Wasudev G, Smith B E, Limbird T J
Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN 37232-2550.
Arthroscopy. 1990;6(1):40-2. doi: 10.1016/0749-8063(90)90095-u.
Toxic levels of bupivacaine have been reported in other types of surgery, but have not been previously noted in arthroscopic procedures. The purpose of this study was to evaluate bupivacaine levels after an intraarticular bolus of bupivacaine administered after arthroscopic surgery. Blood levels of bupivacaine were found to be significantly higher in patients in whom synovial surgery had been performed compared with those patients in whom the procedure involved only meniscal or articular cartilage surgery. A reduction in the bupivacaine dosage when the synovium has been resected or divided is recommended to keep the serum level below the potentially toxic range.
据报道，在其他类型的手术中曾出现布比卡因中毒水平，但在关节镜手术中此前尚未有过此类情况。本研究的目的是评估关节镜手术后关节腔内注射布比卡因后的布比卡因水平。结果发现，与仅进行半月板或关节软骨手术的患者相比，接受滑膜手术的患者血液中的布比卡因水平显著更高。建议在切除或切开滑膜时减少布比卡因剂量，以使血清水平保持在潜在中毒范围以下。
