Ephedrine Shows Synergistic Motor Blockade When Combined with Bupivacaine or Lidocaine for Spinal Anesthesia in a Rat Model
Ephedrine Shows Synergistic Motor Blockade When Combined with Bupivacaine or Lidocaine for Spinal Anesthesia in a Rat Model
复制标题
麻黄碱与布比卡因或利多卡因联合用于大鼠模型中的脊髓麻醉时显示出协同运动阻滞作用
DOI：
10.1213/ane.0b013e3182834662
复制
发表时间：
2013
影响因子：
5.7
通讯作者：
P. Gerner
中科院分区：
文献类型：
--
作者：
A. Djalali;J. Wang;J. R. Pérez;T. Danninger;G. Fritsch;D. Zurakowski;P. Gerner
背景：麻黄碱是一种直接/间接血管活性药物。此外，它还具有固有的局部麻醉特性，这主要是由于其钠通道阻断作用。我们研究了当通过脊髓导管注射到大鼠脊髓间隙时，麻黄碱是否表现出与布比卡因和利多卡因的协同作用。方法：通过手术在47只大鼠体内置入脊髓导管（每组n=8；排除7只大鼠）。将不同浓度的布比卡因、利多卡因和麻黄碱定体积（60μL）注入脊髓导管中，以确定每种药物的等价性。然后将麻黄碱与布比卡因或利多卡因组合注射到脊髓导管中。结果：麻黄碱与布比卡因以及利多卡因固定组合具有统计学上显着的协同作用。反映协同效应的组合指数，麻黄碱+布比卡因为0.792（95%置信区间：0.665-0.919），麻黄碱+利多卡因为0.663（95%置信区间：0.532-0.794）。结论：麻黄碱与布比卡因或利多卡因联合可协同阻滞运动功能，并有可能减少脊髓阻滞所需的局麻药用量。麻黄碱与局麻药联合使用的协同作用是一个有趣的药理学现象，值得进一步的临床评估。
BACKGROUND:Ephedrine is a direct/indirect vasoactive drug. In addition, it also possesses intrinsic local anesthetic properties, mainly due to its sodium-channel blockage. We investigated whether ephedrine demonstrates a synergistic effect with bupivacaine and lidocaine when injected via a spinal catheter into the spinal space of rats. METHODS:Spinal catheters were surgically placed in 47 rats (n = 8 per group; 7 rats were excluded.) Bupivacaine, lidocaine, and ephedrine in various concentrations and constant volumes (60 &mgr;L) were injected into the spinal catheters to determine the equipotency of each drug. Ephedrine in combination with either bupivacaine or lidocaine was then injected into the spinal catheters. RESULTS:Ephedrine demonstrated statistically significant synergistic effects with bupivacaine as well as with lidocaine in fixed combinations. The combination index reflecting a synergistic effect was 0.792 (95% confidence interval: 0.665–0.919) for ephedrine + bupivacaine and 0.663 (95% confidence interval: 0.532–0.794) for ephedrine + lidocaine. CONCLUSION:Ephedrine combined with either bupivacaine or lidocaine acted synergistically to block motor function and has the potential to reduce the amount of local anesthetic needed for spinal block. The synergistic effect of ephedrine in combination with local anesthetics is an interesting pharmacological phenomenon that warrants further clinical evaluation.
影响因子：
21.1
作者：
W. Greco;G. Bravo;J. C. Parsons
通讯作者：
W. Greco;G. Bravo;J. C. Parsons