羟乙基淀粉130/0.4、长链及中长链脂肪乳缓解布比卡因心脏毒性作用比较  

Alleviating effect of hydroxyethyl starch 130/0.4,long chain lipid emulsion and medium-long chain lipid emulsion on cardiotoxicity of bupivacaine

作　　者：彭玉璇[1] 封小美[1] 陈冰[2] 李娟[2] 薛庆生[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,200025 [2]上海交通大学医学院附属瑞金医院药剂科,200025

出　　处：《临床麻醉学杂志》2012年第7期714-716,共3页Journal of Clinical Anesthesiology

基　　金：国家自然科学基金(30901409)

摘　　要：目的比较羟乙基淀粉130/0.4、长链及中长链脂肪乳剂预先给药缓解布比卡因大鼠心脏毒性的作用。方法雄性SD大鼠40只,体重300～350g,随机均分为四组:生理盐水组(NS组)、羟乙基淀粉130/0.4组(H组)、长链脂肪乳剂组(L组)和中/长链脂肪乳剂组(M组)。四组分别输注0.9%氯化钠、6%羟乙基淀粉130/0.4、20%长链脂肪乳及20%中/长链脂肪乳,输注速率均为3ml·kg^(-1)·min^(-1);5min后均静脉输注0.75%盐酸布比卡因10mg·kg^(-1)·min^(-1),直至心跳停止后30s。记录出现心跳停止的时间及心跳停止时布比卡因的用量;高效液相色谱法检测大鼠心跳停止时血浆及心肌组织中布比卡因浓度。结果与NS组比较,其它三组出现心跳停止时间延长,且心跳停止时布比卡因用量增加(P<0.05),而L组与M组较H组时间更长、用量更大(P<0.05);L、M组心跳停止时血浆布比卡因浓度高于NS、H组;而L组心跳停止时心肌布比卡因浓度高于M组。结论羟乙基淀粉130/0.4、长链脂肪乳及中/长链脂肪乳预先给药均可减轻布比卡因致大鼠心脏毒性,依次为长链脂肪乳>中/长链脂肪乳>羟乙基淀粉130/0.4。Objective To compare the alleviating effect of hydroxyethyl starch 130/0. 4, long- chain and medium-long chain lipid emulsions on bupivacaine-induced cardiotoxicity in rats. Methods Forty male SD rats weighing 300-350g were randomized into four groups （n = 10 each） .. normal saline （group NS） ; hydroxyethyl starch 130/0.4 （group H） ; long chain lipid emulsion （group L） and medium and long chain lipid emulsion （group M）. The infusion rate was set at 3 ml.kg-1 -min-1 for 5 min. 0.75o//00 bupivacaine was then infused at 10 mg.kg-1 .rain-1 to an end point of 30 s of asystole. The time and the amount of bupivacaine infused when cardiac arrest occurred were recorded, and concentrations of bupivacaine in plasma and myocardial tissue were measured by high performance liquid chromatography. Results The amount of bupivacaine infused was significantly larger in the groups H, L and M than that of the group NS （P（0.05）, and the groups L and M were higher than the group H （P（ 0. 05）. Concentrations of bupivacaine in plasma were significantly higher in groups L and M than that of groups NS and Hi meanwhile hupivacaine concentration in the myocardial tissue was significantly higher in group L than the group M. Conclusion Pretreated with hydroxyethyl starch 130/0.4, long chain lipid emulsion or medium-long chain lipid emulsion alleviates bupivacaine-indueed cardiotoxicity in rats, and the sequence is long-chain lipid emulsion〉mediumlong chain lipid emulsion^hydroxyethyl starch 130/0.4.

关 键 词：羟乙基淀粉 脂肪乳剂 布比卡因 心脏停搏 

分 类 号：R614[医药卫生—麻醉学]