预先输注不同脂肪乳对罗哌卡因硬膜外麻醉后血浆浓度与药效动力学的影响被引量：3

The effect of lipid emulsion pretreatment on plasma concentrations and pharmacodynamics of ropivacaine after epidural administration in adults

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摘要目的研究预先输注不同脂肪乳（lipid emulsion，LE）对下肢手术罗哌卡因硬膜外麻醉后血浆浓度与药效动力学的影响。方法择期下肢手术的成年患者29例，美国麻醉医师协会（ASA）I-Ⅱ级。采用完全随机法分为3组：生理盐水组（NS组，n=11）、中／长链LE组（MLE组，n=8）、长链LE组（LLE组，n=10）。分别以2ml·kg-1·h-1速度泵注0．9％氯化钠注射液、20％MLE、20％LLE，持续30min。硬膜外腔注射1％罗哌卡因2mg／kg后1（N1）、5（N2）、10（N3）、15（N4）、30（N5）、45（N6）、60（N7）、90（N8）、120min（N9）时动脉采血检测血浆罗哌卡因浓度。记录术中血流动力学指标、麻醉质量评分、感觉及运动阻滞情况等。结果术中血流动力学参数、麻醉质量评分、感觉与运动神经阻滞效果组间比较，差异无统计学意义。组间比较血浆罗哌卡因浓度差异无统计学意义。结论预先输注不同LE对下肢手术罗哌卡因硬膜外麻醉后的血流动力学影响甚微，亦不影响感觉、运动神经阻滞效果及血浆罗哌卡因浓度。 Objective To determine whether there is a change of ropivacaine plasma concentration and analgesia efficacy associated to the pretreatment of lipid emulsion （LE） during epidural anesthesia in adults undergoing lower limb operations. Method Twenty-nine adult patients aged 18 to 65 years, ASA I -II , scheduled for elective lower limb operations under epidural anesthesia, were invited to participate in the study. The patients were randomized into three groups： control group（NS group, n=11 ）, medium and long chain fat emulsion group（MLE group, n=8） and long chain fat emulsion group（LLE group, n=10）. Three groups of patients were pretreated with 0.9 % saline, 20 % LLE or 20 % MLE, at 2 ml·kg-1· h-1 for 30 min Via left upper limb vein. 2 mg/kg （including the test dose） of ropivacaine was injected through the epidural catheter. Hemodynamic parameters were recorded. Sensory block and the degree of motor block was determined. Ropivacaine plasma concentrations were measured from artery plasma samples at 1, 5, 10, 15, 30, 45, 60, 90, 120 min after total ropivacaine was given. Results No significant differences were observed between groups in onset time of sensory and motor block, time to maximum spread of sensory block, the segments of spinal nerve block, persistent time of sensory and motor block. The plasma ropivacaine concentration among all groups had no significant differences at each time. Conclusions Pretreatment of LLE and MLE had no effect on plasma concentration and phannacodynamics of ropivacaine during epidural anesthesia in adults undergoing lower limb operations.

作者张鸿飞徐世元雷洪伊温预关李凤仙

机构地区兰州大学第二医院麻醉科南方医科大学珠江医院麻醉科广州市脑科医院国家药品临床研究基地

出处《国际麻醉学与复苏杂志》 CAS 2013年第1期12-16,共5页 International Journal of Anesthesiology and Resuscitation

关键词脂肪乳剂局部麻醉药罗哌卡因药效动力学椎管内麻醉硬膜外 Lipid emulsion Local anesthetic,ropivacaine Pharmacodynamics Plasma concentration Intraspinal anesthesia, Epidural

分类号 R614 [医药卫生—麻醉学]

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参考文献22

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二级参考文献29

1朱波,龚志毅,叶铁虎,吴新民,孟美金,王庚,贾乃光,张亚军,刘春霞.国产0.5%盐酸左旋布比卡因用于硬膜外麻醉的可行性[J].中华麻醉学杂志,2004,24(8):582-584. 被引量：26
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