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布比卡因蛛网膜下腔麻醉对清醒大鼠脊髓局部血流及葡萄糖利用的影响

Local spinal cord blood flow and glucose utilization during spinal anesthesia with bupivacaine in conscious rats.

作者信息

Crosby G

出版信息

Anesthesiology. 1985 Jul;63(1):55-60. doi: 10.1097/00000542-198507000-00008.

Abstract

The author studied in conscious rats the local spinal blood flow (SCBF) and metabolic effects of intrathecally administered bupivacaine. Fourteen rats received 0.75% bupivacaine, 15 microliters, through a chronically implanted lumbar subarachnoid catheter. Twelve control animals were treated identically, except that they received only an equal volume of saline intrathecally. Ten minutes after intrathecal drug injection, either local SCBF or glucose utilization was measured in the lumbar spinal cord of seven experimental and six control animals with the quantitative autoradiographic iodo-[14C]antipyrine or 2-[14C]deoxyglucose methods, respectively. Intrathecal bupivacaine produced a limp tail, absent hindlimb withdrawal to pinch, and 25-30 min of analgesia on the tail-flick test. Mean arterial blood pressure decreased 14% (P less than 0.01) after bupivacaine was administered, but there was no change in arterial blood gases, pH, or rectal temperature. Subarachnoid bupivacaine reduced both local SCBF and glucose utilization, but the SCBF effect was larger. Local SCBF decreased 27-34% (P less than 0.01) in all five spinal gray and three white matter areas measured, and there was little regional variability in the response. The reduction in spinal glucose utilization was regionally selective and less marked. For example, glucose utilization decreased 15% (P less than 0.05) and 21% (P less than 0.05) in lateral and anterior spinal white matter, respectively, but only decreased approximately 3% in laminae I-III and dorsal white matter (P greater than 0.1). A trend toward metabolic depression was also evident in laminae VIII (-15%, P = 0.06), VII (-13%, P = 0.09), and IV-VI (-11%, P greater than 0.1).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

作者在清醒大鼠身上研究了鞘内注射布比卡因对局部脊髓血流(SCBF)和代谢的影响。14只大鼠通过长期植入的腰段蛛网膜下腔导管接受15微升0.75%的布比卡因。12只对照动物接受相同处理,只是鞘内仅注射等量的生理盐水。鞘内注射药物10分钟后,分别用定量放射自显影碘代-[14C]安替比林或2-[14C]脱氧葡萄糖法,测量7只实验动物和6只对照动物腰段脊髓的局部SCBF或葡萄糖利用率。鞘内注射布比卡因导致尾巴松弛、后肢对捏夹无退缩反应,并且在甩尾试验中有25 - 30分钟的镇痛效果。注射布比卡因后平均动脉血压下降14%(P < 0.01),但动脉血气、pH值或直肠温度无变化。蛛网膜下腔注射布比卡因使局部SCBF和葡萄糖利用率均降低,但对SCBF的影响更大。在所测量的所有五个脊髓灰质区和三个白质区,局部SCBF下降了27 - 34%(P < 0.01),反应的区域差异很小。脊髓葡萄糖利用率的降低具有区域选择性且不太明显。例如,外侧和前侧脊髓白质的葡萄糖利用率分别下降了15%(P < 0.05)和21%(P < 0.05),但在I - III层和背侧白质仅下降了约3%(P > 0.1)。在VIII层(-15%,P = 0.06)、VII层(-13%,P = 0.09)和IV - VI层(-11%,P > 0.1)也有代谢抑制的趋势。(摘要截短于250字)

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