Hou S M, Liu T K, Yu H Y
Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taipei, R.O.C.
J Orthop Res. 1991 Jul;9(4):545-9. doi: 10.1002/jor.1100090410.
Fifty rabbits were used to investigate the absorption of lidocaine following its topical application to blood vessels. The lidocaine level in the blood was determined by gas chromatography and the enzyme immunoassay. Animals were divided into five groups according to anatomic site (femoral vs iliac) and according to whether vessels were intact or anastomosed. In the last group (E), a water-tight sleeve was placed on the anastomosed femoral artery so that the lidocaine contacted only a small segment of the artery. In each group, 0.4 and 1 ml of 10% lidocaine were used. Our results revealed that absorption of lidocaine from topical usage was rapid. The absorption peak occurred within 5-15 min. The serum concentration of lidocaine was significantly higher in groups with intact vessels than in those with anastomosed ones. The peak level of lidocaine in the serum occurred sooner in the iliac area than in the femoral area. Absorption in group E was very low due to only a small segment of the artery being immersed with lidocaine. The main absorption site of lidocaine was not through the vessel but through the perivascular area. Toxicity may develop clinically if a high concentration of lidocaine is applied on a vessel during microsurgery.
五十只兔子被用于研究利多卡因局部应用于血管后的吸收情况。通过气相色谱法和酶免疫测定法测定血液中的利多卡因水平。根据解剖部位(股动脉与髂动脉)以及血管是否完整或吻合,将动物分为五组。在最后一组(E组)中,在吻合的股动脉上放置一个防水套管,使利多卡因仅接触动脉的一小段。每组使用0.4毫升和1毫升10%的利多卡因。我们的结果显示,局部使用利多卡因的吸收很快。吸收峰值出现在5至15分钟内。完整血管组的利多卡因血清浓度显著高于吻合血管组。利多卡因血清峰值水平在髂区比股区出现得更早。由于E组只有一小段动脉被利多卡因浸泡,其吸收非常低。利多卡因的主要吸收部位不是通过血管,而是通过血管周围区域。如果在显微手术期间在血管上应用高浓度的利多卡因,临床上可能会出现毒性反应。