脂肪乳剂对布比卡因心脏抑制犬血压、心率及心电图影响.docVIP

脂肪乳剂对布比卡因心脏抑制犬血压、心率及心电图影响 　 作者：王权光，刘乐，徐旭仲，陈莺，施通，陈丽梅，吴辉 【摘要】 　　目的 ：探讨30%脂肪乳剂对布比卡因心脏抑制犬模型的血流动力学和心电图的影响。方法 ：14只杂种犬随机分为实验组和对照组。犬静脉输入布比卡因，使平均动脉压(MAP)降至基础值的60%，布比卡因心脏抑制的中毒模型造模成功。实验组静脉注射30%脂肪乳剂负荷量3 mL/kg，然后10 min匀速输入3 mL/kg脂肪乳剂。对照组以同样速度和容量输入生理盐水。观察两组犬血压、心率和心电图PR间期、QRS间期、QT间期变化。结果：实验组的血压、心率和心电图PR间期、QRS间期、QT间期较对照组恢复快(P lt; 0.05)。结论 ：脂肪乳剂具有改善布比卡因心脏中毒时血流动力学及心肌电生理的作用。 【关键词】 布比卡因 毒性 脂肪乳剂 血流动力学 心电图 　　Abstract: Objective: To investigate the effects of 30% lipid emulsion on hemodynamics and electroardiogram of mongrel with bupivacaine-induced cardiac depression. Methods: Fourteen dogs were randomly divided into 2 groups (n =7 in each group): Lipid emulsion group (experiment group) and normal saline group（controlled group）. 0.5% bupivacaine was administated with a constant rate until the mean arterial pressure (MAP) decreased to 60% of the basic value in order to raise the cardiovascular toxicity model of bupivacaine. In the experimental group， an IV bolus of 30% lipid emulsion (3 mL/kg) was given， followed by continuous lipid emulsion infusion (3 mL/kg) for 10 minutes. In the control group， an IV bolus of saline (3 mL/kg) was given， followed by continuous saline infusion (3 mL/kg) for 10 minutes. The blood pressure，heart rate and electrocardiogram were monitored. Results: After the blood pressure， heart rate，PR interval，QRS interval and QT interval in experimental group recover significantly faster than that in control group (P lt; 0.05). Conclusion: Lipid emulsion has a beneficial effect on the hemodynamics and electrocardiogram of mongrel with bupivacaine-induced cardiac depression. 　　Key words: bupivacaine；toxicity；lipid emulsion；hemodynamics；electroardiogram 　　局部麻醉由于具有对器官功能影响小、对内环境及代谢方面干预轻微等优点在手术麻醉领域被广泛应用。布比卡因是局部麻醉中常用的长效局麻药，临床上布比卡因误注入血管会导致严重的心脏抑制。近年来国内外文献报道，脂肪乳剂可有效复苏布比卡因诱发的心脏停搏[1-3]，但脂肪乳剂对布比卡因所致的心脏抑制是否有治疗效果却鲜见报道。本实验观察脂肪乳剂对布比卡因所致心脏抑制犬的血压、心率及心电图的影响，为脂肪乳剂治疗布比卡因心脏早期毒性提供依据。 　　1 对象和方法 　　1.1 对象 选择成年健康杂种犬（温州医学院实验动物中心提供）14只，雄性，体重8.0～12.5 kg，犬龄12～18个月，随机分为实验组和对照组