浙江医学2017，Vol.39Issue(15)：1243-1247,1257,6.DOI:10.12056/j.issn.1006-2785.2017.39.15.2016-1972
脂肪乳剂救治布比卡因所致心脏骤停时肾上腺素合理使用时机探讨
Delayed injection of epinephrine is harmful in lipid-based resuscitation of bupivacaine-induced cardiac arrest in rats
摘要
Abstract
Objective To investigate the effect of epinephrine given at different time points on lipid-based resuscitation for bupivacaine-induced cardiac arrest in rats.Methods Twenty adult male Sprague-Dawley rats were subjected to bupivacaine-induced asystole;after 30％ intralipid was given 1 min after cardiac arrest the rats were randomly divided into 2 groups with 10 animals in each:epinephrine was given immediately (ALE group) or 1 min after the initial bolus of intralipid administration(DLE group).Epinephrine was administered at regular intervals until return of spontaneous circulation (ROSC) or the end of a 20 minute-resuscitation period.Hemodynamic parameters were monitored,arterial blood gas was analyzed at 2 and 20 min after heart arrest,wet-to-dry lung weight ratio was calculated,and myocardial bupivacaine contents were measured.Results The survival rate of ALE group was significantly higher than that of DLE group (100％ vs.40％,P=-0.005).After ROSC,the rate pressure product (RPP) and systolic blood pressure (SBP) of group ALE were higher than those of DLE group (P＜0.05).Wet-to-dry lung weight ratio of DLE group was higher than the ALE (P＜0.001).The arterial blood pH of ALE group at 2 and 20 min after arrest was higher than that of DLE group (P＜0.05).The rate of damaged alveoli in ALE group was lower than that of DLE group (P＜0.001).The content of bupivacaine in cardiac tissue of ALE group was lower than that of DLE group (P=0.021).Conclusion In rat model of bupivacaine-induced cardiac arrest,delayed injection of epinephrine is harmful,it would reduce the success rate of resuscitation with lipid emulsion.关键词
心肺复苏/布比卡因/脂肪乳剂/肾上腺素Key words
Cardiopulmonary resuscitation/Bupivacaine/Lipids/Epinephrine引用本文复制引用
金周晟,夏芳芳,陈鸿飞,施克俭,陈丽梅..脂肪乳剂救治布比卡因所致心脏骤停时肾上腺素合理使用时机探讨[J].浙江医学,2017,39(15):1243-1247,1257,6.基金项目
温州市科技局(Y20140702) （Y20140702）
