The Dose Response and Effects of Dexamethasone on Bupivacaine Microcapsules for Intercostal Blockade (T9 to T11) in Healthy Volunteers
The Dose Response and Effects of Dexamethasone on Bupivacaine Microcapsules for Intercostal Blockade (T9 to T11) in Healthy Volunteers
复制标题
地塞米松对布比卡因微胶囊对健康志愿者肋间阻滞（T9 至 T11）的剂量反应和影响
DOI：
10.1213/00000539-200302000-00050
复制
发表时间：
2003
影响因子：
5.7
通讯作者：
C. Landau
中科院分区：
文献类型：
--
作者：
D. Kopacz;P. Lacouture;DanLin Wu;P. Nandy;R. Swanton;C. Landau
含有布比卡因/地塞米松的生物可降解微囊在动物模型中产生7-11天的麻醉持续时间。在这项研究中，我们探讨了增加剂量（第1部分）和地塞米松（第2部分）对布比卡因微囊产生的镇痛和麻醉的起效、密度和持续时间的影响。将微囊中浓度范围为0.3125%至5.0%与0.25%布比卡因水溶液（双侧注射，三条肋间神经，每条神经2 mL）进行比较（第1部分）。第2部分通过单侧阻断比较了含有或不含有地塞米松的2.5%微囊。通过针刺、温度感觉和主观麻木（0，不麻木; 10，完全麻木）评估感觉阻滞。测定96 h内布比卡因和地塞米松的药效学评价和血药浓度。在0.3125%~ 5.0%剂量范围内，镇痛起效时间缩短，持续时间延长（P < 0.02）。2.5%微囊的起效时间接近0.25%布比卡因水溶液。微囊阻滞持续时间增加到至少96小时，明显长于布比卡因水溶液（P < 0.001）。在2.5%的微囊中，地塞米松的加入增加了针刺麻醉的持续时间（P = 0.03）。我们得出结论，布比卡因/地塞米松微囊耐受性良好，并表现出剂量相关的影响，在发病和持续时间的肋间阻滞。地塞米松的加入增加了肋间阻滞麻醉。
Biodegradable microcapsules containing bupivacaine/dexamethasone produce an anesthetic duration of 7–11 days in animal models. In this investigation, we explored the effect of increasing doses (Part 1) and the effect of including dexamethasone (Part 2) on the onset, density, and duration of analgesia and anesthesia produced by bupivacaine microcapsules. Concentrations ranging from 0.3125% to 5.0% in microcapsules were compared with 0.25% aqueous bupivacaine (bilateral injection, three intercostal nerves, 2 mL per nerve) (Part 1). Part 2 compared 2.5% microcapsules with or without the inclusion of dexamethasone by unilateral blockade. Sensory block was assessed by pinprick, temperature sensation, and subjective numbness (0, not numb; 10, totally numb). Pharmacodynamic assessments and plasma drug concentrations of bupivacaine and dexamethasone were measured for 96 h. The onset time was reduced and the duration of analgesia increased over the 0.3125%–5.0% dose range (P < 0.02). Onset with 2.5% microcapsules approximated that of 0.25% aqueous bupivacaine. Microcapsule block duration increased to at least 96 h and was significantly longer than aqueous bupivacaine (P < 0.001). Inclusion of dexamethasone increased the duration of pinprick anesthesia in 2.5% microcapsules (P = 0.03). We conclude that bupivacaine/dexamethasone microcapsules are well tolerated and demonstrate a dose-related effect in onset and duration of intercostal blockade. Inclusion of dexamethasone increases intercostal block anesthesia.