【作者】 杨希革；

【导师】 王春喜；

【作者基本信息】 吉林大学 ， 外科学， 2011， 博士

【摘要】 目的：通过右美托咪啶预注预防利多卡因心脏毒性反应的可行性。方法：成熟Wistar大鼠,30只,随机分为3组,每组10只大鼠。A组为右美托咪啶0μg/kg组,B组为右美托咪啶5μg/kg组,C组为右美托咪啶10μg/kg组。行10%水合氯醛4ml/kg腹腔麻醉,经右侧股动脉直接测压、经左侧股静脉置入导管给药。在实验组中,通过左侧股静脉10mmin泵入相对剂量的右美托咪啶1ml。10mmin后以1ml/h泵入2%利多卡因,直至动物产生中毒症状为止,动物一旦产生中毒症状,立即停止用药。利多卡因中毒的界定：ECG波形中发生改变,增宽幅度>基础值20%或出现心律失常、心率变化>基础值25%、MAP下降>25%可定义为利多卡因中毒。动物产生利多卡因等局麻药中毒症状时通过右侧股动脉抽取动脉血,高效液相色谱法测定血中利多卡因浓度。分析给入不同浓度右美托咪啶与血中利多卡因浓度的关系。结果：A、B、C三组中实验大鼠的体重和血流动力学指标(基础值)无统计学差异(P>0.05)；A组大鼠利多卡因中毒时血药浓度为1.049±0.883μg/ml, B组大鼠利多卡因中毒时血药浓度为5.460±1.814μg/ml,C组大鼠利多卡因中毒时血药浓度为6.066±2.715μg/ml。.结论：右美托咪啶对利多卡因引起的心脏毒性反应有较好的预防作用。更多还原

【Abstract】 Objective:To investigate the effect of dexemedetomidine pre-injection on prevention of lidocaine cardiac toxicity in mature Wistar rats.Methods:Thirty mature Wistar rats were randomized to three groups of 10 rats each to receive pre-injection with dexmedetomidine 0μg/kg (Group A), dexmedetomidine 5μg/kg (Group B), or dexmedetomidine 10μg/kg (Group C). All groups underwent intraperitoneal anesthesia with 4ml/kg 10% Chloral hydrate, noninvasive blood pressure was applied to the rignt femoral,a catheter was inserted in the left femoral vein devoted to medcine infusion.In the experiment groups,1 ml relative dose was infused through the left femoral vein in 10 minutes and then with a continuous lml/h 2% lidocaine infusion with a pump until the rats had the manifestations of poisoning, definded as the ECG waveform changed, including that broadening range>20% of baseline values or arrhythmia, heart rate> 25% of baseline values, MAP decreased>25%.Hardly rats produced poisoning symptoms of local anesthetic when the arterial blood was collected through the right femoral artery, measured the determination of lidocaine concentrations in blood with the High Performance Liquid Chromatography. To analysis the relationship between different concentrations of dexmedetomidine and blood lidocaine concentration.Results:The rats in three groups were similar with regard to weights and hemodynamics (baseline) and there was no significant difference (P>0.05). A group blood concentration of lidocaine poisoning was 1.049±0.883μg/ml, B group blood concentration of lidocaine poisoning was 5.460±1.814μg/ml, C group blood concentration of lidocaine poisoning was 6.066±2.715μg/ml.Conclusion:Pre-injection with dexmedetomidine had a good preventive effect on lidocaine induced cardiac toxicity.更多还原