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探讨30%浓度脂肪乳剂对不同局麻药心脏抑制家兔模型心肌超微结构影响。方法 :27只成年新西兰兔随机平均分为B组(布比卡因组)、T组(丁卡因组)、R组(罗哌卡因组)。各局麻药组分别静脉输入布比卡因、丁卡因、罗哌卡因(4mg·kg-1·min-1),直至MAP降至基础值的60%,成功建立局麻药心脏抑制的中毒模型。B组、T组、R组静脉推注30%脂肪乳剂负荷量1ml/kg,然后以0.5ml·kg-1·min-1剂量持续微量泵泵入。当MAP恢复至基础MAP80%或以上水平时,治疗有效;MAP与ECG无改善或不断恶化者视为治疗失败。监测各组基础心率(HR)和基础MAP;记录各组治疗有效率;各组治疗成功家兔持续监测观察1h后取心肌标本进行透射电镜检查。结果 :各组家兔基础HR、基础MAP未见明显差异。治疗有效率比较,B组与T组相当,R组最高。心肌细胞损害以及线粒体肿胀程度R组低于B组与T组,B组与T组未见明显差异。结论 :脂肪乳剂对不同局麻药导致的家兔心脏毒性有治疗作用,其作用机制可能与沉积效应有关。
To investigate the effects of 30% fat emulsion on myocardial ultrastructure in rabbits with different local anesthetics. Methods: Twenty-seven adult New Zealand rabbits were randomly divided into group B (bupivacaine group), group T (tetracaine group) and group R (ropivacaine group). Each local anesthetic group received intravenous bupivacaine, tetracaine, and ropivacaine (4 mg · kg -1 · min -1) intravenously until the MAP dropped to 60% of the baseline value, and successful establishment of the cardiotoxicosis model of local anesthetics . Group B, group T and group R were intravenously injected with 30% lipid emulsion loading 1ml / kg, then pumped with 0.5ml · kg-1 · min-1 continuous micro-pump. Treatment is effective when MAP returns to basal levels of 80% or above; failure to treat without improvement or worsening of MAP and ECG is considered. The basal heart rate (HR) and basal MAP of each group were monitored. The treatment efficiency of each group was recorded. The successful treatment of each group was observed continuously in the rabbits for 1 hour and then the myocardial samples were taken for transmission electron microscopy. Results: The basal HR and basal MAP of rabbits in each group showed no significant difference. Treatment efficiency, B group and T group, R group was the highest. Myocardial cell damage and mitochondria swelling degree R group was lower than B group and T group, B group and T group no significant difference. Conclusion: Fat emulsion has therapeutic effect on cardiotoxicity of rabbits induced by different local anesthetics. Its mechanism may be related to sedimentation effect.