Wang Xi-Feng, Luo Xiao-Ling, Liu Wei-Cheng, Hou Ben-Chao, Huang Jian, Zhan Yan-Ping, Chen Shi-Biao
Department of Anesthesia, the First Affiliated Hospital of Nanchang University, Nanchang Department of Anesthesia, the Seventh People' s Hospital of Shenzhen, China.
Medicine (Baltimore). 2016 Oct;95(43):e4781. doi: 10.1097/MD.0000000000004781.
To study the effect of dexmedetomidine priming on convulsion reaction induced by lidocaine.The New Zealand white rabbits were applied for the mechanism study of dexmedetomidine priming for preventing convulsion reaction induced by lidocaine. The influence of dexmedetomidine priming with different doses on the time for convulsion occurrence and the duration time of convulsion induced by lidocaine, as well as contents of excitatory amino acids (aspartate [Asp], glutamate [Glu]) and inhibitory amino acids (glycine [Gly], γ-aminobutyric acid [GABA]) in the brain tissue were investigated.With 3 and 5 μg/kg dexmedetomidine priming, the occurrence times of convulsion were prolonged from 196 seconds to 349 and 414 seconds, respectively. With dexmedetomidine priming, the contents of excitatory amino acids (Asp, Glu) were much reduced at occurrence time of convulsion comparing with that without dexmedetomidine priming, while content of inhibitory amino acids Gly was much enhanced.The application of dexmedetomidine before local anesthetics can improve intoxication dose threshold of the lidocaine, delay occurrence of the convulsion, and helped for the recovery of convulsion induced by lidocaine. The positive effect of dexmedetomidine on preventing convulsion would owe to not only the inhibition of excitatory amino acids (Asp, Glu), but also the promotion of inhibitory amino acids Gly secretion.
研究右美托咪定预注对利多卡因所致惊厥反应的影响。选用新西兰白兔进行右美托咪定预注预防利多卡因所致惊厥反应的机制研究。观察不同剂量右美托咪定预注对利多卡因致惊厥发生时间、惊厥持续时间的影响，以及脑组织中兴奋性氨基酸（天冬氨酸[Asp]、谷氨酸[Glu]）和抑制性氨基酸（甘氨酸[Gly]、γ-氨基丁酸[GABA]）含量的变化。右美托咪定3μg/kg和5μg/kg预注时，惊厥发生时间分别从196秒延长至349秒和414秒。右美托咪定预注后，惊厥发生时兴奋性氨基酸（Asp、Glu）含量较未预注时明显降低，而抑制性氨基酸Gly含量明显升高。局麻药前应用右美托咪定可提高利多卡因中毒剂量阈值，延迟惊厥发生，并有助于利多卡因所致惊厥的恢复。右美托咪定预防惊厥的积极作用不仅归因于对兴奋性氨基酸（Asp、Glu）的抑制，还归因于对抑制性氨基酸Gly分泌的促进。
