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利多卡因和布比卡因对麻醉犬局部心肌功能和冠状动脉血流的影响。

Effects of lignocaine and bupivacaine on regional myocardial function and coronary blood flow in anaesthetized dogs.

作者信息

Leone B J, Lehot J J, Runciman W B, Welding R N, Ramsay J G, Arvieux C C, Ryder W A, Foëx P

机构信息

Nuffield Department of Anaesthetics, Radcliffe Infirmary, University of Oxford.

出版信息

Br J Anaesth. 1988 May;60(6):671-9. doi: 10.1093/bja/60.6.671.

Abstract

Empirical i.v. doses of lignocaine or bupivacaine of equal local anaesthetic potency were administered to halothane-anaesthetized dogs. Both local anaesthetics caused the expected depression of global haemodynamic function. Regional myocardial systolic shortening was depressed similarly by both agents. Regional myocardial dysfunction, seen as post-systolic shortening, occurred to a similar extent with both lignocaine and bupivacaine. Coronary blood flow and coronary perfusion pressure were significantly correlated during the administration of lignocaine; bupivacaine had erratic effects on coronary blood flow and no correlation between coronary blood flow and coronary perfusion pressure was seen. These results suggest that regional myocardial dysfunction occurs with both local anaesthetics and does not account for the apparent increased cardiotoxicity of bupivacaine. Bupivacaine did, however, cause wider individual variations compared with lignocaine with respect to coronary blood flow.

摘要

给氟烷麻醉的犬静脉注射具有同等局部麻醉效力的利多卡因或布比卡因经验剂量。两种局部麻醉药均引起预期的整体血流动力学功能抑制。两种药物对局部心肌收缩性缩短的抑制作用相似。利多卡因和布比卡因导致的局部心肌功能障碍(表现为收缩后缩短)程度相似。在给予利多卡因期间,冠状动脉血流量与冠状动脉灌注压显著相关;布比卡因对冠状动脉血流量有不稳定的影响,且未观察到冠状动脉血流量与冠状动脉灌注压之间的相关性。这些结果表明,两种局部麻醉药均可导致局部心肌功能障碍,且这并非布比卡因明显增加的心脏毒性的原因。然而,与利多卡因相比,布比卡因在冠状动脉血流量方面确实引起了更广泛的个体差异。

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