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可乐定可延长犬丁卡因脊髓麻醉时间。

Clonidine prolongs canine tetracaine spinal anaesthesia.

作者信息

Bedder M D, Kozody R, Palahniuk R J, Cumming M O, Pucci W R

出版信息

Can Anaesth Soc J. 1986 Sep;33(5):591-6. doi: 10.1007/BF03014266.

DOI:10.1007/BF03014266
PMID:3768767
Abstract

Using a randomized blind cross-over design, the comparative efficacy of clonidine in prolonging tetracaine spinal anaesthesia was studied in six mongrel dogs. Lumbar subarachnoid injections (1 ml) of: tetracaine 4 mg with clonidine 150 micrograms, tetracaine 4 mg with epinephrine 200 micrograms, tetracaine 4 mg, clonidine 150 micrograms, epinephrine 200 micrograms, and five per cent dextrose in H2O (vehicle) were administered randomly to each animal at 5-7 day intervals. Subarachnoid tetracaine produced a motor blockade of 186 +/- 58 (mean +/- SEM) min. Both clonidine and epinephrine produced a similar prolongation of tetracaine motor blockade, 135 per cent (p less than 0.01) and 116 per cent (p less than 0.05) respectively, compared with tetracaine alone. No motor blockade was observed in dogs receiving clonidine, epinephrine or five per cent dextrose in H2O. The addition of clonidine to tetracaine spinal anaesthesia produced a significant increase in duration of sensory blockade, 56 per cent (p less than 0.01) and 107 per cent (p less than 0.01) respectively, when compared to tetracaine with and without epinephrine. Subarachnoid clonidine alone produced a sensory blockade of 76 +/- 17 minutes, while only one animal receiving subarachnoid epinephrine had a sensory blockade (40 minutes). No neurologic deficits were observed in any of the animals. The study concludes that during spinal anaesthesia with tetracaine in dogs, clonidine is as effective as epinephrine in prolonging motor blockade, but is more effective in prolonging sensory blockade.

摘要

采用随机双盲交叉设计,在6只杂种犬中研究可乐定延长丁卡因脊髓麻醉的比较疗效。以5至7天的间隔,对每只动物随机给予以下腰椎蛛网膜下腔注射(1毫升):含150微克可乐定的4毫克丁卡因、含200微克肾上腺素的4毫克丁卡因、4毫克丁卡因、150微克可乐定、200微克肾上腺素以及5%葡萄糖水溶液(溶媒)。蛛网膜下腔注射丁卡因产生的运动阻滞时间为186±58(均值±标准误)分钟。与单独使用丁卡因相比,可乐定和肾上腺素均使丁卡因的运动阻滞时间有相似程度的延长,分别延长了135%(p<0.01)和116%(p<0.05)。接受可乐定、肾上腺素或5%葡萄糖水溶液的犬未观察到运动阻滞。与含和不含肾上腺素的丁卡因相比,在丁卡因脊髓麻醉中添加可乐定使感觉阻滞时间显著延长,分别延长了56%(p<0.01)和107%(p<0.01)。单独蛛网膜下腔注射可乐定产生的感觉阻滞时间为76±17分钟,而仅一只接受蛛网膜下腔注射肾上腺素的动物出现了感觉阻滞(40分钟)。所有动物均未观察到神经功能缺损。该研究得出结论,在犬的丁卡因脊髓麻醉过程中,可乐定在延长运动阻滞方面与肾上腺素效果相当,但在延长感觉阻滞方面更有效。

