右美托咪定对脂肪乳剂逆转布比卡因所致大鼠离体心脏停搏的影响  

Effect of dexmedetomidine on lipid emusion-based resuscitation in reserving bupivacaine-induced asystole in the isolated rat hearts

作　　者：夏芳芳[1] 金周晟[1] 董娇娇[1] 蔡瑶瑶 陈鸿飞[1] XIA Fangfang;JIN Zhousheng;DONG Jiaojiao(Department of Anesthesiology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou325000,China)

机构地区：[1]温州医科大学附属第一医院麻醉科

出　　处：《浙江医学》2019年第24期2584-2587,共4页Zhejiang Medical Journal

基　　金：浙江省自然科学基金资助项目（LQ18H090006）;温州市科技局资助项目（Y20170042)

摘　　要：目的研究右美托咪定对脂肪乳剂复苏布比卡因所致离体心脏停搏效果的影响。方法30只雄性SD大鼠随机分为右美托咪定组(Dex组)和对照组,每组15只,建立Langendorff离体心脏灌流模型,采用100μmol/L布比卡因灌流建立心脏停搏模型。Dex组灌流含有50ng/ml右美托咪定和2%脂肪乳剂的K-H液,对照组灌流含有2%脂肪乳剂的K-H液。记录离体心脏首个心搏时间(Te)、复跳时间(Tr)以及复跳后40min内心率、左心室发展压(LvdevP)以及心率左心室发展压乘积(RPP),同时测定各时间点心室肌布比卡因浓度。结果Dex组的Te和Tr均较对照组长(均P<0.05)。Dex组心率、LvdevP和RPP在复跳后1min(T1)、3min(T3)和5 min(T5)均低于对照组(均P<0.05)。复跳后T1、T3和T5时间点,Dex组心肌布比卡因浓度均高于对照组(均P<0.05)。结论右美托咪定可以延长脂肪乳剂逆转布比卡因所致离体心脏停搏的时间,这可能与右美托咪定减慢离体心肌布比卡因排出有关。Objective To investigate the effect of dexmedetomidine(Dex)on lipid emusion-based resuscitation in reserving bupivacaine-induced asystole in the isolated rat hearts.Methods Thirty male Sprague-Dawley rats were randomly divided into two groups(n=15 in each group),the dexmedetomidine group(Dex)and control group(Con).Asystole was induced by perfusion of 100μmol/L bupivacaine in the Langendorff isolated heart perfusion model.The Dex group was then perfused with K-H solution containing 50 ng/ml dexmedetomidine and 2%lipid emulsion,and the Con group was perfused with K-H solution containing 2%lipid emulsion.The first heart beat time(Te),resuscitation time(Tr),and the heart rate(HR),left ventricular development pressure(LvdevP),heart rate left ventricular development pressure product(RPP)in the isolated heart were recorded,and the concentration of bupivacaine in ventricular myocardial was measured.Results Both Te and Tr in the Dex group were longer than those in the Con group(both P<0.05).The HR,LvdevP and RPP in the Dex group were lower than those in the Con group at 1 min(T1),3 min(T3)and 5 min(T5)after re-beating(P<0.05 for all).At the time points T1,T3 and T5 after re-beating,the concentration of bupivacaine in the Dex group was higher than that in the Con group(P<0.05 for all).Conclusion Dexmedetomidine can prolong the time of lipid emulsion reversing bupivacaine-induced cardiac arrest,which may be related to its slowing excretion of bupivacaine in the isolated myocardial.

关 键 词：右美托咪定 脂肪乳剂 布比卡因 心脏停搏 复苏 

分 类 号：R61[医药卫生—外科学]