肾上腺素复苏布比卡因所致大鼠离体心脏停跳的能力研究  

The effect of epinephrine on reversing bupivacaine-induced asystole in isolated rat heart

作　　者：陈鸿飞[1] 张裕坚[1] 吴一泉[1] 王权光[1] 张鸿飞[2] 徐旭仲[1] 

机构地区：[1]温州医科大学附属第一医院麻醉科,325000 [2]南方医科大学珠江医院麻醉科,广州510280

出　　处：《国际麻醉学与复苏杂志》2016年第12期1068-1071,共4页International Journal of Anesthesiology and Resuscitation

基　　金：国家自然科学基金（81470419）;浙江省自然科学基金（LY13H090008）;浙江省科技计划合作项目（2012C24018）;温州市科技局自然科学基金（Y20150239）

摘　　要：目的研究肾上腺素复苏布比卡因所致大鼠离体心脏停跳的能力。方法成年雄性SD大鼠24只，按照随机数字法分为B40组、EB40组、B50组和EB50组（每组6只）。制作Langendorff离体心脏灌流模型，以100μmol／L布比卡因诱导心脏停跳后继续灌注3min，造模成功。B40组，含40μmol／L布比卡因的K-H液灌流20min；EB40组，含40μmol／L布比卡因和0．15mg／L肾上腺素的K-H液灌流20min；B50组，含50μmol／L布比卡因的K-H液灌流20min；EB50组，含50μmol／L布比卡因和0．15mg／L肾上腺素的K-H液灌流10min，复跳后继续灌流，如未复跳则增加肾上腺素浓度为0．3mg／L继续灌流10min。比较各组复跳情况以及复灌20rain内离体心脏心功能参数，包括HR、左室发展压（1eft ventricular developed pressure，LvdevP）、HR和左室发展压乘积（rate-pressure product，RPP）及冠状动脉流量（coronary flow，CF）。结果EB40组复跳率100％明显高于其他3组复跳率（0）（P〈0．01）；EB40组离体心脏的复跳时间为（35±9）S，复跳后再发停跳时间为（568±182）s；增加肾上腺素浓度为0．3mg/L后，EB50组离体心脏仍未复跳。复灌20min期间，EB40组和EB50组的CF高于B40组和B50组（P〈0．01）。结论肾上腺素复苏布比卡因所致大鼠离体心脏停跳的能力与布比卡因浓度有关，布比卡因浓度为40～50μmol／L时，肾上腺素的复苏能力可能无法显示。Objective To study the influence of epinephrine on reversing bupivacaine-induced asystole in isolated rat heart. Methods Twenty-four adult male SD rats were randomly divided into four groups according to the table of random number （n=6）： group B40, EB40, B50 and EB50. Langendorff isolated heart perfusion model was used. Continuous infusion with 100 μmol/L bupivacaine until asystole had been induced for 3 min, then the model was completed. Group B40, perfused with K-H solution containing 40 μmol/L bupivacaine for 20 min. Group EB40, perfused with K-H solution containing 0.15 mg/L epinephrine and 40 μmol/L bupivacaine for 20 min. Group BSO, perfused with K-H solution containing 50 μmol/L bupivacaine for 20 min. Group EB50, perfused with K-H solution containing 0.15 mg/L epinephrine and 50 μmol/L bupivacaine for 10 min, then epinephrine was increased to 0.3 mg/L for 10 min. The situation of recovery of heart beat was recorded and the following cardiac functional parameters were monitored during 20 min perfusion： HR, heart rate-pressure product （RPP） and coronary flow （CF）. Results The recovery rate of heart beat（100%） in the group EB40 was higher than which in other groups （0）（P〈0.01）. The recovery time of heart beat in the group EB40 was （35±9） s and the asystole time after recovery of heart beat was （568±182） s. The CF in the groups EBg0 and EB50 were higher compared with the groups B40 and BSO （P〈0.01）. Conelusiotm The ability of epinephrine on reversing asystole induced by bupivacaine in isolated rat heart is related to the concentration of bupivacaine. When drug concentration of bupivacaine was 40-50 Ixmol/L, the ability of epinephrine could not be displayed.

关 键 词：肾上腺素 布比卡因 心脏停搏 复苏 

分 类 号：R614[医药卫生—麻醉学]