Bodenham A, Park G R
Department of Anaesthesia, Addenbrookes Hospital, Cambridge.
Br J Anaesth. 1990 Apr;64(4):436-41. doi: 10.1093/bja/64.4.436.
Bilateral intercostal nerve blocks were performed on 12 occasions in 11 patients after liver transplantation. Group 1 (six patients) received bupivacaine 2 mg kg-1 on one occasion; in group 2 (five patients) bupivacaine 2 mg kg-1 with adrenaline 1:200,000 was injected on two occasions separated by 6 h. Arterial blood was sampled repeatedly and analysed for total bupivacaine concentrations by high performance liquid chromatography (HPLC). Six patients had bupivacaine concentrations within the putative toxic threshold of 2-4 micrograms ml-1. The use of adrenaline-containing solutions neither slowed absorption reliably nor decreased peak concentrations of bupivacaine. Cumulation of bupivacaine occurred in group 2. No patient had adverse effects attributable to the bupivacaine.
对11例肝移植患者进行了12次双侧肋间神经阻滞。第1组（6例患者）一次接受2 mg/kg布比卡因；第2组（5例患者）在相隔6小时的两次注射中注入2 mg/kg布比卡因与1:200,000肾上腺素混合液。反复采集动脉血样，通过高效液相色谱法（HPLC）分析布比卡因总浓度。6例患者的布比卡因浓度在假定的2 - 4微克/毫升毒性阈值范围内。含肾上腺素溶液的使用既不能可靠地减缓吸收，也不能降低布比卡因的峰值浓度。第2组出现了布比卡因蓄积。没有患者出现与布比卡因相关的不良反应。
