乳化七氟烷选择性阻滞外周神经对骨骼肌松弛作用的研究  

The Effect of Emulsified Sevofluran on Muscular Relaxation through Selective Blockage of Peripheral Nerves

作　　者：叶菱[1] 孙辛欣[2] 朱涛[2] 杨平亮[3] 

机构地区：[1]四川大学华西医院疼痛科,成都610041 [2]四川大学华西医院麻醉科,成都610041 [3]四川大学华西第二医院麻醉科,成都610041

出　　处：《四川大学学报（医学版）》2016年第4期522-526,540,共6页Journal of Sichuan University(Medical Sciences)

基　　金：国家自然科学基金(No.81200865)资助

摘　　要：目的探索七氟烷松弛骨骼肌作用的位点是否位于外周神经。方法健康新西兰大白兔36只,随机分配到乳化七氟烷低浓度组〔4mL/(kg·h)〕、中浓度组〔6mL/(kg·h)〕、高浓度组〔10mL/(kg·h)〕及脂肪乳对照组〔以10mL/(kg·h)的速率泵入30%脂肪乳〕,每组9只。选择性麻醉下肢外周神经、神经-肌肉接头及骨骼肌肌纤维;模型建立成功后,比较麻醉前后所测得胫骨前肌静息张力和肌肉收缩力的变化。结果七氟烷低、中、高浓度组七氟烷分压在股静脉与颈内静脉之间的差异均具有统计学意义(P<0.05)。七氟烷低、中浓度组的胫骨前肌的静息张力几乎没有发生改变,给予电流刺激时测得的单收缩力和强直收缩力与麻醉前的基础值差异也无统计学意义。高浓度组麻醉后兔胫骨前肌的单收缩力、强直收缩力有所减弱(P<0.05)。结论成功建立选择性外周神经阻滞模型。中、低浓度七氟烷松弛骨骼肌的作用位点不在外周神经,可能在脊髓或更高级别的中枢。Objective To identify the site that emulsified sevoflurane influences in the nerve system.Methods Thirty-six healthy New Zealand rabbits were randomly and equally divided into low concentration emulsified sevoflurane group 〔4 mL/（kg·h）〕,medium concentration 〔6 mL/（kg·h）〕group,high concentration group〔10mL/（kg·h）〕and intralipid control group.Emulsified sevoflurane was infused through arterial to selectively block peripheral nerves,neuro-muscular junctions and muscle fibers.The anterior tibial muscle resting tensions and muscle contraction forces were compared before and after the infusions.Results Significant differences of blood sevoflurane pressure between femoral veins and internal jugular veins appeared in rabbits in all the groups（P〈0.05）.No significant changes in the resting tension of anterior tibia muscles were found in terms of single contractions and tetanic forces with the low and medium levels of infusion of sevoflurane compared to the base values.High level of infusion of sevoflurane resulted in decreased single contraction forces and tetanic forces of anterior tibia muscles（P〈0.05）.Conclusion A rabbit model with selective blockage of peripheral nerves was established.Peripheral nerves are not the primary site which low and medium levels of emulsified sevoflurane influence skeletal muscle relaxations.

关 键 词：乳化七氟烷 选择性麻醉模型 骨骼肌松弛 

分 类 号：R614[医药卫生—麻醉学]