相似文献

1
Clonidine prolongs canine tetracaine spinal anaesthesia.可乐定可延长犬丁卡因脊髓麻醉时间。
Can Anaesth Soc J. 1986 Sep;33(5):591-6. doi: 10.1007/BF03014266.
2
Dose-response relationship of clonidine in tetracaine spinal anesthesia.可乐定在丁卡因脊髓麻醉中的剂量-反应关系。
Anesthesiology. 1987 Nov;67(5):717-21. doi: 10.1097/00000542-198711000-00016.
3
Spinal cord blood flow during spinal anesthesia in dogs: the effects of tetracaine, epinephrine, acute blood loss, and hypercapnia.犬脊髓麻醉期间的脊髓血流:丁卡因、肾上腺素、急性失血和高碳酸血症的影响。
Anesth Analg. 1987 Jul;66(7):599-606.
4
Spinal cord blood flow following subarachnoid tetracaine.
Can Anaesth Soc J. 1985 Jan;32(1):23-9. doi: 10.1007/BF03008534.
5
Effect of oral clonidine and intrathecal fentanyl on tetracaine spinal block.
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6
Dose-related prolongation of hyperbaric tetracaine spinal anesthesia by clonidine in humans.可乐定对人体高压丁卡因脊髓麻醉的剂量相关延长作用。
Anesth Analg. 1989 May;68(5):619-22.
7
Subarachnoid bupivacaine decreases spinal cord blood flow in dogs.蛛网膜下腔注射布比卡因会降低犬脊髓血流量。
Can Anaesth Soc J. 1985 May;32(3 Pt 1):216-22. doi: 10.1007/BF03015129.
8
Vasoconstrictors in spinal anesthesia with tetracaine--a comparison of epinephrine and phenylephrine.
Anesth Analg. 1984 Feb;63(2):134-8.
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Dosing interval for prolongation of tetracaine spinal anesthesia by oral clonidine in humans.口服可乐定延长人体丁卡因脊髓麻醉的给药间隔时间。
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Inclusion of epinephrine to hyperbaric tetracaine and the supine position enhance the cephalad spread of spinal anaesthesia compared with hyperbaric teracaine alone in the lithotomy position.与单独使用重比重丁卡因且处于截石位相比,在重比重丁卡因中加入肾上腺素并采用仰卧位可增强脊髓麻醉药物向头端的扩散。
Acta Anaesthesiol Scand. 2004 Mar;48(3):342-6. doi: 10.1111/j.0001-5172.2004.0331.x.

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1
Effects of fadolmidine, an α -adrenoceptor agonist, as an adjuvant to spinal bupivacaine on antinociception and motor function in rats and dogs.阿片受体激动剂法舒地尔作为佐剂用于椎管布比卡因对大鼠和犬的镇痛和运动功能的影响。
Pharmacol Res Perspect. 2021 Aug;9(4):e00830. doi: 10.1002/prp2.830.
2
Local anesthetic update.局部麻醉最新进展。
Anesth Prog. 1993;40(2):29-34.
3
Cerebrospinal fluid catecholamine levels and duration of spinal anaesthesia.
Can J Anaesth. 1988 Mar;35(2):157-61. doi: 10.1007/BF03010657.

本文引用的文献

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Distribution of alpha 2 agonist binding sites in the rat and human central nervous system: analysis of some functional, anatomic correlates of the pharmacologic effects of clonidine and related adrenergic agents.α2激动剂结合位点在大鼠和人类中枢神经系统中的分布:可乐定及相关肾上腺素能药物药理作用的一些功能和解剖学相关性分析
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Spinally administered epinephrine suppresses noxiously evoked activity of WDR neurons in the dorsal horn of the spinal cord.
Anesthesiology. 1984 Apr;60(4):269-75. doi: 10.1097/00000542-198404000-00001.
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Alpha 2 adrenoceptor-mediated vasoconstriction of arteries.α2肾上腺素能受体介导的动脉血管收缩。
Clin Pharmacol Ther. 1983 Nov;34(5):565-9. doi: 10.1038/clpt.1983.216.
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Spinal noradrenergic terminal system mediates antinociception.脊髓去甲肾上腺素能终末系统介导抗伤害感受。
Brain Res. 1980 May 12;189(2):391-401. doi: 10.1016/0006-8993(80)90099-2.
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Clonidine is not neurotoxic.可乐定没有神经毒性。
Lancet. 1984 Oct 13;2(8407):876. doi: 10.1016/s0140-6736(84)90919-x.