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目的:将结构不同的维库溴铵(VEC)与阿曲库铵(ATC)复合应用,观测肌松效果和判断其作用类型。方法:54例择期手术病人(ASA Ⅰ～Ⅱ级)分三组,静注咪唑安定-依托咪酯-芬太尼麻醉诱导后,以单次静注给药方式,采用“四个成串”(TOF)刺激尺神经,监测拇内收肌肌颤搐变化。观察起效时间和T_1达到最大抑制,得出ATC或VEC单用和ATC+VEC合用时的量-效曲线,求得各自ED_(50)、ED_(95)值。并运用等效图法和代数法对相互作用进行分析。结果:复合用药后ATC、VEC的ED_(50)值分别为56.26和11.71μg/kg,复合用药时ED_(50)的合用代数值等于0.75<1。结论:维库溴铵与阿曲库铵复合应用时产生协同作用,表现为量-效曲线左移。
OBJECTIVE: To evaluate the effect of VEC and atracurium (ATC) on different structures of muscles and observe the effect of muscle relaxant. Methods: Fifty-four patients undergoing elective surgery (ASA Ⅰ ~ Ⅱ) were divided into three groups. After intravenous midazolam-etomidate-fentanyl induction, a single intravenous injection "(TOF) to stimulate the ulnar nerve, monitor the adductor myotubus twitch changes. Observe the onset time and T_1 to achieve the maximum inhibition, get ATC or VEC single and ATC + VEC combined use of the dose-effect curve obtained their ED_ (50), ED_ (95) value. And use the equivalent graph method and algebra method to analyze the interaction. Results: The ED 50 values of ATC and VEC were 56.26 and 11.71 μg / kg respectively after combination therapy, and the combined value of ED 50 for combination therapy was 0.75. Conclusion: The combination of vecuronium and atracurium has a synergistic effect, showing the shift of the dose-effect curve to the left.