不同浓度罗哌卡因对家兔硬膜外麻醉中脊神经的毒性作用研究  

Toxic effect of different concentrations of ropivacaine on spinal nerve in rabbits undergoing epidural anesthesia

作　　者：张琴[1] 韩志强[2] 段志强[1] 郑渤[1] Zhang Qin;Han Zhiqiang;Dnan Zhiqiang;Zheng Bo(Department of Anesthesiology,Bayannar Hospital,Inner Mongolia Autonomous Region,Bayannur 015000,China;Department of Anesthesiology,the Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010030,China)

机构地区：[1]内蒙古自治区巴彦淖尔市医院麻醉科,015000 [2]内蒙古医科大学附属医院麻醉科,呼和浩特010030

出　　处：《中国医药》2019年第1期117-121,共5页China Medicine

基　　金：内蒙古自治区自然科学基金(2013MS1139)~~

摘　　要：目的探讨不同浓度罗哌卡因对家兔硬膜外麻醉中脊神经的毒性作用。方法选择无特定病原体级健康成年家兔40只,雌雄不限,L_6～L_7间隙硬膜外麻醉置管成功后,采用随机数字表法分为4组,各10只,硬膜外导管分别注射0. 2%、0.5%、1%罗哌卡因(0. 2%罗哌卡因组、0. 5%罗哌卡因组、1%罗哌卡因组)和0.9%氯化钠注射液(NS组)0.5 ml/kg,注药速度为0.05 ml/s。比较4组家兔给药前10 min,给药后10、30、60和90 min以及给药3 d后处死前的心率、收缩压、血氧饱和度以及后肢运动改良Tarlovs评分。给药3 d后对家兔进行心脏灌注处死,取脊神经制成苏木精-伊红染色冰冻切片及免疫组织化学石蜡切片,在显微镜下观察神经细胞Bcl-2的表达,通过Image-proplus计算神经细胞Bcl-2阳性细胞表达量。结果 0.5%罗哌卡因组和1%罗哌卡因组给药后30和60 min心率、收缩压、血氧饱和度均低于NS组,1%罗哌卡因组给药后30 min心率、收缩压和血氧饱和度均低于0. 5%罗哌卡因组,差异均有统计学意义(均P <0. 05)。给药后30和60 min,0.5%罗哌卡因组、1%罗哌卡因组Tarlovs评分均低于NS组(均P<0.05),0.2%罗哌卡因组与NS组比较差异均无统计学意义(均P>0. 05)。1%罗哌卡因组、0. 5%罗哌卡因组家兔脊神经Bcl-2阳性表达量高于NS组[(74. 5±2. 3)、(42. 1±4.4)比(17. 5±1. 6)],差异均有统计学意义(均P <0.01),0.2%罗哌卡因组Bcl-2阳性表达量(20.6±1.8)与NS组比较差异无统计学意义(P>0.05)。结论家兔硬膜外腔注射1%罗哌卡因后心率、血压、血氧饱和度均明显下降,后肢运动TarIovs评分明显降低,Bcl-2表达量明显升高。Objective To analyze the toxicity of different concentrations of ropivacaine on spinal nerve in rabbits undergoing epidural anesthesia. Methods Forty specific-pathogen-free healthy adult rabbits had epidural puncture at L6-L7 and they were randomly divided into 4 groups(n=10) which had epidural injection of 0.2% ropivacaine, 0.5% ropivacaine, 1% ropivacaine and 0.5 ml/kg 0.9% sodium chloride solution(NS group);the drug administration rate was 0.05 ml/s. Heart rate, systolic blood pressure, blood oxygen saturation and modified-Tarlovs score of hindlimb motor were recorded 10 min before and 10, 30, 60, 90 min, 3 d after drug administration. At 3 d after administration, the rabbits were sacrificed by heart perfusion and the spinal nerve was taken for hematoxylin-eosin frozen section and immunohistochemistry parafin section. Expression of Bcl-2 in nerve cells was observed under microscope and the Bcl-2 positive rate was calculated by Image-proplus. Results Heart rate, systolic blood pressure and blood oxygen saturation 30, 60 min after administration in the 0.5% and 1% ropivacaine groups were significantly lower than those in the NS group;heart rate, systolic blood pressure and blood oxygen saturation 30 min after administration in the 1% ropivacaine group were significantly lower than those in the 0.5% ropivacaine group(all P<0.05). At 30 and 60 min after administration, Tarlovs score in the 0.5% and 1% ropivacaine groups were significantly lower than that in the NS group(all P<0.05). Bcl-2 positive expression quantity in spinal nerve in the 1% and 0.5% ropivacaine groups were significantly higher than that in the NS group[(74.5±2.3),(42.1±4.4) vs (17.5±1.6)](P<0.01). Bcl-2 expression in the 0.2% ropivacaine group[(20.6±1.8)] was similar to that in the NS group(P>0.05). Conclusion Epidural injection of 1% ropivacaine can significantly reduce heart rate, blood pressure, blood oxygen saturation, Tarlvos score and increase Bcl-2 expression in rabbits.

关 键 词：硬膜外麻醉 罗哌卡因 局部麻醉药 

分 类 号：R614.4[医药卫生—麻醉学]