摘要
目的观察罗哌卡因用于老年患者坐骨神经阻滞的药代动力学特点。方法20例坐骨神经痛的患者随机分成2组,老年组(n=12)和青年组(n=8)。使用0.185%盐酸罗哌卡因行坐骨神经阻滞,在给药后5、10、15、25、50、90、180、360、720min采静脉血2ml,应用高效液相色谱仪测定血浆罗哌卡因的浓度。结果老年组患者感觉阻滞的持续时间明显长于青年组(P〈0.01),无明显运动阻滞。老年组峰浓度明显低于青年组(P〈0.01,1.53±0.73mg/Lvs2.75±0.97mg/L)。老年组吸收半衰期(11.25±3.58min vs 6.23±3.91min)和清除半衰期(10.01±3.99min vs 4.50±1.12min)均明显长于青年组(P〈0.01)。结论0.185%盐酸罗哌卡因可安全用于坐骨神经痛的老年患者,但罗哌卡因等浓度和剂量下,老年患者对该药的吸收、分布和清除均相对缓慢,药物在体内蓄积时间较长。
Objective To investigate the pharmacokinetics of ropivacaine used for sciatic nerve block in elderly patients. Methods Twenty patients suffered from sciatica were randomly divided into 2 groups:geriatric group(n= 12) and young group(n= 8). Ropivacine 0. 185% was used for sciatic nerve block, and 2 ml of blood was taken from vein at 5,10,15,25,50,90,180,360,720 rain to determine the concentration of ropivacaine by LabTechLC method after administration. Results The duration of sensory block in geriatric group was longer than that in young group(P〈0.01). No significant motor block was observed. The peak concentration of ropivacaine in the geriatric group was significantly lower than that in young group(P〈0.01, 1.53±0.73mg/L vs 2.75±0.97 mg/L), the half-time of absorption(11.25± 3.58min vs 6.23 ± 3.91min) and elimination of ropivacaine(10. 01 ± 3.99min vs 4.50 ± 1.12min) in geriatric group was much longer than that in young group (P〈0.01). Conlusion Ropivacaine hydrochloride 0. 185% is safe for sciatic nerve block in elderly patients with sciatica, but with the same concentration and dosage, the ahsorbtion, distribution and elimination rate of ropivacaine in eldly patients were comparatively slower,so the drug accumulation time in the body was longer.
出处
《实用疼痛学杂志》
2009年第2期110-111,共2页
Pain Clinic Journal