鞘内注射不同浓度甲磺酸罗哌卡因对大鼠脊髓的神经毒性  

Neurotoxic effects of intrathecal different concentrations of ethanesulfonic acid ropivacaine on spinal cord in rats

作　　者：汪芳俊[1] 刘洋[1] 涂发平[1] 吴咏梅[1] 谢贤镛[1] 贺红侠[1] 自华芬 

机构地区：[1]川北医学院附属医院麻醉科,四川省南充市637000

出　　处：《中华麻醉学杂志》2010年第5期533-535,共3页Chinese Journal of Anesthesiology

基　　金：川北医学院苗圃基金[校基金（07）临-05]

摘　　要：目的 评价鞘内注射不同浓度甲磺酸罗哌卡因对大鼠脊髓的神经毒性.方法 取鞘内置管成功的Wistar大鼠60只,体重210～220 g,雌雄不拘,随机分为5组（n=12）,对照组（C组）鞘内注射0.9%NaCl溶液0.4 ml;不同浓度甲磺酸罗哌卡因组（R1～4组）鞘内注射甲磺酸罗哌卡因0.4 ml,浓度依次为0.224%、0.447%、0.671%、0.894%.记录阻滞起效时间（鞘内给药结束至鼠尾丧失运动的时间）和维持时间（鼠尾丧失运动至恢复运动的时间）.鞘内给药后第7天处死大鼠,取L4.5脊髓节段,透射电镜下观察超微结构,并进行脊髓损伤评分.脊髓损伤评分≥2分为发生神经毒性,记录脊髓神经毒性的发生情况.结果 随甲磺酸罗哌卡因浓度的升高起效时间逐渐缩短,维持时间逐渐延长（P＜0.05或0.01）.脊髓神经毒性发生率C组为0,R1组为0,R2组为17%,R3组为42%,R4组为100%;随甲磺酸罗哌卡因浓度的升高,脊髓神经毒性发生率逐渐增加（P＜0.05或0.01）.结论 鞘内注射甲磺酸罗哌卡因对大鼠可产生脊髓神经毒性,且取决于其浓度.Objective To evaluate the neurotoxic effects of intrathecal （IT） different concentrations of ethanesulfonic acid ropivacaine on spinal cord in rats. Methods Sixty healthy Wistar rats of both sexes weighing 210-220 g in which IT catheters were successfully placed according to Yaksh et al. were randomly divided into 5 groups （n= 12 each）. The animals received 0.9% NaCl solution 0.4 ml （group C）; 0.224%, 0.447%,0.671%, 0.894% ethanesulfonic acid ropivacaine 0.4 ml （group R1-4 ）. The onset time and duration of the block were recorded. The animals were killed on 7th day after IT administration. The L4,5 segment of the spinal cord were removed for neuropathologic examination with electron microscope. The spinal cord injury was scored.Neurotoxicity was defined as the spinal cord injury score ≥ 2 and the spinal neurotoxicity was recorded. Results Onset time was shorter and duration of the block was prolonged with increasing concentrations of ethanesulfonic acid ropivacaine. The incidence of the spinal neurotoxicity was 0, 0, 17%, 42% and 100% in group C, R1, R2, R3 and R4 respectively. The incidence of the spinal neurotoxicity was gradually increased with increasing concentrations of ethanesulfonic acid ropivacaine. Conclusion IT ethanesulfonic acid ropivacaine can produce neurotoxicity to the spinal cord and it depends on the concentration.

关 键 词：甲磺酸盐类 酰胺类 药物毒性 注射 脊髓 

分 类 号：R614[医药卫生—麻醉学]