毒理性
◉ 母乳喂养期间使用总结：关于母乳喂养期间使用维库溴铵的信息有限，表明对婴儿没有不良影响。由于它作用时间短，极性高，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有问题的药物的建议。以维库溴铵为组成部分的剖宫产全身麻醉可能会延迟泌乳的开始。
◉ 对哺乳婴儿的影响：四名正在哺乳3至5个月大婴儿的母亲在接受全身麻醉时，给予了静脉注射丙泊酚和瑞芬太尼作为诱导剂，以及0.5 mg/kg的维库溴铵用于插管。诱导后，停止丙泊酚，并使用氙气吸入来维持麻醉，持续时间为57至70分钟。婴儿在手术结束后的1.5至5小时内恢复哺乳。没有一个婴儿出现明显的头晕或嗜睡症状。所有婴儿在母亲出院后在家中都表现良好，没有注意到任何不良事件。
◉ 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的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和维库溴铵0.6 mg/kg进行诱导，随后根据需要使用七氟醚和维库溴铵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，则额外给予0.2 mg的甲基麦角新碱。全身麻醉组在分娩后给予了1至1.5 mcg/kg的芬太尼。全身麻醉组（n = 21）的术后催乳素水平较高，平均泌乳开始时间（25小时）长于其他组（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麻醉和脊髓麻醉组。
◉ Summary of Use during Lactation:Limited information on the use of rocuronium during breastfeeding indicates that no adverse infant effects occur. 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 rocuronium as a component may delay the onset of lactation.
◉ Effects in Breastfed Infants:Four mothers who were breastfeeding 3- to 5-month-old infants underwent general anesthesia were given intravenous propofol and remifentanil as induction agents and rocuronium 0.5 mg/kg for intubation. After induction, propofol was stopped and xenon inhalation was used to maintain anesthesia for between 57 and 70 minutes. Infants resumed breastfeeding from 1.5 to 5 hours after the end of surgery. None of the infants had noticeable symptoms of dizziness or drowsiness. All infants fared well at home after their mothers were discharged with no adverse events noticed at home.
◉ 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)
