Neuromuscular blockade of atracurium in permissive hypercapnic versus normocapnic swine undergoing laparoscopy.
Neuromuscular blockade of atracurium in permissive hypercapnic versus normocapnic swine undergoing laparoscopy.
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DOI：
10.1371/journal.pone.0200439
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
De Benedictis GM
中科院分区：
文献类型：
--
作者：
Bellini L;De Benedictis GM
神经肌肉阻滞剂（NMBAs）常用于实验性腹腔镜在猪进行二氧化碳气腹。可能存在高碳酸血症，并可能延长NMBA的药理活性。本研究的目的是评价允许性高碳酸血症对猪阿曲库铵的神经肌肉阻滞作用的影响。6只体重为30.5 ± 1.6 kg的大型白色猪通过肌内注射氯胺酮和美托咪定进行镇静，之后通过丙泊酚诱导麻醉并通过七氟烷维持麻醉。在正常碳酸血症和高碳酸血症条件下（PaCO2范围分别为35 - 45 mmHg和60 - 70 mmHg），静脉内给予阿曲库铵0.4 mg/kg，并通过加速度肌描记术监测神经肌肉阻滞。记录发作时间和达到0.7和0.9的四个比率（TOFR）的时间。在两种条件下测量呼吸参数、电解质和酸碱状态。两种情况的发作时间相似。高碳酸血症动物达到TOFR 0.7和0.9（神经肌肉阻滞持续时间）的时间长于碳酸血症正常动物，分别为1325 ± 300秒vs 855 ± 111秒（p = 0.002）和1823 ± 434秒vs 1218 ± 210秒（p = 0.005）。三只高碳酸血症猪的TOF计数为2和1，而不是4，伴有褪色。允许性高碳酸血症与pH值从7.444 ± 0.039降至7.257 ± 0.025（p <0.001）相关。未观察到心率、七氟烷潮气末浓度、体温和动脉血红蛋白饱和度存在差异。尽管如此，高碳酸血症猪的平均动脉压（p = 0.020）和血浆钾浓度（p = 0.003）在统计学上显著增加。高碳酸血症期间达到的PaCO2值在接受腹腔镜CO2气腹的猪中耐受良好。允许性高碳酸血症增加了阿曲库铵效应的持续时间，并导致少数猪的神经肌肉阻滞强度增加。
Neuromuscular blocking agents (NMBAs) are commonly used in experimental laparoscopy in swine undergoing carbon dioxide pneumoperitoneum. Hypercapnia may be present and may prolong NMBAs’ pharmacologic activity. The aim of this study is to evaluate the effect of permissive hypercapnia on the neuromuscular blockade of atracurium in swine. Six Large White swine weighing 30.5 ± 1.6 kg were sedated with intramuscular ketamine and medetomidine, after which anaesthesia was induced with propofol and maintained with sevoflurane. Atracurium 0.4 mg/kg was administered intravenously and the neuromuscular block monitored by acceleromyography during normocapnic and hypercapnic conditions (PaCO2 range 35–45 mmHg and 60–70 mmHg, respectively). Onset time and time to reach a train of four ratio (TOFR) of 0.7 and 0.9 were recorded. Cardiorespiratory parameters, electrolytes and acid-base status were measured under both conditions. Onset time was similar between the two conditions. Time to reach a TOFR of 0.7 and 0.9 (duration of the neuromuscular block) was longer in hypercapnic compared to normocapnic animals being 1325 ± 300 vs 855 ±111 (p = 0.002) and 1823 ± 434 vs 1218 ± 210 seconds (p = 0.005), respectively. Three hypercapnic swine had a TOF count of 2 and 1 instead of a count of 4 with fade. Permissive hypercapnia was associated with a decrease in pH from 7.444 ± 0.039 to 7.257 ± 0.025 (p < 0.001). No differences were observed for heart rate, end-tidal concentration of sevoflurane, body temperature and arterial haemoglobin saturation. Nonetheless, hypercapnic swine had a statistically significant increase in mean arterial pressure (p = 0.020) and plasma potassium concentration (p = 0.003). The values of PaCO2 achieved during hypercapnia were well tolerated in swine undergoing CO2 pneumoperitoneum for laparoscopy. Permissive hypercapnia increased the duration of the atracurium effect and caused an increase in the intensity of the neuromuscular block in few swine.
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影响因子：
6.7
作者：
Bevan, DR
通讯作者：
Bevan, DR
影响因子：
2.2
作者：
Madsen, Matias V.;Donatsky, Anders M.;Gatke, Mona R.
通讯作者：
Gatke, Mona R.
影响因子：
2.1
作者：
Gyermek, L;Lee, C;Nguyen, N
通讯作者：
Nguyen, N
影响因子：
8.8
作者：
PITTET, JF;TASSONYI, E;BENAKIS, A
通讯作者：
BENAKIS, A
DOI：
10.1007/bf03017852
发表时间：
2003-02-01
期刊：
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE
影响因子：
--
作者：
Pinard, AM;Donati, F;Carrier, M
通讯作者：
Carrier, M