对不同剂量布比卡因心肺毒性作用及复苏效果的实验研究  

Cardiopulmonary toxicity of bupivacaine at different doses and effects of cardiopulmonary resuscitation： experiment with rabbits

作　　者：王德领[1] 刘亚华[2] 刘坚华[4] 董兰[3] 蒋玉君 

机构地区：[1]徐州市第一人民医院麻醉科,江苏221002 [2]中国人民武装警察部队总医院急救医学中心 [3]中国人民武装警察部队总医院麻醉科 [4]湖南长沙市中心医院药剂科 [5]武警河北总队石家庄市支队卫生队

出　　处：《中国急救复苏与灾害医学杂志》2011年第10期876-878,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的 观察不同剂量布比卡因对心肺的毒性作用及标准心肺复苏的效果.方法 32只新西兰大白兔随机均分为四组：A组（正常对照组）B组（3mg/kg布比卡因快速静脉注入,制作兔布比卡因心肺中毒模型）C组（5mg/kg布比卡因快速静脉注入）,和D组（7mg/kg布比卡因快速静脉注入）.观察呼吸、循环变化,在心,搏骤停2分钟时开始标准心肺复苏观,察复苏效果,记录自主循环和自主呼吸恢复时间,并进行24小时后神经缺陷功能评分.结果 B组（3mg/kg）仅见心率变慢,短时间内恢复;C组见呼吸抑制和心脏节律改变,3～6min不处理则继发心脏骤停;D组心跳呼吸迅速停止.心搏骤停2min经心肺复苏后,C组的自主循环恢复（ROSC）时间为（1.50±0.41）min,显著短于D组（[14.50±5.86）min,P〈0.01],C组自主呼吸恢复（ROSB）时间为（5.43±1.68）min,显著短于D组（[29.38±5.53）min,P〈0.01].24h后神经缺陷功能评分两组均为1分.结论 布比卡因心肺毒性作用呈明显剂量相关性,其所致的心搏骤停兔预后较好.Objective To investigate the dardiopulmonary toxicity of bupivacaine at different doses and the effects of cardiopulmonary resuscitation in the recovery of cardiopulmonary function. Methods Thirty-two New Zealand White rabbits were randomly divided into 4 equal groups： Group A group as control group, and Groups B to D as experimental groups. In Groups B to D bupivacaine at the dose of 3 mg/kg, 5 mg/kg, and 7 mg/kg respectively was injected intravenously to establish models of cardiopulmonary toxicity, cardiopulmonary resuscitation and was started 2 min after cardiac arrest till the recovery of automatic rhythm, the changes of breath and circulation were observed, and the neurological deficit functional score was recorded 24 hours later. Results Only heart rate was changed and returned to normal in a short time in Group B. The respiratory and cardiac arrest times of Group D were （3.13±1.89） s and （7.25±3.20） s respectively, both significantly shorter than those of Group C [（33.00±10.56） s and （308.75±35.63） s respectively, both P〈0.01]. The time of restoration of spontaneous circulation of Group C was （1.50±0.41） min, significantly shorter than that of Group D [（5.43±1.68） min, P〈0.01]. The time of restoration of spontaneous breath of Group C was （14.50±5.86）min, significantly shorter than that of Group D [（29.38 ± 5.53） min, P〈0.01]. The neurological deficit score after 24 hours was 1 for both groups. Conclusion The toxic effect of bupivacalne is dose-related. The prognosis of experimental rabbits with bupivacaine toxicity is good.

关 键 词：布比卡因 毒性 心肺复苏 

分 类 号：R971.2[医药卫生—药品]