脂肪乳剂解救布比卡因致离体大鼠心脏停搏.docVIP

脂肪乳剂解救布比卡因致离体大鼠心脏停搏的 浓度-效应关系探讨 陈莺1， 刘乐1，徐旭仲1，王权光1，施通1，施克俭1，王万铁2 作者单位：1．温州医学院附属第一医院 麻醉科，浙江 温州 325000； 2．温州医学院病理生理学教研室 第一作者：陈莺Email：cy2521918@163.com 通讯作者：徐旭仲Email: xuzhong@263.net 论文类别：麻醉临床与基础研究 【摘要】 目的 观察脂肪乳剂解救布比卡因致离体大鼠心脏停搏的浓度-效应关系。方法 48只SD大鼠随机分为8组：对照组（C组）和各浓度脂肪乳组（E0.25、E0.5、E1、E2、E4、E8、E16组）。建立Langendorff离体心脏灌模型25分钟后，以100μmol/L布比卡因诱导心脏停搏3分钟。之后对照组给予40μmol/L布比KH液，各浓度脂肪乳组分别给予含40μmol/L布比0.25%、0.5%、1%、2%、4%、8%、16%Tr）；记录心脏停跳前及复跳后40min内的心率（HR）、心率-左心室发展压乘积（RPP）RPP最高值（RPPh）及其与Tb时RPP的比值（RPPr）。RPPr为纵坐标，行浓度-效应曲线拟合并行非线性回归分析。结果 对照组无复跳，各浓度脂肪乳剂组均复跳，复跳时间组间比较：E1、E2、E4、E8、E16均少于E0.25、E0.5（P0.05）RPPr 组间比较：E2、E4、E8、E16均大于E0.25、E0.5、E1，E8 E4 E2 E1（P0.05）EC50为3.3%。脂肪乳剂浓度4%时，复跳后心脏功能衰减明显。结论 脂肪乳剂能解救布比卡因致离体大鼠心脏停搏，并在一定范围内呈浓度-依赖关系。脂肪乳剂在较高浓度时能更好地纠正心功能状态，而超过一定浓度时其复跳后心功能反而衰减明显。 【关键词】离体心脏；布比卡因；脂肪乳剂；浓度-效应关系 Concentration-Response relationship for Lipid Rescuing Bupivacaine toxicity in The Isolated Rat Heart CHEN Ying*, LIU Le, XU Xu-zhong, WANG Quan-guang, SHI Tong, SHI Ke-jian,WANG Wan-tie. *Department of Anesthesiology，the First Affiated Hospital of Wenzhou Medical College，Wenzhou 325000，China. Objective To observe the concentration-response relationship between resuscitation with the lipid infusion to bupivacaine induced asystole.Methods We used an isolated rat heart, constant-pressure perfused, nonrecirculating Langendorff preparation. All the rats were randomly divided into eight groups. After Krebs-Henseleit buffer (KHB) was perfused for 25 min, infusion of 100μmol/L bupivacaine was initiated and sustained for 3 min after asystole, then :1) 40μmol/L bupivacaine was perfused in group C 2)seven different concentrations of lipid emulsion(0.25%,0.5%,1%,2%,4%,8%,16%) contained 40μmol/L bupivacaine was perfused in group E0.25 ,E0. 5, E1, E2, E4, E8, E16 . And then we observed the hearts for 45 minutes. We observed weather the hearts could recover and record the time from the end of the 100μmol/L bupivacaine infusion to heart resuscitation (Tr). During the 40 minutes th