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目的 研究罗比卡因用于幼儿骶管阻滞时药代动力学特征,为临床应用提供理论依据。方法 选择先天性巨结肠根治术患儿14例,随机分为两组,在骶管阻滞时分别注入0.25％罗比卡因0.75 ml/kg或0.2％布比卡因0.75 ml/kg。用气相色谱法测定血浆药物浓度,并监测呼吸和循环指标,观察麻醉效果。结果 罗比卡因和布比卡因的药-时曲线均符合一室开放模型,t_(1/2)分别为0.16h和0.11h,T_(peak)分别为0.53h和0.49h,C_(max)分别为0.81mg/L和1.08mg/L。另外发现其主要药代动力学参数、血药浓度-时间曲线下面积(AUC)分别为2.0 mg·L~(-1)·h~(-1)和3.9mg·L~(-1)·h~(-1),t_(1/2)β分别为1.21h和2.2h,总清除率(CL)分别为567 ml/min和287 ml/min,两组间均有显著差异(P<0.05);呼吸、循环各指标均平稳,麻醉效果满意。结论 罗比卡因比布比卡因较少发生中枢神经系统及心血管的蓄积,用于小儿骶管阻滞是安全可行的。
Objective To study the pharmacokinetic characteristics of rosucaine for caudal caudal block in children and provide a theoretical basis for its clinical application. Methods Fourteen children with Hirschsprung’s disease were randomly divided into two groups. 0.75% / kg or 0.2% bupivacaine 0.75 ml / kg were injected into caudal sacs respectively. Gas chromatographic determination of plasma drug concentration, and monitoring of respiratory and circulatory indicators, to observe the anesthetic effect. Results The drug-time curves of ropivacaine and bupivacaine were in accordance with the open-chamber model. The t_ (1/2) were 0.16h and 0.11h, the peak values were 0.53h and 0.49h, respectively, ) Were 0.81 mg / L and 1.08 mg / L, respectively. In addition, the main pharmacokinetic parameters were found. The area under the plasma concentration-time curve (AUC) was 2.0 mg · L -1 · h -1 and 3.9 mg · L -1 · h ~ (-1) and t_ (1/2) β were 1.21 h and 2.2 h, respectively, and the total clearance rates were 567 ml / min and 287 ml / min, respectively. There was significant difference between the two groups (P < 0.05). Respiratory and circulatory indexes were stable and the anesthetic effect was satisfactory. Conclusion Ropivacaine less bupivacaine central nervous system and cardiovascular accumulation, for children sacral block is safe and feasible.