丙泊酚预防和治疗局部麻醉药中枢和心脏毒性反应体会.docVIP

丙泊酚预防和治疗局部麻醉药中枢和心脏毒性反应体会 (海南省农垦那大医院麻醉科海南儋州571700）【摘要】目的：局部麻醉药的毒性反应严重威胁患者生命安全，我们力求寻找安全有效的药物，以控制局部麻醉药引起的惊厥，并减轻心血管系统毒性，提高复苏率和生存率具有重要的临床意义。方法：①提取2例局麻药中毒反应丙泊酚抢救成功案例；方法：②抽取10例拟行臂丛麻醉患者，均为急诊入室，分为AB两组，A组术前丙泊酚推注，B组地西泮推注，A组术前，推药后，术后，均抽取血观察PaCO2。结果：1治疗：两例局麻药中毒反应，丙泊酚抢救均成功。2预防：AB两组患者均再无出现局麻药毒性反应，观察A组术前PaCO2明显高于静推丙泊酚后的PaCO2，说明降低PaCO2确实可降低局麻药对大脑皮质的刺激作用。3结论：研究表明：丙泊酚对脑和心脏缺血、缺氧性损伤更具保护作用。【关键词】丙泊酚；预防和治疗；麻药毒性反应【中国分类号】R614【文献标识码】A【文章编号】1004-5511（2012）04-0097-02 【Abstract】Objective: local anesthetic toxicity threat the patients’ safety seriously, we strive to find safe and effective drugs to control the convulsions caused by local anesthetic, and reduce the toxicity of cardiovascular system, this has important sense to improving recovery and survival rates. Method: ① extract two cases of patients who were rescued successfully with propofol from local anesthetic toxic reactions. ② collected 10 cases of patients who are supposed to underwent brachial plexus anesthesia after emergency admission. Divided them into two groups A and B. give the patients in group A propofol with syringe pumps before operation, and give the patients in group B diazepam with syringe pumps. Taking blood observed PaCO2 in group A before operation, after pushing drugs, and after the operation. Results: 1. treatment:there are two cases of patients who were rescued successfully with propofol from local anesthetic toxic reactions. 2. Prevention: no longer local anesthetic toxicity appears in patients in both two groups. Preoperative PaCO2 in group A was significantly higher than the PaCO2 after giving propofol with syringe pumps. This demonstrates that reducing PaCO2 can do reduce the stimulation of the cerebral cortex caused by local anesthetics. Conclusion: Studies have shown that: propofol is more protective on cerebral , cardiac ischemia, and hypoxic injury.【Key words】propofol , prevention and treatment , local anesthetic toxicity地西泮（安定）不溶于水，刺激性较强，肌肉或静脉注射可引起疼痛，且局部静脉炎发生率高。药理作用： 　　1、中枢神经系统作用，①具有抗焦虑、镇静、抗惊厥；2、心血管系统作用：