论文信息 - A Novel Approach for Administering Neuromuscular Blocking Agents That Considers the Effect-Site Concentration

A Novel Approach for Administering Neuromuscular Blocking Agents That Considers the Effect-Site Concentration

プロポフォールやフェンタニル, レミフェンタニルなどの静脈麻酔薬が, TCIの使用によりその効果部位濃度を意識して投与されるようになり, コントロールが容易になった中, 筋弛緩薬に対して同様の意識をもって投与する者は少ない. ベクロニウムにおいて, 理論上TCIは十分可能であるが, その際障害になるのはその代謝産物3-desacetyl vecuroniumの存在である. 3-desacetyl vecuroniumはベクロニウムの80%の力価をもち, その薬物動態も考慮しなければ一定の筋弛緩効果を得ることは難しい. この代謝物を無視したTCIは実際の濃度と大きな差異を生じ, 覚醒遅延を引き起こす原因になりうる. ロクロニウムはこのような薬理活性をもつ代謝物を産生せず, よりTCIに適した薬物であるといえる.

H. Iwasaki | T. Sasakawa

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