- 期刊
Priming Technique Accelerates the Onset Time of Mivacurium in Children during Halothane Anesthesia
Halothane麻醉之孩童Priming給藥技術可加速Mivacurium之作用起始時間
摘要
Background: Mivacurium is considered a relaxant suitable for tracheal intubation in children due to its rapid onset. We compared the neuromuscular effects of mivacurium, with and without priming, in children under-going elective surgery during halothane anesthesia. Methods: Forty pediatric patients (2-10 yr, ASA class I) were randomly assigned into 2 groups and studied under halothane anesthesia. The non-priming group (n=20) received mivacurium 0.25 mg/kg, and the priming group (n=20) received a priming dose of mivacurium 0.025 mg/kg, followed by an intubating dose of 0.225 mg/kg 3 min later. Thenar Electromyogram responsive to supramaximal train-of-four stimulation of the ulnar nerve at 12 s intervals was used as neuromuscular monitoring. Results: The onset time in the priming group was significantly faster than in the non-priming group (1.04 min vs. 1.7 min). The mean time from injection of intubating dose to spontaneous recovery to 25%, 50% and 75% twitch were not influenced by priming technique. Side effects, such as cutaneous flushing and hypotension, were unremarkable at this dose in children. Conclusions: Priming technique can significantly accelerates the onset of mivacurium in pediatric patients under halothane anesthesia.
並列摘要
背景：由於mivacurium在孩童的作用起始時間較成人為快，故被認為適合直接用於插管。因此我們於行常規手術之孩童、在以halothane麻醉下，比較mivacurium在有無預先給藥的情況下，所產生神經肌肉作用的差異。方法：四十位孩童（二至十歲，ASA class I），在以halothane麻醉下，隨機均分為兩組，無預先給藥組的一組予以注射mivacunium 0.25 mg／kg，有預先給藥先接受預先劑量0.025 mg／kg，三分鐘，再注射插管劑量0.225 mg／kg。比較兩組神經肌肉作用之作用起始時間、最大阻斷效應、阻斷回復時間、插管狀況及副作用。結果：Mivacurium的作用起始時間，於有預先給藥組，較之無預先給藥組，有顯著的增快（1.04分鐘比1.7分鐘）。最大阻斷效應、阻斷回復時間及插管狀況的平均值，並不受預先給藥的影響。副作用，如表皮潮紅和低血壓，於兩組皆不明顯。結論：Halothane麻醉孩童priming給藥技術可加速mivacurium之作用起始時間。