布比卡因用于上腹部手术硬膜外阻滞(国产和进口药临床药理比较)

本文应用国产和进口两种布比卡因(浓度均为0.5%)进行上腹部手术硬膜外阻滞共76例,其中国产组43例,进口组33例。对两药显效时间、作用完全时间、一次剂量维持时间和镇痛持续时间进行比较,均无明显差别,加入1∶20万肾上腺素,上述各时间亦大多未见显著延长。两药在0.5%浓度时镇痛、肌松效果均颇满意,未见毒性反应,但麻醉后切皮前血压下降20%以上者比利多卡因增多,提示交感神经节前纤维更易受布比卡因阻滞。     

股动脉注射琥珀胆碱诱发肌梭传入对膈神经放电的影响

目的 观察肌梭传入活动是否对呼吸运动具有反射性调节作用。方法 实验用63只麻醉、制动、切断双侧颈迷走神经、肌松、人工呼吸的家兔,以膈神经放电作为呼吸观测指标,观察股动脉注射琥珀胆碱(Succinylcholine,Sch)诱发肌梭传入活动对呼吸的影响。结果 ①产生易化作用的有40例(63..49%),其中23例(36..51%)呈吸气延长效应;17例(26..98%)呈抑呼增频效应。产生抑制效应的有11例(17..46%),呈双相反应的4例(6..35%),8例(12..70%)无明显作用。②吸气延长效应主要表现为吸气时程(Ti)延长,呼吸时程(Te)有缩短趋势,但差异无显著性,Ti/Te比值增加,呼吸频率(RF)变化不明显;抑呼增频效应主要表现为Te缩短,Ti变化不明显,Ti/Te比值增加,RF加快。③肌注布比卡因破坏肌梭后,同剂量的Sch使上述呼吸易化效应明显减弱。结论 股动脉注射Sch诱发的肌梭传入活动对呼吸运动具有明显的增强作用。     

NITRIC OXIDE SYNTHESIS INHIBITION ENHANCES BUPIVACAINE CARDIOTOXICITY

ＮＩＴＲＩＣＯＸＩＤＥＳＹＮＴＨＥＳＩＳＩＮＨＩＢＩＴＩＯＮＥＮＨＡＮＣＥＳＢＵＰＩＶＡＣＡＩＮＥＣＡＲＤＩＯＴＯＸＩＣＩＴＹＪ．Ｅ．Ｈｅａｖｎｅｒ，ＳｈｉＢｉｎｇ；Ｍ．Ｐｉｔｋａｎｅｎ（ＤｅｐａｒｔｍｅｎｔｏｆＡｎｅｓｔｈｅｓｉｏｌｏｇｙ，Ｔｅｘａ...     

Effects of labor analgesia on maternal and neonatal outcome by epidural low concentration of bupivacaine combined with anisodamine

Objective To observe the effects of labor analgesia on maternal and neonatal outcome by epidural application of 0.125% bupivacaine combined with anisodamine on the labor stage, and modes of delivery and neonatal Apgar's score. Methods A total of 220 primiparaes with full-term pregnancy, monocyesis and fetal head presentation without any obstetrical or systematic complications were chosen and divided into analgesic group and control group (110 in each group). The mixture of bupivaeaine and anisodamine was injected into the epidural space of the parturients in the analgesic group while those patients in the control group did not receive any analgesics. Results The analgesic effect was satisfactory (91.8 %), and no side effects occurred in the second stage of labor. The instrument delivery rate was lower in the analgesic group, and there was no significant difference between the two groups in neonatal Apgar's score. Conclusion The method is feasible in clinic for labor pain relief without increasing the rate of dystocla and complications of delivery.