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Macau Periodical Index (澳門期刊論文索引)

Author
Chen, Ximing
Title
Inlfuence of succinylcholine on the dose-response relationship of subsequently administered recuronium
Journal Name
澳門醫學雜誌
Pub. Info
2004年12月26日, Vol.4, No.4, pp. 240-243
Keyword
Rocuronium;Succinylcholine;Dose-response relationship;Drug interaction
Abstract
Objective:To study the effects of succinylcholine on the dose-response relationship of subsequenctly administered rocuronium in healthy patients. Method:Forty-eight ASA physical status I-II patients, aged 17-65 years, scheduled for elective general surgery, patients were randomly assigned to either the rocuronium treatment group(R) or succinylcholine-rocuronium treatment group (SR). Gerenal anesthesia was induced with thiopental 4 to 6 mg/kg and fentanyl 2 to 5 μg/kg intravenously and maintained with 60% nitrous oxide in oxygen. Additional doses of thiopental or fentanyl were administered as required. The dose-rsponse relationahip of rocuronium was determined by the single dose-response technique. In R group (n=24), rocuronium was given after induction of anesthesia. In SR group (n=24), patients were intubated after 1.5 mg/kg of succinylcholine and rocuronium was given after the complete recovery of neuromuscular blockade from succinylcholine. Patients were further randomly divided into 4 subgroups receiving 150,200,250 or 300 μg/kg of rocuronium respectively in both groups. Neuromuscular function was assessed accelographically with train-of-four (TOF) stimulation at the wrist every 12 seconds (using the TOF Guard® accelerometer). The relationship between probit-tranformed percentage depression of first twitch height (Th) of train-of-four stimulation and logarithm dose of rocuronium was analyzed using linear regression. Result:The dose-response curve of rocuronium after succinylcholine was shifted to the left in a parallel fashion compared with that of rocuronium given alone. ED50 and ED95 of rocuronium were 193 ± 69 and 367 ± 73 μg/kg respectively in R group, and 158 ± 35 and 317 ± 80μg/kg respectively in SR group (p<0.05). Conclusion:Succinylcholine shifts the dose-response curve of rocuronium to the left and potentiates the effects of the neuromuscular blockade by about 15% of subsequently administered rocuronium. Lower doses of rocuronium are required after prior succinylcholine. Paragraph Headings: 1. Introduction 2. Materials and methods 2.1. Patients and groups 2.2. Anesthesia 2.3. Measurements of neuromuscular function and statistical analysis 3. Results 4. Discussion Tables: 1. Demographic data 2. Dose-response data of rocuronium after and without succinylcholine