摘要
目的观察1:20万肾上腺素对3％盐酸氯普鲁卡因硬膜外阻滞患者药效学和药代动力学的影响。方法择期行下腹部手术患者20例,ASAⅠ或Ⅱ级,随机分为2组(n=10):盐酸氯普鲁卡因组(C组)和盐酸氯普鲁卡因加肾上腺素组(CE组)。分别用3％氯普鲁卡因6 mg·kg-1(C组)和含 1:20万肾上腺素3％氯普鲁卡因6 mg·kg-1(CE组)硬膜外阻滞,记录局麻药的起效时间、运动阻滞起效时间和给药后20min时运动阻滞程度;分别在给药前及给药后3、6、9、11、13、15、17、20、30、45、60、 90min采取桡动脉血1．5ml,高效液相色谱法检测血浆氯普鲁卡因浓度,经计算机软件拟合血药浓度 -时间曲线,并计算各项药代动力学参数。结果两组局麻药的起效时间、运动阻滞起效时间和运动阻滞程度差异无统计学意义。C、CE组血药浓度峰值(Cmax)分别为0．49±0．47、(0．32±0．22)mg· L-1,达峰值时间(Tmax)分别为8±3、(9±4)min;血药浓度曲线下面积(AUC)分别为10±6、(7±4)μg· min·ml-1;清除速率常数(K)分别为0．32±0．21、(0．36±0．32)min-1;两组间Cmax、Tmax、AUC及K比较差异无统计学意义(P>0．05)。结论 1:20万肾上腺素对3％盐酸氯普鲁卡因硬膜外阻滞的药代动力学和药效学没有影响。
Objective To determine the pharmacokinetics and pbarmacodynamics of chloroprocaine with or without epinephrine for epidural blockade. Methods Twenty ASA physical status Ⅰ or Ⅱ patients of both sexes aged 37-55 yrs weighing 45-80 kg undergoing elective lower abdominal surgery were randomly divided into 2 groups （ n = 10 each） ： group C chloroprocaine without epinephrine and group CE chloroprocaine with epinephrine. The epidural catheter was inserted into epidural space at T12-L4 and advanced toward head for about 4 cm. After correct epidural placement was confirmed, 3 % chloroprocaine 6 mg·kg^-1 with or without 1 ： 200 000 epinephrine was injected into epidural space over 2 min. Onset time of analgesia , motor blockade and degree of motor blockade at 20 min after epidural injection （Bromage scale 0 = no motor block, 3 = unable to flex hip, knee and ankle） were recorded. Blood samples were taken from radial artery before and at 3, 6, 9, 11, 13, 15, 17, 20, 30, 45, 60, 90 min after epidural injection for determination of plasma chloroprocaine concentration by HPLC. Results The two groups were comparable with respect to demographic data. There were no significant differences in the pharmokinetics and pharmacodynamics of chloroprocaine between the two groups. The Cmax was （0.491±0.47） mg·L^-1 and （0.32±0.22） mg·L^-1; The Tmax was （8±3） min and （9±4） min; the AUC was （10±6） μg·min·ml^-1 and （7± 4） μg·min· ml^-1 ; the K was 0.32 ± 0.21 min^-1 and 0.36 ± 0.32 min^-1 in group C and CE respectively. Conclusion Epinephrine 1 ： 200 000 does not affect the pharmacokinetics and pharmacodynamics of 3 % chloroprocaine for epidural block.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2006年第5期414-416,共3页
Chinese Journal of Anesthesiology
