Influence of metoclopramide on plasma cholinesterase and duration of action of mivacurium.
Influence of metoclopramide on plasma cholinesterase and duration of action of mivacurium.
复制标题
甲氧氯普胺对血浆胆碱酯酶和米库溴铵作用持续时间的影响。
DOI：
10.1093/bja/82.4.542
复制
发表时间：
1999
影响因子：
9.8
通讯作者：
M. Nathanson
中科院分区：
文献类型：
--
作者：
H. Skinner;K. Girling;A. Whitehurst;M. Nathanson
米库溴铵通过血浆胆碱酯酶（PCHE）代谢。甲氧氯普胺在体外和体内抑制 PCHE。我们评估了甲氧氯普胺对米库溴铵作用持续时间的影响，并测量了基线和最大阻滞时的 PCHE。在一项随机、双盲研究中，30 名患者接受了甲氧氯普胺 0.15 mg kg-1 静脉注射。或生理盐水，然后用异丙酚麻醉和米库氯铵 0.15 mg kg-1。使用 TOF-Guard 加速计，生理盐水组 TI 恢复到 25%、75% 和 90% 的时间分别为 13.4、19.3 和 21.9 分钟，甲氧氯普胺组分别为 17.8、25.3 和 28.8 分钟（分别为 P < 0.01、P < 0.05、P < 0.05）。各组之间的起效时间或恢复指数没有差异。各组内最大阻滞时的 PCHE 活性均下降（P < 0.01），但组间无差异。在对 8 名患者进行的第二项生化研究中，在服用甲氧氯普胺 0.15 mg kg-1 后、服用米库溴铵之前，检测到 PCHE 活性略有下降（P < 0.025）。我们得出结论，甲氧氯普胺可延长米库溴铵的作用持续时间。
Mivacurium is metabolized by plasma cholinesterase (PCHE). Metoclopramide inhibits PCHE in vitro and in vivo. We have assessed the effect of metoclopramide on duration of action of mivacurium and measured PCHE at baseline and at the time of maximal block. In a randomized, double-blind study, 30 patients received metoclopramide 0.15 mg kg-1 i.v. or saline, followed by propofol anaesthesia and mivacurium 0.15 mg kg-1. Using a TOF-Guard accelerometer, times to recovery of TI to 25%, 75% and 90% were 13.4, 19.3 and 21.9 min in the saline group and 17.8, 25.3 and 28.8 min in the metoclopramide group (P < 0.01, P < 0.05, P < 0.05, respectively). There were no differences in onset time or recovery index between the groups. PCHE activity at the time of maximum block decreased within each group (P < 0.01) but there was no difference between groups. In a second biochemical study of eight patients, a small decrease in PCHE activity was detected after metoclopramide 0.15 mg kg-1, but before administration of mivacurium (P < 0.025). We conclude that metoclopramide prolongs the duration of action of mivacurium.