脂肪乳剂对不同局麻药心脏抑制家兔模型心肌超微结构影响  

Effects of lipid emulsion on a rabbit model with different local anesthetics-induced cardiac depression

作　　者：陈楠[1] 李晓霞[1] 

机构地区：[1]重庆医科大学附属第二医院

出　　处：《人人健康》2016年第10期12-12,252,共2页Health for Everyone

摘　　要：探讨30%浓度脂肪乳剂对不同局麻药心脏抑制家兔模型心肌超微结构影响。方法 :27只成年新西兰兔随机平均分为B组(布比卡因组)、T组(丁卡因组)、R组(罗哌卡因组)。各局麻药组分别静脉输入布比卡因、丁卡因、罗哌卡因(4mg·kg-1·min-1),直至MAP降至基础值的60%,成功建立局麻药心脏抑制的中毒模型。B组、T组、R组静脉推注30%脂肪乳剂负荷量1ml/kg,然后以0.5ml·kg-1·min-1剂量持续微量泵泵入。当MAP恢复至基础MAP80%或以上水平时,治疗有效;MAP与ECG无改善或不断恶化者视为治疗失败。监测各组基础心率(HR)和基础MAP;记录各组治疗有效率;各组治疗成功家兔持续监测观察1h后取心肌标本进行透射电镜检查。结果 :各组家兔基础HR、基础MAP未见明显差异。治疗有效率比较,B组与T组相当,R组最高。心肌细胞损害以及线粒体肿胀程度R组低于B组与T组,B组与T组未见明显差异。结论 :脂肪乳剂对不同局麻药导致的家兔心脏毒性有治疗作用,其作用机制可能与沉积效应有关。Objective :To investigate the therapeutic effects of lipid emulsion on a rabbit model with bupivacaine-induced cardiac depression induced by bupivacaine tetracaine and ropivacaine.Method :New Zealand rabbits（n=27） were randomly divided into three groups which are group B（bupivacaine group） group T（tetracaine group）and group R（ropivacaine group）. Different local anesthetics were injected until MAP decreased to 60% of the basic value.The cardiac depression models were successful established then. An IV bolus of 30% lipid emulsion（1 ml/kg） was given followed by continuous lipid emulsion infusion(0.5ml · kg-1 · min-1) for 10 minutes. When MAP increased to 80% of the basic value or above level,treatments were effective. Respectively recorded the basic HR MAP and the effective ratio of treatment. Myocardial specimens were taken for transmission electron microscopy（TEM） examination.Result :No significant differences in basic HR and MAP were observed among the three groups. The effective ratio of treatment was highest in group R. Myocardial and mitochondrial pathology change in group R was less than group B and group T,and there was no difference between group B and group T.Conclusion :Lipid emulsion has therapeutical effect on cardiac toxicity induced by different local anesthetics with a concentration dependence. It’s possible mechanism may be related to the lipid sink theory.

关 键 词：30%脂肪乳剂 布比卡因 丁卡因 罗哌卡因 心脏抑制 心肌超微结构 

分 类 号：R965[医药卫生—药理学]