肾上腺素对丁哌卡因肌间沟臂丛神经阻滞的药效学与药代动力学的影响  

Effects of adrenaline on pharmacodynamics and pharmacokinetics of bupivacatine for interscalene plexus block

作　　者：刘志双[1] 高鹏志[2] 程晓燕 李欣[4] 魏淑明[4] 刘爱香[4] 宋淑兰[4] 孟庆云[4] 

机构地区：[1]河北医科大学第三医院麻醉科,石家庄市050051 [2]石家庄市第一医院外科 [3]河北医科大学第三医院院病案室 [4]河北医科大学第三医院麻醉科,石家庄市050051

出　　处：《中华麻醉学杂志》1997年第11期660-663,共4页Chinese Journal of Anesthesiology

摘　　要：目的:了解肾上腺素对丁哌卡因肌间沟臂丛神经阻滞的药效学及药动学影响。方法:选择ASA Ⅰ～Ⅱ级肩部或上肢择期手术患者16例,随机分成两组,试验组与对照组各8例,分别用含或不含肾上腺素的0.75％丁哌卡因2mg/kg行肌间沟臂丛阻滞。对比观察两组的临床效果及药代动力学。结果:与对照组比较,试验组阻滞完善时间及镇痛时间延长(P<0.05或0.01)。试验组与对照组Cmax分别为0.8295±0.2893ug/ml和0.8898±0.2572ug/ml,Tmax分别为37.6018±8.3461分钟和29.3156±11.1991分钟(P>0.05)。药代动力学参数t1/2Ka及K_(21)两组间有显著性差异(P<0.05或0.01)。结论:肾上腺素能延长丁哌卡因的阻滞完善时间、镇痛维持时间及吸收半衰期,但对血药浓度无明显影响。Objective: To investigate the effects of adrenaline on pharmacodynamics and pharmacokinetics of bupivacaine for interscalene plexus block. Method:Sixteen ASA gradeⅠ-Ⅱadult patients undergoing shoulder or upper limbs operation were randomly divided into two groups (n=8)). The plexus block was induced with 0.75％ bupivacaine 2 mg/kg or 0.75％ bupivacaine 2mg/kg plus 1:200 000 adrenaline. Clinical effects and plasma concentration,the Cmax and Tmax were compared between two groups. Result:The time to reach peak analgesia and the duration of analgesia were longer in adrenaline group than in control group(P<0.05 or 0.01). There were no significant differences in the Cmax and Tmax between two groups. There was significant difference in t1/2ka and K_(21) between two groups. Conclusion: Adrenaline may prolong the time to reach peak analgesia,the duration of analgesia and t1/2Ka. Adrenaline can not affect the plasma concentrations of bupivacaine.

关 键 词：药理学 丁哌卡因 肾上腺素 肌间沟 臂丛神经阻滞 

分 类 号：R971.2[医药卫生—药品]