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不同浓度的皮内注射罗哌卡因和布比卡因在加与不加肾上腺素情况下对人体的局部镇痛及血管效应

Local analgesic and vascular effects of intradermal ropivacaine and bupivacaine in various concentrations with and without addition of adrenaline in man.

作者信息

Cederholm I, Akerman B, Evers H

机构信息

Department of Anaesthesiology, University Hospital, Linköping, Sweden.

出版信息

Acta Anaesthesiol Scand. 1994 May;38(4):322-7. doi: 10.1111/j.1399-6576.1994.tb03901.x.

DOI:10.1111/j.1399-6576.1994.tb03901.x
PMID:8067217
Abstract

Ropivacaine, a new long-acting amino-amide local anaesthetic agent, and bupivacaine, in various concentrations with or without addition of adrenaline, were tested in a randomized, double-blind study using intradermal wheals. Ten non-smoking, healthy, young male volunteers participated. In series I plain solutions of ropivacaine (0.25%, 0.5%, 0.75% and 1%) and bupivacaine (0.25%, 0.5% and 0.75%) were injected intradermally and in series II the same concentrations, with the addition of adrenaline 5 ug.ml-1 (1:200,000), were used. The same volunteers took part in both series, with an interval of at least three weeks between the experiments. Saline was included as control in both series. Pin-pricking was used to assess the dermal analgesia. Plain solutions of ropivacaine produced significantly longer durations of dermal analgesia than did plain solutions of bupivacaine, in all tested concentrations. A significant increase in duration was seen for both local anaesthetics when adding adrenaline. Local vascular effects at the injected areas were determined by visual inspection (nil, pink, pale). Local blanching (pale) was significantly more frequent for plain solutions of ropivacaine, in all tested concentrations. Local redness (pink) was significantly more frequent with plain bupivacaine, in a dose-dependent relation. An initial redness was frequently observed for both local anaesthetics containing adrenaline, followed by blanching at most sites.

摘要

罗哌卡因是一种新型长效氨基酰胺类局部麻醉药,布比卡因则使用了不同浓度且添加或未添加肾上腺素的溶液,通过皮内风团试验进行了一项随机双盲研究。十名不吸烟的健康年轻男性志愿者参与了试验。在第一组中,皮内注射了罗哌卡因(0.25%、0.5%、0.75%和1%)和布比卡因(0.25%、0.5%和0.75%)的普通溶液,在第二组中,使用了相同浓度并添加了5μg.ml-1肾上腺素(1:200,000)的溶液。两组试验均由相同的志愿者参与,试验间隔至少三周。两组均使用生理盐水作为对照。采用针刺法评估皮肤镇痛效果。在所有测试浓度下,罗哌卡因普通溶液产生的皮肤镇痛持续时间均显著长于布比卡因普通溶液。添加肾上腺素后,两种局部麻醉药的持续时间均显著增加。通过肉眼观察确定注射部位的局部血管效应(无、粉红色、苍白)。在所有测试浓度下,罗哌卡因普通溶液出现局部苍白(苍白)的情况明显更频繁。普通布比卡因出现局部发红(粉红色)的情况明显更频繁,且呈剂量依赖性关系。对于两种含肾上腺素的局部麻醉药,最初常观察到发红,随后大多数部位出现苍白。

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