Hasselstrøm L J, Mogensen T, Kehlet H, Christensen N J
Anesth Analg. 1984 Dec;63(12):1053-8.
The effects of the intravenous infusion of bupivacaine (2 mg/min for 3 hr) on cardiovascular function and various endocrine metabolic parameters were studied in a randomized single-blind crossover study in eight normal subjects. Bupivacaine infusion resulted in plasma concentrations about 1-2 micrograms/ml. Heart rate increased significantly from approximately 60 to 70 beats/min. Mean arterial blood pressure increased from 87 to about 100 mm Hg, and cardiac output decreased about 20%, both of these statistically significant. Oxygen consumption did not change significantly. Plasma epinephrine concentrations increased significantly from 0.03 to 0.08 ng/ml, but plasma norepinephrine levels did not change significantly, nor did blood concentrations of glucose, lactate and plasma cortisol, and free fatty acids. These results demonstrate that systematically administered bupivacaine results in plasma concentrations of bupivacaine comparable to those that may be observed during regional anesthesia, including a positive chronotropic and an arterial vasoconstrictive effect. These effects are probably caused mainly by a direct effect of bupivacaine on the cardiovascular system, because only quantitatively minor changes in plasma catecholamines and other endocrine metabolic parameters were observed.
在一项针对8名正常受试者的随机单盲交叉研究中，研究了静脉输注布比卡因（2毫克/分钟，持续3小时）对心血管功能和各种内分泌代谢参数的影响。输注布比卡因导致血浆浓度约为1 - 2微克/毫升。心率从大约60次/分钟显著增加到70次/分钟。平均动脉血压从87毫米汞柱增加到约100毫米汞柱，心输出量减少约20%，这两者均具有统计学意义。氧耗没有显著变化。血浆肾上腺素浓度从0.03纳克/毫升显著增加到0.08纳克/毫升，但血浆去甲肾上腺素水平没有显著变化，血糖、乳酸、血浆皮质醇和游离脂肪酸的血浓度也没有变化。这些结果表明，系统性给予布比卡因导致的血浆布比卡因浓度与区域麻醉期间可能观察到的浓度相当，包括正性变时作用和动脉血管收缩作用。这些作用可能主要是由布比卡因对心血管系统的直接作用引起的，因为在血浆儿茶酚胺和其他内分泌代谢参数中仅观察到数量上较小的变化。
