Alvi R, Jones S, Burrows D, Collins W, McKiernan E P, Jones R P, Bunting P
Department of Plastic Surgery, Royal Preston Hospital, UK.
Burns. 1998 Feb;24(1):54-7. doi: 10.1016/s0305-4179(97)00090-9.
Post operative pain from split skin donor sites is a recognised problem. This study was carried out to assess the safety of a 'depot' preparation of bupivacaine and ketoprofen when applied to denuded dermis of a split donor site. Two groups of six patients each received either bupivacaine gel (2.5 mg/ml) or ketoprofen gel (1.6 mg/ml). One patient from each group was excluded as protocol was not followed. The mean surface area for bupivacaine was 106 cm2 (range 64-160) and the mean for ketoprofen was 130 cm2 (range 64-180). Blood samples were obtained before application and at 10, 20, 30, 60, 120, 240 and 480 min after application. Serum levels were assayed using Gas Liquid Chromatography and High Pressure Liquid Chromatography. Bupivacaine levels peaked at 120 min, mean level obtained was 0.07 microgram/ml (range 0.03-0.1). Ketoprofen levels also peaked at 120 min and the mean level obtained was 0.20 microgram/ml (range 0.12-0.27). The reported toxic serum level for bupivacaine was 4 micrograms/ml and for ketoprofen is 1128 micrograms/ml. In conclusion, these preparations, when applied to denuded dermis of a split skin donor site, are unlikely to result in toxic levels.
来自皮肤供区的术后疼痛是一个公认的问题。本研究旨在评估布比卡因和酮洛芬“贮库”制剂应用于中厚皮片供区裸露真皮时的安全性。两组患者各6例，分别接受布比卡因凝胶（2.5mg/ml）或酮洛芬凝胶（1.6mg/ml）。每组各有1例患者因未遵循方案而被排除。布比卡因的平均表面积为106cm²（范围64 - 160），酮洛芬的平均表面积为130cm²（范围64 - 180）。在用药前以及用药后10、20、30、60、120、240和480分钟采集血样。使用气相色谱法和高压液相色谱法测定血清水平。布比卡因水平在120分钟时达到峰值，测得的平均水平为0.07微克/毫升（范围0.03 - 0.1）。酮洛芬水平也在120分钟时达到峰值，测得的平均水平为0.20微克/毫升（范围0.12 - 0.27）。报道的布比卡因中毒血清水平为4微克/毫升，酮洛芬为1128微克/毫升。总之，这些制剂应用于中厚皮片供区的裸露真皮时，不太可能导致中毒水平。
