脂肪乳剂治疗布比卡因心脏毒性的研究进展  

Developments of the lipid emulsion used in the treatment of cardiac toxicity induced by bupivacaine

作　　者：彭志友[1] 薛庆生[1] 封小美[1] 于布为[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院麻醉科,上海200025

出　　处：《中国新药杂志》2011年第1期29-32,共4页Chinese Journal of New Drugs

基　　金：国家自然科学基金(30901409)

摘　　要：布比卡因是临床常用的长效酰胺类局部麻醉药,大剂量的布比卡因快速入血容易引起室性心律失常甚至心跳骤停,临床常规的复苏治疗成功率低。而临床作为静脉营养物质的脂肪乳剂却能逆转布比卡因心脏毒性,并在很多临床病例和动物实验中得到证实。目前研究的结果支持脂肪乳剂是通过"脂肪池"假说和改善心肌能量代谢来产生治疗作用的。进一步阐明脂肪乳剂逆转布比卡因心脏毒性的量效关系以及如何将脂肪乳剂的治疗和常规生命支持治疗结合起来,将为临床上布比卡因的应用提供更加可靠的安全保障。Bupivacaine is a commonly used long-acting amide of local anesthetic.Large doses of bupivacaine can be rapidly absorbed into the blood,and trigger ventricular arrhythmia and cardiac arrest that can hardly be reversed by conventional resuscitation.Lipid emulsion,which is used as a parenteral nutrition clinically,can reverse the cardiac toxicity induced by bupivacaine.This has been confirmed in many animal experiments and by clinical data.The present research results can explain the therapeutic effects of lipid emulsion with＂lipid sink＂ hypothesis and improvement of myocardial energy metabolism.It will bring more reliable security for the clinical application of bupivacaine after further clarifying the dose-effect relationship of lipid emulsion and reversal of cardiac toxicity induced by bupivacaine,and how to combine the treatment of lipid emulsion with conventional life-support treatment.

关 键 词：脂肪乳剂 布比卡因 心肺复苏 

分 类 号：R614.4[医药卫生—麻醉学] R971.2[医药卫生—外科学]