Impacto de la coadministración de 10 mg/kg de cloruro cálcico y neostigmina en el tiempo de extubación: ensayo controlado aleatorizado

IF 0.9 Q3 ANESTHESIOLOGY
S. Elkenany, M.M. Alseoudy, M.E. Elshehawi, S. Bakrey, M. Aboelela
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Abstract

Introduction and objectives

Some studies investigating the effect of calcium on neostigmine-induced recovery of neuromuscular blockade have shown that this combination promotes neuromuscular recovery, but does not significantly affect the incidence of postoperative residual curarization and time to extubation. This study aimed to evaluate the effects of 10 mg/kg calcium chloride co-administered with neostigmine on early recovery and time to extubation.

Patients and methods

This prospective, randomized, double-blinded, placebo-controlled study included 88 ASA I–II patients aged between 18 and 65 years who were scheduled for elective surgery lasting at least 1 hour under general anaesthesia in which 10 mg/kg of calcium chloride or the same volume of normal saline was co-administered with 5 μg/kg of neostigmine at the end of surgery. Time to extubation (time from neostigmine administration to extubation), time from neostigmine administration to TOF ratio (TOFr) 0.9 (neuromuscular recovery), and the incidence of residual neuromuscular blockade (RNMB) and other adverse effects were recorded.

Results

Median (Q1, Q3) extubation time was significantly shorter in the calcium group vs. the placebo group (6.5 min [5.52-7.43] vs. 9.78 min [8.35-11]), P<.001. Median neuromuscular recovery time in the calcium group was 5 min vs. 7.1 min in the placebo group, P<.001. Patients in the calcium group had significantly higher TOFr and lower incidence of RNMB at 5 and 10 minutes vs. the placebo group, and no significant side effects.

Conclusion

Calcium chloride at a dose of 10 mg/kg co-administered with neostigmine promotes early neuromuscular recovery and reduces time to extubation by about 32%.

Abstract Image

联合使用 10 毫克/千克氯化钙和新斯的明对拔管时间的影响:随机对照试验。
导言和目的一些研究调查了钙对新斯的明诱导的神经肌肉阻滞恢复的影响,结果表明这种联合用药可促进神经肌肉恢复,但不会显著影响术后残余凝血的发生率和拔管时间。本研究旨在评估 10 毫克/千克氯化钙与新斯的明合用对早期恢复和拔管时间的影响。患者和方法这项前瞻性、随机、双盲、安慰剂对照研究纳入了 88 名年龄在 18 岁至 65 岁之间的 ASA I-II 级患者,这些患者计划在全身麻醉下接受至少 1 小时的择期手术,在手术结束时,10 毫克/千克氯化钙或相同体积的生理盐水与 5 微克/千克新斯的明联合给药。记录了拔管时间(从使用新斯的明到拔管的时间)、从使用新斯的明到TOF比率(TOFr)0.9(神经肌肉恢复)的时间、残余神经肌肉阻滞(RNMB)的发生率以及其他不良反应。结果钙剂组与安慰剂组相比,中位(Q1、Q3)拔管时间明显缩短(6.5 分钟 [5.52-7.43] 与 9.78 分钟 [8.35-11]),P<.001。钙剂组的中位神经肌肉恢复时间为 5 分钟,而安慰剂组为 7.1 分钟,P<.001。与安慰剂组相比,钙剂组患者在 5 分钟和 10 分钟时的 TOFr 明显更高,RNMB 发生率更低,且无明显副作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.80
自引率
15.40%
发文量
113
审稿时长
82 days
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