脂肪乳预处理对局部麻醉药中毒大鼠心肌能量代谢的影响  

Effects of lipid emulsion pretreatment on myocardial energy metabolism in rats with local anesthetic poisoning

作　　者：廖铁[1] 肖玄[2] 李妍宏 骆江霞 陈慧[1] 

机构地区：[1]遵义医学院附属医院麻醉科,贵州遵义563000 [2]遵义医学院麻醉学系,贵州遵义563003

出　　处：《现代医药卫生》2015年第22期3374-3376,共3页Journal of Modern Medicine & Health

基　　金：贵州省大学生创新训练计划项目(201313653004)

摘　　要：目的研究脂肪乳(LE)对局部麻醉药(局麻药,丁哌卡因、罗哌卡因)导致大鼠心脏毒性的影响及其可能机制。方法选取SD大鼠54只,采用随机数字表法将其分为五组,生理盐水对照组(CON组)、生理盐水加丁哌卡因组(NS+B组)、脂肪乳加丁哌卡因组(LE+B组)、生理盐水加罗哌卡因组(NS+R组)、脂肪乳加罗哌卡因组(LE+R组)。除CON组外,其余组别再分为2个亚组,即致死组(1组)及取材组(2组)。54只大鼠均分入CON组及每个亚组,每组6只。CON组经静脉泵入NS 3 m L/(kg·min),6 min后开胸取心;其余组静脉泵入NS或LE 3 m L/(kg·min),共5 min,再以2 mg/(kg·min)泵入相应局麻药,取材组(2组)泵入局麻药1 min开胸取心,致死组(1组)泵入局麻药至心搏骤停。记录大鼠心律失常、心搏骤停的时间及局麻药剂量,测定心肌Na+-K+-ATPase、Ca2+-Mg2+-ATPase及琥珀酸脱氢酶(SDH)的活性。结果与NS+B1组比较,LE+B1组大鼠出现心律失常和心搏骤停的时间明显延迟,所用丁哌卡因累积剂量显著增加,差异均有统计学意义(P<0.05);与NS+R1组比较,LE+R1组大鼠出现心律失常和心搏骤停的时间明显延迟,所用罗哌卡因累积剂量显著增加,差异均有统计学意义(P<0.05);CON组Na+-K+-ATPase、Ca2+-Mg2+-ATPase及SDH的活性最高,LE+B2组高于NS+B2组,LE+R2组高于NS+R2组,LE+R2组高于NS+B2组,差异均有统计学意义(P<0.05)。结论 LE预处理能减轻丁哌卡因、罗哌卡因对大鼠心肌的毒性反应,其机制可能与增加心肌能量代谢水平有关。Objective To investigate the effect of lipid emulsion（LE） pretreatment on cardiotoxicity of SD rats caused by local anesthetics of marcaine and ropivacaine and to explore its possible mechanism. Methods 54 SD adult rats were selected and randomly divided into five groups,normal saline（NS） control group（group CON）,NS＋bupivacaine group（group NS＋B）,LE＋ bupivacaine group（group LE＋B）,NS＋ropivacaine group（group NS＋R） and LE＋ropivacaine group（group LE ＋R）. Except for the group CON,other groups were re-divided into two sub-groups：death group（group 1） and material group（group 2）,6 cases in each group and subgroup. The group CON was pumped by NS 3 m L/（kg·min） via vein,and the heart was removed after 6 min.Other groups were intravenously pumped by NS or LE 3 m L/（kg·min） for 5 min,then pumped by local anesthetic 2 mg/（kg·min）.In the material groups（2 groups）,the hearts were removed after 1 min of local anesthetics pumping. The death group（1 group）was pumped by local anesthetic until cardiac arrest. The time of arrhythmia,cardiac arrest and amount of local anesthetics were recorded. The activities of Na^＋-K^＋-ATPase,Ca2＋-Mg^2＋-ATPase and succinate dehydrogenase（SDH） were measured. Results Compared with the group NS ＋B1,the time of arrhythmia and cardiac arrest appearance in the group LE ＋B1 were remarkably prolonged（P〈 0.05） and the accumulated amount of marcaine was obviously increased,the differences were statistically significant（P〈 0.05）. Compared with the group NS＋R1,the time of arrhythmia and cardiac arrest appearance in the group LE＋R1 were significantly prolonged（P〈 0.05） and the accumulated amount of ropivacaine were remarkably increased,the differences were statistically significant（P〈 0.05）;the activities of Na^＋-K^＋-ATPase,Ca2＋-Mg^2＋-ATPase and SDH were highest in the group CON（P〈 0.05）,and the group LE＋B2 was higher than the group NS＋B2,the group LE＋R2 was higher than the

关 键 词：脂肪乳剂 静脉注射用 酰胺类 药物毒性 能量代谢 大鼠 Sprague-Dawley 

分 类 号：R614.42[医药卫生—麻醉学]