参附注射液对三种局麻药中枢及心脏毒性的影响

Effects of Shenfu injection on the central nervous system(CNS) and cardiac toxicities of bupivacaine, ropivacaine and levobupivacaine in rats

目的 比较布比卡因、罗比卡因和左旋布比卡因的毒性,并探讨参附注射液对其中枢 及心脏毒性作用的影响。方法 60只雄性SD大鼠,随机分为三组(n=20):布比卡因组(B组)、罗比 卡因组(R组)和左旋布比卡因组(L组),每组再分为对照和参附两个亚组(每组n=10)。对照组实 验前30min大鼠腹腔注射生理盐水10ml/kg,参附组大鼠腹腔注射参附注射液10ml/kg。所有动物 股静脉置管用于泵注相应的局麻药,B组为0.5%布比卡因,R组为0.5%罗比卡因,L组为0.5%左 旋布比卡因,速度均为2ml·kg-1·min-1,并记录大鼠出现抽搐、心律失常和心跳停止的时间及局 麻药用量。结果 局麻药中毒出现抽搐、心律失常及心跳停止时R组和L组的局麻药用量大于B组 (P<0.01),R组的局麻药用量大于L组(P<0.01)。参附注射液处理后B组的中毒剂量明显大于 用生理盐水处理后的动物(出现抽搐、心律失常和心跳停止时P值分别是0.001,0.007和0.015),但 其对R和L组的中毒剂量无明显影响。结论 罗比卡因和左旋布比卡因的毒性确实低于布比卡因, 预先给予参附注射液可明显减轻布比卡因对大鼠的中枢及心脏毒性,但对罗比卡因和左旋布比卡因 的全身毒性反应无明显作用。

Objective To compare the toxicity of bupicacaine,ropivacaine and levobupivacaine, and investigate the effects of injecting Shenfu, an extract of traditional Chinese herbs, on the central nervous system (CNS) and cardiac toxicities of those local anesthetics in rats. Methods Sixty male Sprague-Dawley rats were randomly assignedto one of three groups (n=20 each): bupicacaine (group B); ropivacaine (group R) and levobupivacaine (group L). Each group was divided into two sub-groups (n=10 each): 10 animals received saline injection 10 ml/kg (control group) while another 10 animals received Shenfu injection 10 ml/kg (shenfu group) intraperitoneally 30 min before intravenous infusion of local anesthetics. The femoral vein was cannulated for the infusion of bupicacaine, ropivacaine and levobupivacaine in groups B, R and L respectively, at a rate of 2 ml·kg -1·min -1 until asytole occurred. The times of convulsions, QRS prolongation in ECG (arrhythmia) and asystole were determined. The infused doses of each local anesthetic were calculated at the corresponding time point respectively. Results The doses of ropivacaine and levobupivacaine that induced convulsions, arrhythmia and cardiac arrest were remarkably larger than that of bupivacaine (P<0.01), and the doses induced convulsion, arrhythmia and cardiac arrest of ropivacaine were larger than that of levobupivacaine(P<0.01). The doses of bupivacaine that induced convulsions, arrhythmia and cardiac arrest were larger in Shenfu-treated animals than in saline-treated rats (P=0.001, 0.007 and 0.015 respectively), but there was no significant difference between Shenfu injection-treated and saline-treated rats in both R and L groups. Conclusion The CNS and cardiac toxicities of ropivacaine and levobupivacaine were lower than that of bupivacaine, the Shenfu injection was able to reduce the toxicity of bupivacaine to CNS and heart in rats, but has no effects on that of ropivacaine and levobupivacaine.