Department of Anesthesiology, First Affiliated Hospital of Wenzhou Medical College, Zhejiang, China.
Basic Clin Pharmacol Toxicol. 2013 Mar;112(3):203-8. doi: 10.1111/bcpt.12008. Epub 2012 Dec 6.
In this controlled, randomized, double-blind study, we compared the pharmacodynamics and pharmacokinetics of ropivacaine and staged injection of lidocaine and ropivacaine in a combined lumbar plexus-sciatic nerve block. The experiment was performed in two parts: pharmacodynamics study (Group r, n = 20; Group lr, n = 20) and pharmacokinetics study (Group R, n = 10; Group LR, n = 10). The sciatic nerve blockade was performed using either (1) 10 mL of 2% lidocaine and then 10 mL of 0.75% ropivacaine (Group lr and Group LR) or (2) 10 mL of normal saline (N.S.) and then 10 mL of 0.75% ropivacaine (Group r and Group R). Two kinds of solutions were 'staged' injection. The sensory onset time and sensory recovery time were assessed in the pharmacodynamics study. Arterial blood samples were collected for the pharmacokinetics study. Sciatic sensory block onset times were reduced, and the sensory recovery times were decreased in Group lr. C(max) of ropivacaine in Group LR was significantly higher than that in Group R. A significant increase in AUC((0-t)) and AUC((0-∞)) was observed in Group LR compared with Group R. When 2% lidocaine and 0.75% ropivacaine are used for a combined sciatic nerve-lumbar plexus block by 'staged' injection, lidocaine induced faster onset times, decreased the block duration and increased the AUC and C(max) of ropivacaine.
在这项对照、随机、双盲研究中，我们比较了罗哌卡因和利多卡因与罗哌卡因序贯注射在联合腰丛-坐骨神经阻滞中的药效学和药代动力学。实验分为两部分进行：药效学研究（r 组，n = 20；lr 组，n = 20）和药代动力学研究（R 组，n = 10；LR 组，n = 10）。坐骨神经阻滞采用以下两种方法之一：（1）10ml 2%利多卡因，然后 10ml 0.75%罗哌卡因（lr 组和 lr 组）或（2）10ml 生理盐水（ns），然后 10ml 0.75%罗哌卡因（r 组和 r 组）。两种溶液均采用“序贯”注射。在药效学研究中评估了感觉起始时间和感觉恢复时间。在药代动力学研究中采集动脉血样。lr 组感觉阻滞起效时间缩短，感觉恢复时间缩短。LR 组罗哌卡因 C(max)明显高于 R 组。与 R 组相比，LR 组 AUC((0-t))和 AUC((0-∞))显著增加。当 2%利多卡因和 0.75%罗哌卡因用于联合坐骨神经-腰丛阻滞的“序贯”注射时，利多卡因可更快地起效，缩短阻滞持续时间，并增加罗哌卡因的 AUC 和 C(max)。
