不同浓度国产盐酸罗哌卡因对大鼠脊神经毒性的影响  

Different concentrations of domestic ropivacaine hydrochloride on the rat spinal neurotoxicity

作　　者：孟雅静[1] 梁小青[1] 杜淑娟[1] 高金贵[2] 

机构地区：[1]石家庄市中心医院麻醉科,050011 [2]河北医科大学附属第二医院麻醉科,石家庄050000

出　　处：《疑难病杂志》2013年第5期371-372,F0003,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察不同浓度国产盐酸罗哌卡因对大鼠脊神经、神经根超微结构的影响。方法 SD大鼠18只,雌雄不限,体质量180～250 g,随机分为3组,每组6只。对照组(N组),鞘内注入生理盐水40μl;R1组予0.5%罗哌卡因(重比重)鞘内注入40μl;R2组予1.0%罗哌卡因(重比重)鞘内注入40μl。注药后3h迅速处死动物,取腰膨大处脊神经及神经根,行透射电镜观察脊神经、神经根超微结构变化。结果电镜观察发现,N组大鼠注药后脊神经组织结构除偶有水肿外基本正常。R1组、R2组注药后大多数神经元细胞质中度水肿,线粒体大部分嵴和部分膜融合,可见线粒体空化;粗面内质网扩张脱颗粒现象明显,游离核糖体数量减少;有髓神经髓鞘明显增生增厚,可见分层断裂现象,髓索未见,线粒体微丝微管数量明显减少;2组脊神经、神经根超微结构变化比较差异无统计学意义(P>0.05)。结论不同浓度(0.5%和1.0%)国产盐酸罗哌卡因用于蛛网膜下腔阻滞导致脊髓神经超微结构有一定改变,可能导致脊神经受损,不适合蛛网膜下腔阻滞,临床应用仍需慎重。Objective To observe the impact of different concentrations of domestic ropivacaine hydrochloride in rat spinal nerve, nerve root ultrastructure. Methods 18 SD rats, male or female, body weight 180 to 250 g, were randomly divided into three groups, each group of six. The control group （N）, intrathecal injection of saline 40 μl; R1 group to 40 μl of 0.5% ropivacaine （hyperbaric） intrathecal injection; R2 group were given 1.0% ropivacaine （hyperbaric） intrathecal injection 40 μl. After 3h, quickly killed the animals, taken at the lumbar enlargement of the spinal nerves and nerve roots, row TEM observations ultrastructural changes in spinal nerve, nerve root injection. Results Electron microscopy showed that the spinal nerve tissue structure basically normal except occasional edema after injection of N rats. Group R1, R2 injection after most neurons the cytoplasm to moderate edema, mitochondria most of the ridge and part of the film fusion visible mitochondrial cavitation; rough endoplasmic reticulum dilatation degranulation significantly reduce the number of free ribosomes; there are the myelinated nerve myelin obvious hyperplasia thickening visible hierarchical fracture phenomena, medullary cable no significantly reduced the number of mitochondria microfilaments microtubules ; 2 groups spinal nerve, nerve root ultrastrueture changes were no significant differences （ P 〉 0.05）. Conclusion Different concentrations （0.5 % and 1.0% ） of domestic ropivacaine hydrochloride for subarachnoid block ultrastructure of spinal nerves have certainly changed, may result in damage to the spinal nerve, subarachnoid block is not suitable for clinical applicationstill need to be careful.

关 键 词：盐酸罗哌卡因 国产 鞘内注射 脊神经 超微结构 大鼠 

分 类 号：R614[医药卫生—麻醉学]