→ ray9401055:個人猜測原因會不會是跟其他藥比起來pancuronium較長效 06/13 03:05
pancuronium為何不能用於有風險病人的麻醉輔助確切解釋我沒找到
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BACKGROUND: After anaesthesia involving pancuronium a high incidence of both
residual neuromuscular block and postoperative pulmonary complications (POPC)
has been reported. The aim of this study was to compare the incidence of POPC
following the use of pancuronium, atracurium, and vecuronium, and to examine
the effect of residual neuromuscular block on the incidence of POPC. METHODS:
A total of 691 adult patients undergoing abdominal, gynaecological, or
orthopaedic surgery under general anaesthesia were randomised to receive
either pancuronium, atracurium, or vecuronium. Perioperatively, the response
to train-of-four (TOF) nerve stimulation was evaluated manually.
Postoperatively, the TOF ratios were measured mechanomyographically, and
through a 6-day follow-up the patients were examined for pulmonary
complications. RESULTS: The incidence of residual block, defined as a TOF
ratio < 0.7, was significantly higher in the pancuronium group (59/226: 26%)
than in the atracurium/vecuronium groups (24/450: 5.3%). In the pancuronium
group, significantly more patients with residual block developed POPC (10/59:
16.9%) as compared to patients without residual block (8/167: 4.8%). In the
atracurium/vecuronium groups, the incidence of POPC was not significantly
different in patients with (1/24: 4.2%) or without (23/426: 5.4%) residual
block. Multiple regression analysis indicated that abdominal surgery, age,
long-lasting surgery, and a TOF ratio < 0.7 following the use of pancuronium
were potential risk factors for the development of POPC. CONCLUSION:
Postoperative residual block caused by pancuronium is a significant risk
factor for development of POPC.
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