[ロクロニウムまたはシサトラクリウムとの神経筋遮断の経過に対するネオスチグミンの影響：無作為化二重盲検試験]

目的：静脈内麻酔中の神経筋遮断の時間コースとロクロニウムまたはシサトラキュリウムを比較すること。 材料と方法：ASA 1-2に分類された患者は、全身麻酔のためにロクロニウムまたはシサトラキュリウムの95％の有効用量の2倍の単回注射の盲検投与を受けるために無作為化され、次に最初の列車の回収時にネオスティグミンとアトロピン4 (TOF) twitch at 5% or 25%, or normal saline solution as placebo at recovery of the first TOF twitch at 25%.The neuromuscular blockade was monitored by acceleromyography.Intergroup comparisons were carried out by Student t test and analysis of variance. RESULTS: Sixty patients were enrolled.平均（SD）発症時間は、（2.58 [0.81]）のシサトラキュリウムと比較して（1.04 [0.32]）ロクロニウムでより速くなり、持続時間は短く、5％の最初のtwichまでの時間は30分でした。rocuronium and 38.1 (9.7) minutes with cisatracurium.神経筋遮断が逆転した場合、遮断の総持続時間（時間から80％のTOF比）もロクロニウムで短くなりましたが、ネオスティグミンが使用されなかったときに反転をブロックする時間に違いはありませんでした：62（18.9）分回回収までfrom the rocuronium blockade vs 66.96 (15.9) minutes to recover from a cisatracurium blockade.逆転が使用されなかった場合、神経筋遮断薬の60分および90分の投与で80％未満のTOF比が使用されていませんでした（ロクロニウムを投与され、60分で60％、90分で20％未満;60分で80％、90分で40％）。 結論：90分未満の外科的処置でロクロニウムまたはシサトラクリウム誘発性神経筋遮断に拮抗しないと、残留遮断のパーセントが高い（TOF比<80％）。

OBJECTIVES: To compare the time-course of neuromuscular blockade with rocuronium or cisatracurium during intravenous anesthesia, in terms of both the time to spontaneous recovery or time to reversal after administration of neostigmine. MATERIAL AND METHODS: Patients classified as ASA 1-2 were randomized to receive blinded administration of a single injection of twice the 95% effective dose of rocuronium or cisatracurium for general anesthesia, and then neostigmine plus atropine at recovery of the first train-of-4 (TOF) twitch at 5% or 25%, or normal saline solution as placebo at recovery of the first TOF twitch at 25%. The neuromuscular blockade was monitored by acceleromyography. Intergroup comparisons were carried out by Student t test and analysis of variance. RESULTS: Sixty patients were enrolled. Mean (SD) time to onset was faster with rocuronium at (1.04 [0.32] minutes) compared with cisatracurium at (2.58 [0.81] minutes) and duration was shorter: time to the first twich at 5% was 30 (6.4) minutes with rocuronium and 38.1 (9.7) minutes with cisatracurium. The total duration of blockade (time to the 80% TOF ratio) was also shorter with rocuronium when the neuromuscular blockade was reversed, but there were no differences in the time to block reversal when neostigmine was not used: 62 (18.9) minutes to recovery from the rocuronium blockade vs 66.96 (15.9) minutes to recover from a cisatracurium blockade. A high percentage of patients had less than an 80% TOF ratio at 60 and 90 minutes of administration of the neuromuscular blockerswhen reversal was not used (patients receiving rocuronium, 60% at 60 minutes, and 20% at 90 minutes; patients receiving cisatracurium, 80% at 60 minutes, and 40% at 90 minutes). CONCLUSION: Not antagonizing a rocuronium- or cisatracurium-induced neuromuscular blockade in surgical procedures lasting less than 90 minutes can lead to a high percentaje of residual blockade (TOF ratio <80%).