Furuki I
Department of Anesthesiology and Intensive Care Medicine, Kanazawa University.
Masui. 1997 Oct;46(10):1299-304.
To test the hypothesis that local anesthetic solution diffuses across the parietal pleura into the intercostal nerves in interpleural analgesia, tissue bupivacaine concentrations were assayed after interpleural injection of bupivacaine in rabbits. Thirty animals were killed at 10, 20, or 30 min after administration of 0.5% bupivacaine (1 ml.kg-1) into the left pleural cavity. The left intercostal muscle (lt-ICM), right intercostal muscle (rt-ICM) and femoral muscle (FM) were sampled immediately after killing the animals. Bupivacaine concentrations were analyzed by high-performance liquid chromatography. Mean bupivacaine concentrations in lt-ICM were 10.8 micrograms.g-1 at 10 min, 15.2 micrograms.g-1 at 20 min and 11.8 micrograms.g-1 at 30 min. On the other hand, the bupivacaine concentrations in rt-ICM and FM were less than 2.0 micrograms.g-1 at any sampling time. (P < 0.01 vs. lt-ICM). These results indicate that bupivacaine administered interpleurally diffuses from the pleural space into the ipsilateral intercostal muscle. Direct diffusion of bupivacaine could cause intercostal nerve block following interpleural analgesia.
为验证局部麻醉药溶液在胸膜间镇痛时通过壁层胸膜扩散至肋间神经这一假说，在兔身上进行了胸膜间注射布比卡因后测定组织中布比卡因浓度的实验。给30只动物的左胸腔注射0.5%布比卡因（1 ml·kg-1），分别于给药后10、20或30分钟处死动物。处死动物后立即采集左侧肋间肌（lt-ICM）、右侧肋间肌（rt-ICM）和股肌（FM）样本。采用高效液相色谱法分析布比卡因浓度。lt-ICM中布比卡因的平均浓度在10分钟时为10.8微克·g-1，20分钟时为15.2微克·g-1，30分钟时为11.8微克·g-1。另一方面，rt-ICM和FM中布比卡因的浓度在任何采样时间均低于2.0微克·g-1。（与lt-ICM相比，P < 0.01）。这些结果表明，胸膜间注射的布比卡因从胸膜腔扩散至同侧肋间肌。布比卡因的直接扩散可能导致胸膜间镇痛后肋间神经阻滞。
