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目的 探讨罗哌卡因与利多卡因混合应用对中枢神经系统(CNS)和心血管(CV)毒性反应的影响。方法 Wistar大鼠36只,随机分为3组,每组12只。A组静脉注射(ⅳ)0.5％罗哌卡因2mg·ks~(-1)·min~(-1),B组ⅳ 1.0％利多卡因4mg·ks~(-1)·min~1,C组ⅳ 0.5％罗哌卡因2mg·kg~(-1)·min~(-1)+1.0％利多卡因4mg·kg~(-1)·min~(-1)。麻醉及相关操作后持续监测脑电图、心电图、平均动脉压(MAP)。待呼吸、循环稳定20min后,血气分析值正常,记录此时的MAP、心率(HR)作为基础值,输入相应的局麻药。记录出现CNS毒性(SZ)、心律失常(DYS)和心脏停搏(ASYS)三个中毒点的时间、计算输入局麻药累积剂量。在各点采动脉血,用高效液相色谱仪测血浆中局麻药浓度。结果 A组发生SZ、ASYS时罗哌卡因累积剂量大于C组(P<0.05),但发生DYS时差异无显著性。B组发生SZ、DYS、ASYS时利多卡因累积剂量大于C组(P<0.05)。A组发生SZ、DYS、ASYS时罗哌卡因血药浓度与C组比较差异无显著性;B组发生SZ、DYS、ASYS时利多卡因血药浓度与C组比较差异无显著性。结论 0.5％罗哌卡因与1.0％利多卡因混合应用后增加了CNS和CV系统毒性。
Objective To investigate the effects of mixed ropivacaine and lidocaine on central nervous system (CNS) and cardiovascular (CV) toxicity. Methods Thirty-six Wistar rats were randomly divided into three groups of 12 rats each. In group A, 0.5% ropivacaine (2 mg · ks -1 · min -1) was intravenously injected into rabbits in group A, and 1.0 mg / kg of lidocaine 1.0 mg / Rats in group C received 0.5 mg ropivacaine 2 mg · kg -1 -1 min -1 and 1.0% lidocaine 4 mg · kg -1 -1 min -1. EEG, ECG and mean arterial pressure (MAP) were monitored continuously after anesthesia and related procedures. To be breathing, circulatory stability 20min, the blood gas analysis was normal, record the MAP, heart rate (HR) as the baseline value, enter the corresponding local anesthetic. The time of three poisoning points including CNS toxicity (SZ), arrhythmia (DYS) and cardiac arrest (ASYS) were recorded and the cumulative dose of imported local anesthetic was calculated. At each point, arterial blood was collected and plasma concentrations of local anesthetic were measured by high performance liquid chromatography. Results The cumulative doses of ropivacaine in group A were higher than those in group C (P <0.05), but there was no significant difference in the incidence of DYS. The cumulative dose of lidocaine in group B was higher than that in group C when SZ, DYS and ASYS occurred (P <0.05). There was no significant difference in the blood concentration of ropivacaine between group A and group S when SZ, DYS and ASYS occurred. There was no significant difference between group B and group C when there were SZ, DYS and ASYS. Conclusion 0.5% ropivacaine combined with 1.0% lidocaine increased CNS and CV toxicity.