Cederholm I, Evers H, Löfström J B
Department of Anaesthesiology, University Hospital, Linköping, Sweden.
Reg Anesth. 1992 Nov-Dec;17(6):322-8.
Skin blood flow changes after intradermal injection of ropivacaine in various concentrations with or without epinephrine were investigated using laser Doppler flowmetry.
Twenty-three non-smoking, healthy, young male volunteers participated. Four test sites were used on each forearm (volar surface) in a randomized, double-blind study. Recordings were made at 20, 40, 60, and 90 minutes after intradermal injection (0.1 ml, 30-gauge needle). Injections of saline and 1% lidocaine and an untreated area served as controls. In Series 1, various concentrations of ropivacaine (1%, 0.5%, 0.375%, 0.125%, and 0.063%) were injected.
The data from this series showed a dose-response relationship: 1% ropivacaine provoked an increase in skin blood flow similar to saline; 0.5% and weaker concentrations of ropivacaine showed a reduction in flow compared to saline, this being more pronounced with the weakest solutions (0.125% and 0.063%). In Series 2, injection of 1:200,000 (5 micrograms/ml) epinephrine alone and injections of ropivacaine in various concentrations (1%, 0.5%, and 0.25%) with addition of epinephrine were carried out. Injection of epinephrine alone showed a flow almost as low as at the untreated control sites. Ropivacaine epinephrine injections were followed by a lower skin blood flow compared to saline, but the flow was significantly larger compared to the effect of epinephrine itself at the 20-minute recording.
The combination of ropivacaine and adrenaline did not accentuate but instead diminished the vasoconstrictive effect of epinephrine.
采用激光多普勒血流仪研究不同浓度罗哌卡因皮内注射后，加用或不加用肾上腺素时的皮肤血流变化。
23名不吸烟的健康年轻男性志愿者参与研究。在一项随机双盲研究中，于每个前臂（掌侧）设置4个测试部位。皮内注射（0.1 ml，30号针头）后20、40、60和90分钟进行记录。注射生理盐水、1%利多卡因以及未处理区域作为对照。在系列1中，注射不同浓度的罗哌卡因（1%、0.5%、0.375%、0.125%和0.063%）。
该系列数据显示出剂量反应关系：1%罗哌卡因引起的皮肤血流增加类似于生理盐水；0.5%及更低浓度的罗哌卡因与生理盐水相比血流减少，最弱浓度（0.125%和0.063%）时更为明显。在系列2中，单独注射1:200,000（5微克/毫升）肾上腺素，以及注射不同浓度（1%、0.5%和0.25%）罗哌卡因并添加肾上腺素。单独注射肾上腺素时血流几乎与未处理对照部位一样低。罗哌卡因加肾上腺素注射后皮肤血流低于生理盐水，但在20分钟记录时，与肾上腺素本身的作用相比血流显著更大。
罗哌卡因与肾上腺素联合使用并未增强反而减弱了肾上腺素的血管收缩作用。
