老年和青壯年患者腰叢-坐骨神經(jīng)阻滯時(shí)局麻藥藥doc-展示頁
2025-07-24 06:01本頁面
【正文】 ( needle SN and needle LP). In both groups, SN were blocked by 2% lidocaine 10ml and then % ropivacaine 10ml,LP were blocked by % ropivacaine samples were taken from radial artery before and at 5,10,15,20,30,45,60,120,180,360min after injection for determination of plasma ropivacaine and lidocaine concentration by HPLC. The blood drug level time curve was drawn. The pharmacokinetic parameters of two groups were pared. Results No differences between two groups in AUC(0t), AUC(0∞),Tmax, and Clz/F of lidocaine were found (P). Cmax of lidocaine in group A was significantly higher than that in group B. No differences between two groups in AUC(0t), AUC(0∞), Tmax and Clz/F of ropivacaine were found(P). Cmax of ropivacaine in group A was significantly higher than that in group B. t1/2 of ropivacaine in group A was significantly higher than that in group B(P﹤). Conclusion When lidocaine and ropivacaine are both used in aged for sciatic nerve bined lumbar plexus block, Cmax of lidocaine and ropivacaine were significantly reduced, indicating that the absorption of local anesthetics was slower in aged than that in the young. The metabolism of ropivacaine was significantly slower in aged. For no differences between Tmax of lidocaine and ropivacaine were found in two groups, the total dosage should be restricted When both drugs are used in sciatic nerve bined lumbar plexus block.Key words lidocaine。 sciatic nerve。 the aged。 pharmacokinetics老年和青壯年患者腰叢坐骨神經(jīng)阻滯時(shí)局麻藥藥代動(dòng)力學(xué)對比研究華平安 徐旭仲 陳麗梅 鄭浩 王權(quán)光 陳鶯隨著神經(jīng)刺激器在臨床上的應(yīng)用，腰叢復(fù)合坐骨神經(jīng)阻滯的成功率大大提高，并成為一種很成熟的麻醉方式廣泛應(yīng)用于下肢手術(shù)。坐骨神經(jīng)作為全身最粗大的神經(jīng)，周圍有多層筋膜包繞，常需要大容量、高濃度的局麻藥浸潤才能達(dá)到較好的阻滯效果，如果復(fù)合腰叢阻滯，所需的局麻藥的用量還要增大，這對于臨床安全用藥提出了挑戰(zhàn)。本文擬利用高效液相色譜檢測法，就利多卡因復(fù)合羅哌卡因應(yīng)用于老年患者和青壯年患者下肢手術(shù)腰叢坐骨神經(jīng)阻滯時(shí)局麻藥的藥代動(dòng)力學(xué)進(jìn)行對比研究?；颊唧w重50～75kg，身高155～180cm，ASAⅠ～Ⅱ級，無顯著肝腎心功能異常，無低蛋白血癥，無糖尿病史，無術(shù)側(cè)腰叢、坐骨神經(jīng)損傷及神經(jīng)支配區(qū)皮膚感覺異常。2. 儀器和耗材: 神經(jīng)刺激器(Stimuplex Dig RC型，德國)2臺和21G、100mm絕緣穿刺針(Stimuplex A 100，日本)。高速離心機(jī)(TGL16G，上海安亭科學(xué)儀器廠)。%鹽酸羅哌卡因?yàn)槿鹗堪⑺估抵扑幱邢薰旧a(chǎn)，批號為X980550，2%鹽酸利多卡因?yàn)檎憬\意藥業(yè)有限公司，批號為20070606。、咪唑安定1mg。病人側(cè)臥位，患肢在上，采用神經(jīng)刺激器定位行改良骶旁坐骨神經(jīng)阻滯和后路腰叢阻滯。
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