Imai M, Chang K S, Tanz R D, Stevens W C, Kemmotsu O
Department of Anesthesia, Sapporo Tonan Hospital.
Masui. 1991 Jun;40(6):868-72.
We examined the direct effects of bupivacaine on the diabetic rat myocardium using an isolated perfused (Langendorff) heart preparation. Rats were made diabetic by injection of streptozotocin (55 mg.kg-1, i. v.). 12 weeks after the administration of streptozotocin, hearts were excised and perfused using Langendorff technique. Following 60 min for equilibration, diabetic hearts from the 12-week animals exhibited significant bradycardia. Bupivacaine 3 mcg.ml-1 did not decrease myocardial contractility in control animals. However, 3 mcg.ml-1 bupivacaine decreased contractility significantly in diabetic animals at nearly all periods. Bupivacaine decreased heart rate and coronary flow significantly and similarly in control and diabetic rats hearts. After pacing at 4 Hz, bupivacaine decreased contractility more in diabetic group than in control group. These results indicate that the presence of a diabetic state appears to enhance the sensitivity of the heart to the myocardial depressant effect of bupivacaine.
我们使用离体灌注（Langendorff）心脏制备方法，研究了布比卡因对糖尿病大鼠心肌的直接影响。通过静脉注射链脲佐菌素（55 mg·kg-1）使大鼠患糖尿病。在给予链脲佐菌素12周后，取出心脏并采用Langendorff技术进行灌注。平衡60分钟后，12周龄动物的糖尿病心脏出现明显的心动过缓。3 mcg·ml-1的布比卡因对对照动物的心肌收缩力没有降低作用。然而，在几乎所有时间段，3 mcg·ml-1的布比卡因显著降低了糖尿病动物的收缩力。布比卡因对对照大鼠和糖尿病大鼠心脏的心率和冠状动脉血流量均有显著且相似的降低作用。在以4 Hz起搏后，布比卡因对糖尿病组收缩力的降低作用比对对照组更明显。这些结果表明，糖尿病状态的存在似乎增强了心脏对布比卡因心肌抑制作用的敏感性。
