Vainionpää V A, Haavisto E T, Huha T M, Korpi K J, Nuutinen L S, Hollmén A I, Jozwiak H M, Magnusson A A
Department of Anaesthesiology, Oulu University Hospital, Finland.
Anesth Analg. 1995 Sep;81(3):534-8. doi: 10.1097/00000539-199509000-00019.
The clinical and pharmacokinetic properties of ropivacaine and bupivacaine, both 5 mg/mL, used in axillary plexus block were compared in 60 patients in this randomized, double-blind, parallel-group study. The axillary plexus was identified with a nerve stimulator and 30, 35, or 40 mL of drug, depending on body weight, was injected into the perivascular sheath. In 20 patients, venous blood samples for the pharmacokinetic measurement were obtained over 24 h. The median onset times for anesthesia and complete motor block were in the range of 12-48 min and 5-20 min, respectively. Thirty-eight percent of patients in the ropivacaine group and 29% in the bupivacaine group needed additional nerve block(s) or supplementary analgesia and 7% in the bupivacaine group needed general anesthesia for surgery. Anesthesia was achieved in 52%-86% of the evaluated six nerves in the ropivacaine group and in 36%-87% in the bupivacaine group; the lowest figures were seen in the musculocutaneous nerve. In the pharmacokinetic study the mean peak plasma concentrations (Cmax) were 1.28 +/- 0.21 mg/L in the ropivacaine group and 1.28 +/- 0.47 mg/L in the bupivacaine group and the median times to peak plasma concentration (tmax) were 0.86 h and 0.96 h, respectively. The median terminal half-lives (t1/2) were 7.1 h and 11.5 h in the ropivacaine group and the bupivacaine group, respectively (P = 0.07). No statistically significant differences were found between ropivacaine and bupivacaine in either the clinical or the pharmacokinetic comparisons.
在这项随机、双盲、平行组研究中，对60例患者使用浓度均为5mg/mL的罗哌卡因和布比卡因进行腋路臂丛神经阻滞时的临床和药代动力学特性进行了比较。使用神经刺激器定位腋路臂丛神经，根据体重注入30、35或40mL药物至血管周围鞘内。20例患者在24小时内采集静脉血样用于药代动力学测定。麻醉和完全运动阻滞的中位起效时间分别在12 - 48分钟和5 - 20分钟范围内。罗哌卡因组38%的患者和布比卡因组29%的患者需要额外的神经阻滞或辅助镇痛，布比卡因组7%的患者手术时需要全身麻醉。罗哌卡因组6条评估神经中有52% - 86%达到麻醉效果，布比卡因组为36% - 87%；最低值出现在肌皮神经。在药代动力学研究中，罗哌卡因组的平均血浆峰浓度（Cmax）为1.28±0.21mg/L，布比卡因组为1.28±0.47mg/L，达到血浆峰浓度的中位时间（tmax）分别为0.86小时和0.96小时。罗哌卡因组和布比卡因组的中位终末半衰期（t1/2）分别为7.1小时和11.5小时（P = 0.07）。罗哌卡因和布比卡因在临床或药代动力学比较中均未发现统计学上的显著差异。
