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添加血管加压素对利多卡因在组织中的分布、麻醉作用和循环动力学的影响。

Effect of adding vasopressin on the distribution of lidocaine in tissues, anesthetic action, and circulatory dynamics.

机构信息

Department of Dental Anesthesiology, The Nippon Dental University School of Life Dentistry at Tokyo, 1-9-20, Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan.

The Nippon Dental University, Tokyo, Japan.

出版信息

Odontology. 2020 Apr;108(2):292-299. doi: 10.1007/s10266-019-00449-z. Epub 2019 Aug 26.

Abstract

We examined whether vasopressin affects the distribution, anesthesia duration, and circulatory dynamics of lidocaine. Blood flow was measured after injecting 0.003, 0.03, or 0.3 U/mL vasopressin and 2% lidocaine (L) to the upper lip of rats. Radioactivity and distribution of C-labeled L (CL) in the palate, palatal mucosa, maxilla bone, and blood was measured by autoradiography after injecting CL and CL + 0.03 U/mL vasopressin. To evaluate anesthesia duration, somatosensory-evoked potentials, blood pressure, and pulse rate were measured after L, 0.03 U/mL vasopressin, and L + 0.03 U/mL vasopressin injection to the palatal mucosa. Blood flow from 10 to 60 min was significantly lower with 0.03 U/mL vasopressin and L + 0.03 U/mL vasopressin than with L. Radioactivity in the palatal mucosa and maxilla bone was significantly higher at 5-60 min and 2-60 min with CL + 0.03 U/mL vasopressin than with CL. Blood radioactivity reached the maximum at 0.5 and 50 min with CL and CL + 0.03 U/mL vasopressin, respectively. Autoradiogram showed higher distribution with CL + 0.03 U/mL vasopressin than CL. Peak-to-peak amplitude 30-60 min was significantly lower with L + 0.03 U/mL vasopressin than with L. Lidocaine did not affect blood pressure and pulse rate with 0.03 U/mL vasopressin-only or combined with 2%-lidocaine. Topical 0.03 U/mL vasopressin injection reduced the tissue blood flow, promoted the localization and retention, and extended the anesthesia duration of lidocaine, leaving circulatory dynamics unaffected.

摘要

我们研究了加压素是否会影响利多卡因的分布、麻醉持续时间和循环动力学。向大鼠上唇注射 0.003、0.03 或 0.3U/mL 加压素和 2%利多卡因(L)后,测量血流。通过放射自显影测量注射 CL 和 CL+0.03U/mL 加压素后腭、腭黏膜、上颌骨和血液中 C 标记的 L(CL)的放射性和分布。为了评估麻醉持续时间,在向腭黏膜注射 L、0.03U/mL 加压素和 L+0.03U/mL 加压素后测量体感诱发电位、血压和脉搏率。与 L 相比,0.03U/mL 加压素和 L+0.03U/mL 加压素的 10-60 分钟时血流显著降低。与 CL 相比,CL+0.03U/mL 加压素在 5-60 分钟和 2-60 分钟时腭黏膜和上颌骨的放射性显著升高。CL 和 CL+0.03U/mL 加压素的血液放射性分别在 0.5 和 50 分钟时达到最大值。与 CL 相比,CL+0.03U/mL 加压素的放射自显影显示出更高的分布。L+0.03U/mL 加压素的 30-60 分钟峰峰值明显低于 L。仅用 0.03U/mL 加压素或与 2%利多卡因联合使用时,利多卡因不影响血压和脉搏率。局部注射 0.03U/mL 加压素可降低组织血流,促进定位和滞留,延长利多卡因的麻醉持续时间,而不影响循环动力学。

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