Bupivacaine cardiotoxicity and subendocardial microcirculation

布比卡因心脏毒性和心内膜下微循环

基本信息

批准号：
07457364
负责人：
FUJITA Yoshihisa
金额：
$ 3.97万
依托单位：
KAWASAKI MEDICAL SCHOOL
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
1995
资助国家：
日本
起止时间：
1995 至 1996
项目状态：
已结题

项目摘要

Ventricular fibrillation (VF) and depression of myocardial contractility are two important factors for bupivacaine-induced cardiotoxicity. The efficacy of lidocaine for bupivacaine-induced VF and the vasoconstricting effects of bupivacaine were examined in the beating hearts in vivo. In the first set of the experiment, 0.25% bupivacaine, 1% lidocaine and 0.25% bupivacaine plus lidocaine solutions were infused into the left anterior descending coronary artery (LAD) in an increasing sequence of 0,1,2,4,8 and 16 mL/hr for 15 min into the LAD in three groups consisting of eight pigs. Regional myocardial function was evaluated by the sonomicrometry technique. While there were no VF in the Lid group, VF occurred in one at 4 mL/hr and seven at 8 mL/hr infusion rates in the bupivacaine group, and in one at 8 mL/hr and seven at 16 mL/hr infusion rates in the bupivacaine plus lidocaine group. Although regional myocardial function decreased in a dose-related manner in the three groups, the myocardial depressant effects of bupivacaine were significantly greater than that of lidocaine, and did not differ with that of bupivacaine plus lidocaine. In the second set of the experiment, six samples of bupivacaine-containing autologous blood (0,0.25,1.25,2.5,5,10mug/mL) were injected into the coronary artery via a catheter placed in the first diagonal branch in the five pigs, while left ventricular subendocardial microvessels (50-100mum in diameter) in the septal region were visualized by a needle type video microscope. Diameter of the

心室纤颤（VF）和心肌收缩性抑郁症是布比卡因诱导的心脏毒性的两个重要因素。利多卡因对布比卡因诱导的VF的功效和布比卡因的血管收缩作用在体内进行了检查。在第一组实验中，将0.25％布比卡因，1％利多卡因和0.25％布比卡因加上利多卡因溶液注入左前降冠状动脉（LAD），以越来越多的0,1,2,4,4,8和16 ml/hr的序列越来越多，持续15分钟，持续15分钟，持续15分钟，持续15分钟，持续15分钟，将三组组成八组。通过Sonomictry技术评估了区域心肌功能。虽然盖子组没有VF，但在布比卡因组中以4 ml/hr的速度为4 ml/hr，以8 ml/hr的输注率发生，在Bupivivacaine Plus Lidocaine组中，以8 ml/hr的速度为8 ml/hr。尽管在这三组中，区域心肌功能以与剂量相关的方式降低，但布比卡因的心肌抑制作用显着大于利多卡因的心肌抑制作用，并且与布比卡因和利多卡因的心肌抑制作用没有差异。在第二组实验中，将六个含有布比卡因的自体血（0,0,0.25,1.25,2.5,5,5,5,5,5,5,5,10mug/ml注射到冠状动脉中，通过在五头猪中的第一个对决分支中放置在冠状动脉中，而左心室下区微腹部（50-100-100mimumimum）（50-100-100mimumimum intutial in Diby Arimiend in Diby in Diby Aime）（50-100-100mimumimum intutial in Diby Arimiens in Cymimum in Cymimum in Diby in in 50-100mmim sectize nibles）in 50-100mmim sectize（视频显微镜。直径