Gin T, Chan K, Kan A F, Gregory M A, Wong Y C, Oh T E
Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Shatin, N.T., Hong Kong.
Br J Anaesth. 1990 Jun;64(6):662-6. doi: 10.1093/bja/64.6.662.
Bupivacaine 2.5 mg kg-1 (0.5 ml kg-1 of 0.5% solution), with or without adrenaline 5 micrograms ml-1, was administered by interpleural injection to 12 patients after elective cholecystectomy. Noncompartmental analysis indicated that the addition of adrenaline had no effect on total body clearance, apparent volume of distribution at steady state or elimination half-life of bupivacaine. However, peak plasma concentrations were lower in the adrenaline group (mean (SD) [range]: 2.57 (0.61) [1.52-3.11] vs 3.22 (0.27) [2.84-3.53] micrograms ml-1, P less than 0.05) and the time to maximum concentration was delayed (median [range]: 25 [15-30] vs 15 [10-20] min, P less than 0.05). Analgesia was variable and no differences were detected between the two groups. The addition of adrenaline appears prudent to minimize possible bupivacaine toxicity.
对12例择期胆囊切除术后患者进行胸膜间注射，给予布比卡因2.5mg/kg（0.5%溶液0.5ml/kg），加或不加5μg/ml肾上腺素。非房室分析表明，加入肾上腺素对布比卡因的全身清除率、稳态分布容积或消除半衰期无影响。然而，肾上腺素组的血浆峰值浓度较低（均值（标准差）[范围]：2.57（0.61）[1.52 - 3.11] vs 3.22（0.27）[2.84 - 3.53]μg/ml，P<0.05），达到最大浓度的时间延迟（中位数[范围]：25[15 - 30] vs 15[10 - 20]分钟，P<0.05）。镇痛效果不一，两组间未检测到差异。加入肾上腺素似乎有助于谨慎地将布比卡因可能的毒性降至最低。
