Nolte H
Reg Anaesth. 1986 Jul;9(3):57-9.
A survey of American publications on the problem of cardiotoxicity of bupivacaine 0.75% is given. It can easily be demonstrated that all investigations were done on animals. Furthermore the dosages used in these investigations are far above those which are applied in humans. It seems to be rather obvious that with increasing emotional discussions of the problem of bupivacaine 0.75% the conclusions of the investigators are becoming more and more "defensive". Even the same group of investigators who dealt with the problem previously explain their results more cautiously 3 or 4 years later! Besides these investigations some of the more positive publications of the last 2 or 3 years are discussed. Finally it is pointed out that all clinical or experimental investigations on humans did not show any negative results when bupivacaine 0.75% was used. Careful application and a dose of not more than 2 mg per kg body weight are mandatory. With this in mind there seems to be no justified reasons to withdraw bupivacaine 0.75% from the market. Finally recommendations for correct application of bupivacaine 0.75% for epidural anaesthesia in obstetrics and surgery are given.
本文对美国有关0.75%布比卡因心脏毒性问题的出版物进行了综述。很容易证明，所有研究都是在动物身上进行的。此外，这些研究中使用的剂量远远高于人类应用的剂量。随着对0.75%布比卡因问题的情绪化讨论日益增加，研究人员的结论似乎越来越“保守”，这一点相当明显。甚至同一组之前研究过该问题的研究人员，在3或4年后也更加谨慎地解释他们的结果！除了这些研究，还讨论了过去两三年一些较为积极的出版物。最后指出，当使用0.75%布比卡因时，所有针对人类的临床或实验研究均未显示出任何负面结果。必须谨慎使用，且剂量不超过每公斤体重2毫克。考虑到这一点，似乎没有合理的理由将0.75%布比卡因从市场上撤下。最后给出了在产科和外科硬膜外麻醉中正确使用0.75%布比卡因的建议。
