毒理性
◉ 母乳喂养期间使用总结:目前没有关于维库溴铵在哺乳期使用的资料。由于它作用时间短、极性高且口服吸收不良,因此不太可能以高浓度进入母乳或进入婴儿的血液循环。当使用多种麻醉剂组合进行手术时,请遵循手术期间使用的最具问题的药物的建议。使用维库溴铵作为组成部分的全身麻醉进行剖宫产可能会延迟哺乳的开始。
◉ 对哺乳婴儿的影响:截至修订日期,没有找到相关的已发布信息。
◉ 对泌乳和母乳的影响:一项随机研究比较了使用全身麻醉、脊髓麻醉或硬脊膜外麻醉进行剖宫产与正常阴道分娩对血清催乳素和催产素的影响以及开始泌乳的时间。全身麻醉使用丙泊酚2 mg/kg和罗库溴铵0.6 mg/kg进行诱导,然后根据需要使用七氟醚和罗库溴铵0.15 mg/kg。分娩后,所有组的患者都接受了1 L生理盐水中含有30国际单位催产素的输注,如果她们没有高血压,则给予0.2 mg的甲基麦角新碱。全身麻醉组在分娩后给予芬太尼1至1.5 mcg/kg。全身麻醉组(n = 21)的术后催乳素水平高于其他组,开始泌乳的平均时间也更长(25小时),而其他组为10.8至11.8小时。非药物阴道分娩组产后的催产素水平高于全身和脊髓麻醉组。
◉ Summary of Use during Lactation:No information is available on the use of vecuronium during breastfeeding Because it is short acting, highly polar and poorly absorbed orally, it is not likely to reach the breastmilk in high concentration or to reach the bloodstream of the infant. When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication used during the procedure. General anesthesia for cesarean section using vecuronium as a component may delay the onset of lactation.
◉ Effects in Breastfed Infants:Relevant published information was not found as of the revision date.
◉ Effects on Lactation and Breastmilk:A randomized study compared the effects of cesarean section using general anesthesia, spinal anesthesia, or epidural anesthesia, to normal vaginal delivery on serum prolactin and oxytocin as well as time to initiation of lactation. General anesthesia was performed using propofol 2 mg/kg and rocuronium 0.6 mg/kg for induction, followed by sevoflurane and rocuronium 0.15 mg/kg as needed. After delivery, patients in all groups received an infusion of oxytocin 30 international units in 1 L of saline, and 0.2 mg of methylergonovine if they were not hypertensive. Fentanyl 1 to 1.5 mcg/kg was administered after delivery to the general anesthesia group. Patients in the general anesthesia group (n = 21) had higher post-procedure prolactin levels and a longer mean time to lactation initiation (25 hours) than in the other groups (10.8 to 11.8 hours). Postpartum oxytocin levels in the nonmedicated vaginal delivery group were higher than in the general and spinal anesthesia groups.
来源:Drugs and Lactation Database (LactMed)