布比卡因及辅助药物对骨骼肌组织血氧测定和血流量影响的实验研究

IF 1.5 Q3 ANESTHESIOLOGY Local and Regional Anesthesia Pub Date : 2019-08-29 DOI:10.2147/LRA.S203569
A. Schubert, S. Müller, H. Wulf, T. Steinfeldt, T. Wiesmann
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引用次数: 0

摘要

背景骨骼肌微血管血流在许多肌病中起着至关重要的作用。布比卡因和佐剂对骨骼肌微血管灌注和组织血氧测定的影响尚不清楚,但可能是局部麻醉后肌病的相关风险因素。本实验研究的目的是确定布比卡因单独或与肾上腺素或可乐定联合使用对骨骼肌灌注和组织血氧测定的影响。方法采用组织分光光度法、激光多普勒血流测定法和组织血氧计相结合的方法,对麻醉猪局部注射试验溶液(布比卡因、布比卡因加肾上腺素或可乐定、生理盐水)后的局部肌肉血流量进行评估。测量时间长达60分钟。结果单独应用布比卡因不会显著改变相对肌肉血流量,而在T30和T60时,在布比卡因中加入肾上腺素或可乐定会显著降低相对肌肉血流速。然而,在T30和T60时,与生理盐水对照组相比,布比卡因导致组织血氧测定值显著降低。与单独使用布比卡因相比,布比卡因与可乐定或肾上腺素联合使用并没有显著降低组织血氧饱和度。结论单独使用布比卡因可显著降低骨骼肌组织血氧饱和度,尽管微循环灌注进一步减少,但加入肾上腺素或可乐定并不能增加组织血氧饱和度。总的来说,布比卡因单独或与佐剂一起确实会产生局部肌肉缺血,其病理后果需要在进一步的研究中解决。
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Effect of bupivacaine and adjuvant drugs on skeletal muscle tissue oximetry and blood flow: an experimental study
Background Skeletal muscle microvascular blood flow plays a critical role in many myopathologies. The influence of bupivacaine and adjuvants on skeletal muscle microvascular perfusion and tissue oximetry is poorly understood but might be a relevant risk factor for myopathies after local anesthetic administration. The aim of this experimental study was to determine the effects of bupivacaine alone or in combination with epinephrine or clonidine on skeletal muscle perfusion and tissue oximetry. Methods Combined tissue spectrophotometry and Laser-Doppler flowmetry and tissue oximetry were used to assess local muscle blood flow in anesthetized pigs after topical administration of test solutions (bupivacaine, bupivacaine with epinephrine or clonidine, saline). Measurements were performed for up to 60 mins. Results The application of bupivacaine alone did not alter relative muscle blood flow significantly, whereas the addition of epinephrine or clonidine to bupivacaine resulted in a significant reduction of relative muscle blood flow at T30 and T60. However, bupivacaine resulted in a significant decrease of tissue oximetry values when compared to saline control group at T30 and T60. The application of bupivacaine combined with clonidine or epinephrine resulted in no significant reduction of tissue oximetry when compared to bupivacaine alone. Conclusion Bupivacaine alone results in a significant decrease of tissue oximetry in skeletal muscle which is not increased by the addition of epinephrine or clonidine despite further reductions of microcirculatory perfusion. Overall, bupivacaine alone or with adjuvants does produce local muscle ischemia for which pathological consequences need to be addressed in further studies.
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来源期刊
CiteScore
6.30
自引率
0.00%
发文量
12
审稿时长
16 weeks
期刊最新文献
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