罗哌卡因用于蛛网膜下腔阻滞的实验研究  

The effect of intrathecal ropivacaine on spinal cord in dogs

作　　者：郭艳辉[1] 王俊科[1] 许国忠[1] 虞建刚[1] 

机构地区：[1]中国医科大学附属第一医院麻醉科,沈阳市110001

出　　处：《中华麻醉学杂志》2002年第1期42-45,共4页Chinese Journal of Anesthesiology

摘　　要：目的 观察不同浓度不同剂量罗哌卡因注入犬的蛛网膜下腔后,脊髓、神经根早期超微结构及脊髓组织钙含量的变化。方法 杂种犬18只,雌雄兼有,体重10kg左右。随机分为三组,A组为对照组6只,生理盐水2ml;B组6只,0.5％罗哌卡因2ml（10mg）,C组6只,1％罗哌卡因2ml（20mg）。动物麻醉后以氯胺酮、芬太尼间断静脉注射维持麻醉。于L3-4穿刺,注入生理盐水或罗哌卡因。于注药后3h,迅速处死动物后,取L1-2脊髓及神经根,每组随机取1mm3脊髓前角组织和神经根,固定于2.5％戊二醛磷酸缓冲液中行透射电镜观察脊髓及神经根超微结构的改变。并采用原子吸收分光光度法测脊髓组织钙含量。结果（1）C组脊髓组织钙离子含量明显高于A、B两组。（2）A、B两组电镜标本正常,神经膜完整,脊髓标本显示线粒体、内质网完整。C组神经膜分层,部分断裂,脊髓组织线粒体肿胀,部分空泡变性,内质网肿胀。结论 1％浓度的罗哌卡因用于蛛网膜下腔可以造成脊髓缺血损伤,所以应用于蛛网膜下腔还需谨慎。ve When a new drug is introduced for intrathecal (IT) administration, its effect on spinal cord should be studied for safety reason. The aim of this study was to determine the ultra-microstructure of spinal cord and Ca2+ content in spinal cord after IT administration of ropivacaine in dogs. Methods Eighteen mongrel dogs of either sex weighing about 10kg were randomly assigned to one of three groups according to the dose of ropivacaine administered IT: group A received normal saline 2ml IT and served as control; group B received 0.5% ropivacaine 2ml(10mg) IT; group C received 1% ropivacaine 2ml(20mg) IT. Anesthesia was induced with intramuscular ketamine 20mg.kg-1 and atropine 0.05mg·kg-1 and maintained with intermittent iv boluses of ketamine 3mg·kg-1 and fentanyl 5μg·kg-1 Left internal jugular artery was cannulated for intra-arterial pressure monitoring. An incision was made in the back at L3-4 and lumbar puncture was confirmed by aspiration of cerebral-spinal fluid (CSF). Normal saline or ropivacaine was then injected over 20 seconds. 3 hours after IT administration the animals were sacrificed and L1-2 segment of spinal cord and nerve roots were immediately removed for Ca content determination and electron microscopic examination. Results The Ca2+ content of spinal cord was significantly higher in group C than that in group A and B. Electron microscope revealed that in group A and B neurolemma of the nerve root and mitochondria and endoplasmic reticulum of the neurons in spinal cord were intact, while in group C neurolemma was stratified and partly disrupted and mitochondria and endoplasmic reticulum underwent swelling and there was vacuole degeneration. Conclusions Ropivacaine of high concentration or at high dose may be injurious to spinal cord.

关 键 词：麻醉药 超微结构 钙 罗哌卡因 蛛网膜下腔阻滞 实验研究 

分 类 号：R614[医药卫生—麻醉学]