Exler U, Nolte H, Milatz W
Reg Anaesth. 1986 Jul;9(3):68-73.
Fifteen patients undergoing orthopaedic surgery on the lower limbs were give continuous epidural anaesthesia with bupivacaine 0.75%. It was looked after changes in heart frequency, beat volume and changes in heart rhythm. Changes in cardiac output were investigated by ventriculography with 99mTC during 4 periods--10 min before and 10, 20 and 30 min after epidural blockade--the cardiac output was measured by a computer mathematically. Each patient received 2 mg/kg body weight of bupivacaine 0.75%. Besides the observation of blood pressure, heart rate and electrocardiogram the venous plasma levels of bupivacaine were measured up to 60 min after blockade. The results showed no changed in cardiac output. Except for one case with bradycardia--which could be treated with atropine--no changes in heart frequency occurred. Tachy- or bradycardia was not seen at all. Besides rare respiratory sinus arrhythmia no arrhythmia could be detected. The venous plasma levels of bupivacaine increased after 30 min up to 0.81 microgram/ml. The highest concentration measured was 1.45 microgram/ml 10 min after injection of bupivacaine. According to the results of the study the following statement can be given: Following bupivacaine 0.75% (2 mg/kg) given epidurally no changes in cardiac output, no changes in beat frequency, no pathological changes in cardiac rhythm and no specific cardiac toxicity related to bupivacaine 0.75% could be found in this study.
15例接受下肢骨科手术的患者接受了0.75%布比卡因持续硬膜外麻醉。观察了心率、每搏量和心律的变化。在4个时间段——硬膜外阻滞前10分钟以及阻滞 后10、20和30分钟——通过99m锝心室造影研究心输出量的变化，心输出量由计算机进行数学测量。每位患者接受2mg/kg体重的0.75%布比卡因。除了观察血压、心率和心电图外，还测量了阻滞 后60分钟内布比卡因的静脉血浆水平。结果显示心输出量没有变化。除1例心动过缓（可用阿托品治疗）外，心率没有变化。完全没有观察到心动过速或心动过缓。除了罕见的呼吸性窦性心律失常外，未检测到心律失常。布比卡因的静脉血浆水平在30分钟后升至0.81微克/毫升。注射布比卡因后10分钟测得的最高浓度为1.45微克/毫升。根据该研究结果可得出以下结论：在本研究中，硬膜外给予0.75%布比卡因（2mg/kg）后，未发现心输出量变化、搏动频率变化、心律无病理变化以及与0.75%布比卡因相关的特定心脏毒性。
