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加压素对利多卡因麻醉反应时间和循环动力学的影响。

Effects of vasopressin on anesthetic response time and circulatory dynamics of lidocaine.

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.

出版信息

Odontology. 2021 Jul;109(3):632-638. doi: 10.1007/s10266-020-00585-x. Epub 2021 Jan 15.

Abstract

This study aimed to investigate the hypothesis that vasopressin extends the anesthetic response time of lidocaine and does not affect the circulatory dynamics. Rats were sedated with isoflurane; subsequently, breathing was maintained through mechanical ventilation. We infiltrated the first molar area of the upper left jaw with saline (NS, test solution), 2% lidocaine (L), 0.025 IU vasopressin-supplemented 2% lidocaine, 0.05 IU vasopressin-supplemented 2% lidocaine, 0.1 IU vasopressin-supplemented 2% lidocaine, and 0.2 IU vasopressin-supplemented 2% lidocaine (VL). Further, anesthetic response times were measured up to 30 min using electric pulp testing methods (n = 4). The anesthetic response times of NS, L, and VL were measured up to 45 min with the aforementioned results as reference values (n = 7). The circulatory dynamics of NS, L, VL, and 0.2 IU vasopressin (V) were measured up to 45 min using a non-invasive blood pressure measuring device. VL extended the anesthetic response times of lidocaine compared to L (p < 0.05). Further, V and VL significantly increased the systolic and diastolic blood pressure and significantly decreased the pulse rate (p < 0.05). VL is not a suitable addition to the local anesthetic solution used in dentistry. Further study is needed to determine vasopressin concentration that extends the anesthetic effect without affecting the circulatory dynamics.

摘要

本研究旨在验证加压素可延长利多卡因的麻醉反应时间且不影响循环动力学这一假说。研究对象为使用异氟醚镇静的大鼠,随后通过机械通气维持其呼吸。我们用生理盐水(NS,测试溶液)、2%利多卡因(L)、含 0.025IU 加压素的 2%利多卡因、含 0.05IU 加压素的 2%利多卡因、含 0.1IU 加压素的 2%利多卡因和含 0.2IU 加压素的 2%利多卡因(VL)浸润左上颚第一磨牙区域。进一步采用电牙髓测试方法测量 30min 内的麻醉反应时间(n=4)。根据上述结果作为参考值,进一步测量 NS、L 和 VL 至 45min 的麻醉反应时间(n=7)。采用非侵入性血压测量装置测量 NS、L、VL 和 0.2IU 加压素(V)至 45min 的循环动力学。VL 可延长与 L 相比的利多卡因麻醉反应时间(p<0.05)。此外,V 和 VL 显著增加收缩压和舒张压,显著降低脉搏率(p<0.05)。VL 不适合添加到牙科局部麻醉溶液中。需要进一步研究确定加压素浓度,在不影响循环动力学的情况下延长麻醉效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa75/8178135/abc4925d47ee/10266_2020_585_Fig1_HTML.jpg

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