foot muscle. During the recovery from vecuronium by neostigmine, TOF of the foot was slower to recover compared with the adductor pollicis, but the T1 of the foot exceeded the recovery of adductor pollicis finally. Therefore T1 of the EMG of the foot muscle does not necessary reflect the good recovery of single twitch of the adductor pollicis. In a 19 year old anephric man, we measured both vecuronium and 3-OH vecuronium concentrations and demonstrated that 3-OH vecuronium is contributing to the slow recovery of neuromuscular blockade in this patient. An automatic infusion system of neuromuscular blocking agents based on a closed loop system using a personal computer and monitoring the TOF was developed and this was proved to be clinically useful.
监测神经肌肉阻滞剂的作用对合理、安全地给药变得越来越重要。为了了解这些药物及其活性代谢物的浓度和作用,有必要对各种参数进行整体评价。在这个项目中,首先我们开发了两种类型的传感器,这两种传感器都是实用的,可以抵抗外部干扰。强直消退和TOF消退被认为反映了神经肌肉阻滞剂的突触前效应。但这两个参数是否反映了同一种现象还不确定。比较了拇收肌强直收缩和小鱼际肌脑电图的TOF。强直性收缩在肌松恢复过程中表现出突触前兴奋效应,而TOF无此现象。当无法监测拇收肌时,足部肌肉的EMG常用于测量神经肌肉阻滞。我们比较了拇内收肌的单次抽动和足肌肌电图的TOF。新斯的明在维库溴铵恢复过程中,足TOF恢复较拇收肌慢,但足T1最终超过拇收肌恢复。因此,足肌肌电图的T1并不一定反映拇收肌单次抽动恢复良好。在一名19岁无肾男性患者中,我们测量了维库溴铵和3-OH维库溴铵的浓度,并证明3-OH维库溴铵有助于该患者神经肌肉阻滞的缓慢恢复。本文介绍了一种基于微机闭环控制和TOF监测的神经肌肉阻滞剂自动输注系统。
项目成果
期刊论文数量(54)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
菅井直介,矢島直: "神経筋モニターにおける拇指内転筋の単収縮力と足の筋肉のEMGとの比較" 麻酔集中治療とテクノロジー. 1994. 1-4 (1994)
Naosuke Sugai,Nao Yajima:“神经肌肉监测中拇内收肌抽搐力和腿部肌肉肌电图的比较”麻醉重症监护和技术 1994 年。 1-4 (1994)。
- DOI:
- 发表时间:
- 期刊:
- 影响因子:0
- 作者:
- 通讯作者:
菅井直介: "筋弛緩導の基礎 鈴木太編 筋弛緩導の臨床" 真誠堂出版, 23 (1994)
菅井尚介:“肌肉放松指导的基础,铃木富俊主编,肌肉放松指导的临床实践”新星堂出版社,23(1994)
- DOI:
- 发表时间:
- 期刊:
- 影响因子:0
- 作者:
- 通讯作者:
Sugai N,Yajima C.: "Pharmacokinetics of pipecuronium and rocuronium." Masui. 42 (10). S46 (1993)
Sugai N,Yajima C.:“哌库溴铵和罗库溴铵的药代动力学”。
- DOI:
- 发表时间:
- 期刊:
- 影响因子:0
- 作者:
- 通讯作者:
Sugimoto M,Yajima C,Sugai N,et al.: "Prolonged neuromuscular blockade with vecuronium in a 19-year-old man." Masui. 42 (10). S414 (1993)
Sugimoto M、Yajima C、Sugai N 等人:“对一名 19 岁男性使用维库溴铵进行长期神经肌肉阻滞。”
- DOI:
- 发表时间:
- 期刊:
- 影响因子:0
- 作者:
- 通讯作者:
菅井直介(鈴木太編): "筋弛緩薬" 克誠堂出版(1994年出版予定), (1994)
菅井尚介(铃木富俊主编):《肌肉松弛剂》久生堂出版社(预定1994年出版),(1994年)
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- 影响因子:0
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