Morita H, Higashizawa T, Yuasa H, Hiramatsu K, Koga Y
Department of Anesthesiology, Kinki University School of Medicine, Osakasayama.
Masui. 1998 Nov;47(11):1311-4.
Mexiletine, an antiarrhythmic agent, was preincisionally administered intravenously for the purpose of reducing postoperative pain. Twenty-eight female patients for mastectomy were studied. The patients were divided into three groups. Group 1 received no mexiletine. Group 2 received bolus administration of mexiletine 1 mg.kg-1 with additional continuous administration of 1 mg.kg-1.hr-1 for 75 minutes. Group 3 received bolus administration of mexiletine 2 mg.kg-1. The requirement of butorphanol as a postoperative analgesic within 1 hour after mastectomy in Group 3 was significantly lower than that in Group 1 (P < 0.05), but butorphanol requirement in Group 2 was not significantly lower than that in Group 1. Plasma mexiletine concentration was slightly higher in Group 3 (1.7 micrograms.ml-1) than that in Group 2 (1.0 microgram.ml-1) immediately after the intravenous mexiletine administration, although there was no significant difference. The results indicate that mexiletine 2 mg.kg-1 as preoperative bolus administration maintains its plasma concentration above 1.7 micrograms.ml-1, and is clinically effective for reducing the postoperative pain after mastectomy.
美西律是一种抗心律失常药物，术前静脉给药以减轻术后疼痛。对28例行乳房切除术的女性患者进行了研究。患者被分为三组。第一组未接受美西律治疗。第二组静脉推注1mg/kg美西律，并以1mg·kg⁻¹·h⁻¹的速度持续给药75分钟。第三组静脉推注2mg/kg美西律。乳房切除术后1小时内，第三组布托啡诺作为术后镇痛药的需求量显著低于第一组（P<0.05），但第二组布托啡诺的需求量与第一组相比无显著降低。静脉注射美西律后，第三组血浆美西律浓度（1.7μg/ml）略高于第二组（1.0μg/ml），尽管差异无统计学意义。结果表明，术前静脉推注2mg/kg美西律可使血浆浓度维持在1.7μg/ml以上，对减轻乳房切除术后的疼痛具有临床疗效。
