不同浓度脂肪乳剂对布比卡因心脏抑制家兔模型血流动力学影响  

Effects of lipid emulsion with various concentrations on hemodynamics of a rabbit model with bupivacaine-induced cardiac depression

作　　者：李晓霞[1] 郎中兵 陈楠[1] 龙海林[1] 徐昆[1] 

机构地区：[1]重庆医科大学附属第二医院麻醉科,重庆400010 [2]重庆市武警总队医院麻醉科,重庆400061

出　　处：《激光杂志》2011年第4期82-83,共2页Laser Journal

基　　金：重庆市教委资助项目;编号KJ090314

摘　　要：目的:探讨不同浓度脂肪乳剂分别对布比卡因心脏抑制家兔模型血流动力学影响。方法:28只家兔随机分为B组(布比卡因与生理盐水组),BF10组(布比卡因与30%脂肪乳组),BF20组(布比卡因与20%脂肪乳组),BF10组(布比卡因与10%脂肪乳组)。家兔静脉输入布比卡因(4mg.kg-1.min-1),使平均动脉压(MAP)降至基础值的60%,局麻药心脏抑制的中毒模型造模成功。BF30组、BF20组、BF10组分别静脉注射30%、20%、10%脂肪乳剂负荷量1mL/kg,然后匀速输入0.5mL/kg/min脂肪乳剂。B组以同样速度和容量输入生理盐水。家兔平均动脉压和心率恢复至基础值80%视为治疗成功。分别监测记录各组家兔基础心率和基础平均动脉压、治疗成功时间以及治疗成功率。结果:各组家兔的基础心率、基础平均动脉压无差异。BF30组的治疗成功时间显著小于BF20组、BF10组以及B组,BF20组的治疗成功时间小于BF10组以及B组。BF30组的治疗成功率显著高于BF20组、BF10组以及B组,BF20组的治疗成功率高于BF10组与B组,BF10组与B组间未见明显差异。结论:脂肪乳剂有拮抗布比卡因导致的家兔心脏毒性的作用,且呈现浓度依赖性,30%脂肪乳剂的拮抗作用最大。Objective：To investigate the effects of lipid emulsion with various concentrations on hemodynamics of a rabbit model with bupivacaine-induced cardiac depression.Methods：New Zealand rabbits（n=28） were randomly divided into four groups which are group B（n=7,treated with bupivacaine plus saline）,group BF30（n=7,treated with bupivacaine plus lipid emulsion with 30% original concentration）,group BF20（n=7,treated with bupivacaine plus lipid emulsion with 20% original concentration）and group BF10（n=7,treated with bupivacaine plus lipid emulsion with 10% original concentration）.Bupivacaine was injected via rabbit＇s auricular vein,and MAP decreased to 60% of the basic value were served as evidence of successful establishment of cardiac depression models.An IV bolus of 30%,20% and 10% lipid emulsion（1 mL/kg） was given in each group respectively,followed by continuous lipid emulsion infusion（0.5mL.kg-1.min-1）.In groupB,an IV bolus of saline（lmL/kg） was given,followed by continuous saline infusion（0.5mL.kg-1.min-1）for 10minutes.The treatment was success when MAP increased to 80% of the basic value.To record the basic HR and MAP,the time of successful treatment and the treatment success rate.Results：There was no significant difference in basic HR and MAP among the four groups.The time of successful treatment and the treatment success rate were significantly high in group BF30 as compared with those in group BF20,group BF10 and group B（P0.05）.The time of successful treatment was high in group BF20 as compared with those in group BF10 and group B,but there was no significant difference between group BF10 and group B.Conclusions：Lipid emulsion has rivalry effect on cardiac toxicity induced by bupivacaine.This rivalry effect increased progressively with the concentration of lipid emulsion.Lipid emulsion with 30% original concentration has the most conspicuous rivalry effect on cardiac toxicity induced by bupivacaine.

关 键 词：脂肪乳剂 布比卡因 心脏抑制 

分 类 号：R477[医药卫生—护理学]