Neurotoxicity of Intrathecal Local Anesthetics in Rabbits
Neurotoxicity of Intrathecal Local Anesthetics in Rabbits
复制标题
兔鞘内局部麻醉药的神经毒性
作者：
L. Ready;M. Plumer;R. Haschke;E. Austin;S. Sumi
本文介绍了一种新的局部麻醉药鞘内注射方法，以研究麻醉药浓度与神经功能损害的关系。他们发现，在临床使用的浓度下，所研究的局部麻醉剂都不会产生持续的神经损伤。然而，利多卡因和丁卡因可以高浓度制备（远远超过临床使用的浓度），这将产生广泛的不可逆神经损伤和组织学变化。亚硫酸氢钠也是如此，亚硫酸氢钠是一种用于许多商业制备的局部麻醉剂溶液的抗氧化剂。相对不溶性的局部麻醉剂（布比卡因和2-氯普鲁卡因）的纯溶液在其溶解度极限的浓度下测试时，未能产生可比的神经学或神经病理学变化。广泛的神经功能损害不一定伴随着脊髓和神经根的同样广泛的病变。
The authors developed a new method of intrathecal local anesthetic injection in rabbits in order to study the relationship between anesthetic concentration and impaired neurologic function. They found that none of the local anesthetics studied produced persistent neurologic damage in concentrations used clinically. However, lidocaine and tetracaine can be prepared in high concentrations (far exceeding those clinically used) that will produce extensive irreversible neurologic injury and histologic changes. This was also true for sodium bisulfite, an antioxidant used in a number of commercially prepared local anesthetic solutions. Pure solutions of relatively insoluble local anesthetics (bupivacaine and 2-chloroprocaine) failed to produce comparable neurologic or neuropathologic changes when tested at concentrations up to their solubility limits. Extensive neurologic impairment was not necessarily accompanied by equally extensive lesions in the spinal cord and nerve roots.