Surg Endosc. 2011 Apr;25(4):1341-2; author reply 1343. doi: 10.1007/s00464-010-1276-7.
Recently, Zimmer and colleagues reported a lack of analgesic efficacy from intraperitoneal nebulization of bupivacaine using the Insuflow device for patients undergoing laparoscopic cholecystectomy. This is not surprising. An in vitro study in 2008 showed that hot evaporation-based devices, similar to Insuflow, are unable to transport drug molecules dissolved in a water solvent. These results are in keeping with the physical principle that hot evaporation enables only evaporation of the solvent (e.g., water) and not of the solute (e.g., bupivacaine). Although this well-conducted human study has a defendable medical justification and a high theoretical interest, it is not acceptable to choose a human model for an experimental study that attempts to explore a question whose answer has already been published years before in a bench setting.
最近,Zimmer 及其同事报告称,使用 Insuflow 装置对接受腹腔镜胆囊切除术的患者进行腹腔内布比卡因雾化时,其镇痛效果不佳。这并不奇怪。2008 年的一项体外研究表明,类似于 Insuflow 的热蒸发装置无法输送溶解在水溶剂中的药物分子。这些结果与物理原理一致,即热蒸发仅能蒸发溶剂(例如水),而不能蒸发溶质(例如布比卡因)。尽管这项精心设计的人体研究具有合理的医学依据和很高的理论意义,但在一个旨在探索一个问题的实验研究中选择人体模型,而该问题的答案早在几年前在一个实验环境中已经发表,是不可接受的。