Eledjam J J, de la Coussaye J E, Colson P, Viel E, Bassoul B, Bertinchant J P, D'Athis F
Department of Anaesthesiology, Centre Hospitalier Régional et Universitaire, Nimes, France.
Acta Anaesthesiol Scand. 1989 Jul;33(5):402-4. doi: 10.1111/j.1399-6576.1989.tb02932.x.
Bupivacaine is known to interact with the conductive system of the heart, also when used in epidural anaesthesia. Ten patients, undergoing bupivacaine epidural anaesthesia for lower limb or pelvic surgery, who presented a history of cardiac conduction disturbances, were studied. The ECG was continuously monitored and a right ventricular bipolar electrode was used to monitor the following parameters: heart rate, QRS duration, QT, Atria-His and His-Ventricle intervals. No significant change was noticed, even in patients with a high grade conduction defect. The mean plasma level of bupivacaine was 0.33 +/- 0.23 micrograms/ml. Based on this experience, it seems that lumbar epidural anaesthesia with bupivacaine can be safely used in patients with asymptomatic AV conduction abnormalities.
已知布比卡因即使在用于硬膜外麻醉时也会与心脏传导系统相互作用。对10例有心脏传导障碍病史、接受布比卡因硬膜外麻醉进行下肢或盆腔手术的患者进行了研究。持续监测心电图，并使用右心室双极电极监测以下参数：心率、QRS波时限、QT间期、心房-希氏束间期和希氏束-心室间期。即使在有高度传导缺陷的患者中也未发现明显变化。布比卡因的平均血浆水平为0.33±0.23微克/毫升。基于这一经验，似乎布比卡因腰段硬膜外麻醉可安全用于无症状房室传导异常的患者。
