Rimbäck G, Cassuto J, Faxén A, Högström S, Wallin G, Tollesson P O
Gut. 1986 Feb;27(2):170-5. doi: 10.1136/gut.27.2.170.
Effect of intra-abdominal instillation of a local anaesthetic, bupivacaine, on postoperative colonic adynamic ileus was studied in a double blind manner in a randomised series of patients undergoing upper laparotomy. Propulsive colonic activity was studied postoperatively with radio-opaque markers and serial abdominal radiographs. Intra-abdominal instillation of bupivacaine 2 mg/kg bw significantly shortened the period of postoperative colonic inhibition (p less than 0.01), but did not hasten colonic transit. Furthermore, bupivacaine significantly decreased the hyperglycaemic response to surgery. It is suggested that bupivacaine inhibits the inflammatory response within the bowel wall, a response which may maintain the inhibitory spinal reflexes in the postoperative period. Blood concentrations of bupivacaine were shown to be well below toxic levels and no adverse reactions were observed.
在一组接受上腹部剖腹手术的患者中，以双盲方式随机研究了腹腔内注入局部麻醉药布比卡因对术后结肠动力性肠梗阻的影响。术后用不透X线标志物和系列腹部X线片研究结肠推进活动。腹腔内注入2mg/kg体重的布比卡因显著缩短了术后结肠抑制期（p<0.01），但并未加速结肠转运。此外，布比卡因显著降低了手术引起的高血糖反应。提示布比卡因抑制肠壁内的炎症反应，这种反应可能在术后维持抑制性脊髓反射。布比卡因的血药浓度显示远低于中毒水平，且未观察到不良反应。
