Title: Paralytic Agents for RSI
题目：RSI时麻痹剂的使用
作者：肖锋（Feng Xiao）
Emergency Physicians regularly use neuromuscular blocking agents for rapid sequence intubation. It is not uncommon to wonder why a specific patient seems to respond with inadequate paralysis or an extended duration of neuromuscular blockade. Some pearls regarding the use of nondepolarizing agents:
急诊医师经常做快速序列气管插管时使用神经肌肉阻断剂。经常引人思考的是为什么一个特定的病人不是反应麻痹不足就是出现神经肌肉阻滞的持续时间延长。下面是几个在使用非去极化剂时的要点：
Hypercalcemia decreases duration of blockade.
高血钙缩短阻滞时间。
Hypermagnesemia prolongs the duration of action.
高镁血症将延长有效时间。
Hypothermia can prolong the duration of action.
低温可以延长有效时间。
Hypokalemia may augment the blockade.
低钾血症可增强阻滞效果。
Acidosis enhances the blockade effect.
酸中毒加强阻滞的效果。
Aminoglycosides are known to prolong the duration of action.

Patients chronically on phenytoin/carbamazepine exhibit resistance to rocuronium.
氨基苷类抗生素延长有效时间是众而周知的。长期服用苯妥英钠/卡马西平的患者会出现对罗库溴铵的耐药。
Severe hepatic dysfunction prolongs rocuronium's effect. However, renal failure does not affect the duration of single doses.
严重肝功能障碍延长罗库溴铵的作用。然而，肾功能衰竭并不影响单剂量的持续时间。
References 参考文献:

(1) Greenberg SB, et al. Crit Care Med 2013;41:1332-44.
(2) Warr J, et al. Ann Pharmacother 2011;45:1116-1126.