复方盐酸利多卡因薄荷醇注射液用于兔颈上神经节阻滞的效果和安全性  

Effectiveness and safety of compound lidocaine hydrochloride and menthol solution for the rabbit superior cervical sympathetic ganglion block

作　　者：郝立净[1] 李志华[1] 徐贯杰[1] 柳顺锁[1] Hao Lijing;Li Zhihua;Xu Guanjie;Liu Shunsuo(Department of Anesthesiology, Third Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province 050051, China)

机构地区：[1]河北医科大学第三医院麻醉科,石家庄市050051

出　　处：《实用疼痛学杂志》2019年第3期176-181,共6页Pain Clinic Journal

基　　金：河北省卫生厅青年科技课题(20130521)。

摘　　要：目的评价复方盐酸利多卡因薄荷醇注射液用于兔颈上神经节阻滞的安全性及有效性。方法健康清洁级新西兰兔72只,4月龄,雌雄不拘,体重2.5~3.0kg,采用随机数字表法将其分为:利多卡因组(L组)和复方盐酸利多卡因薄荷醇注射液组(K组),每组36只。两组均于氯胺酮注射麻醉下暴露左侧颈上交感神经节,直视下将2%利多卡因或复方盐酸利多卡因薄荷醇注射液0.4ml滴注在神经节周围。记录两组兔给药前及给药后5min、30min、1周、2周时眼睑下垂程度,左耳根部皮温。分别于给药前及给药后2h、1周、2周时各选取6只,取左侧颈上交感神经节,行HE及甲苯胺蓝染色,采用光镜及电镜观察细胞形态学及超微结构变化。结果给药后两组均出现左侧眼睑下垂和左耳根皮温升高,K组较L组出现晚、持续时间长(P<0.05);光镜检查显示给药后2h两组均出现神经节细胞中度水肿,线粒体膜部分融合或消失,尼氏体含量降低(P<0.05);1周时L组细胞结构形态改变基本恢复正常,尼氏体含量与给药前相比差异无统计学意义(P>0.05),而K组仍有细胞轻度水肿,尼氏体含量低于给药前(P<0.05);2周时K组细胞结构形态改变恢复正常,两组尼氏体含量与给药前相比差异无统计学意义(P>0.05)。结论复方盐酸利多卡因薄荷醇注射液用于兔颈上交感神经节阻滞安全有效,且作用时间长。Objective To investigate the effectiveness and safety of compound lidocaine hydrochloride and menthol solution for the superior cervical sympathetic ganglion block in rabbits. Methods Seventy-two healthy pathogen-free New Zealand rabbits of both sexes, aged 4 months, weighing 2.5-3.5 kg, were divided into 2 groups using a random number table: lidocaine group (Group L) and compound lidocaine hydrochloride group (Group K), 36 cases in each group. All rabbits were anesthetized with katamine. Then the left superior cervical ganglions were exposed, 0.4 ml 2% lidocaine was dropped near the ganglion in group L, while 0.4 ml compound lidocaine hydrochloride and menthol solution was dropped at the same place in group K. The persistence time of Horner's syndrome was observed, the extent of ptosis and the skin temperature were also recorded before the block, and 5 min, 30 min, 1 week, 2 weeks after the block. Furthermore, 6 rabbits were anesthetized and their left superior cervical ganglions were taken out before the block and 2 h, 1 week, 2 weeks after the block. Cytomorphology and ultrastructure were observed with HE staining, toluidine blue staining and electromicroscope. Results Horner's syndrome appeared in all rabbits, but it appeared later and lasted longer in group K than that in group L (P<0.05). Content of Nissl bodies was significantly less at 2 h than that at other times in both groups (P<0.05). There was no significant difference in the cytomorphology at 1 week after the block than that before the block in group L (P>0.05). But the content of Nissl bodies was still less at 2 weeks after the block than that before the block in group K (P<0.05), of which there was no significant difference at 2 weeks after the block than that before the block in group K (P>0.05). Conclusion Compound lidocaine hydrochloride and menthol solution is effective and safe with longer action for block superior cervical ganglion in rabbits.

关 键 词：神经节 交感 神经传导阻滞 利多卡因 尼氏体 兔 

分 类 号：R614[医药卫生—麻醉学]