脂肪乳剂用于酰胺类局麻药毒性反应的救治

Lipid infusion resuscitation for aminoamide local anesthetic toxicity

局麻药全身毒性反应发生率低，但其导致的并发症严重。动物和离体心脏的实验研究证明脂肪乳剂能快速逆转强效酰胺类局麻药导致的心血管系统衰竭。多例成功复苏酰胺类局麻药所致心脏停搏的报道显示，脂肪乳剂可成功逆转局麻药中毒所导致的心脏和中枢神经系统衰竭。脂肪乳救治局麻药中毒的机制可能通过两个途径共同作用：降低组织中的局麻药浓压丽改善心肌细胞的能量代谢。

Systemic local anesthetic toxicity is a rare, but potentially fatal complication. Experiments have shown that lipid emulsion therapy can rapidly restore circulation after aminoamide local anesthetic induced cardiovascular collapse in both intact animals and isolated hearts. Several case reports have showed that lipid emulsion quickly resuscitated cardiac arrest following regional anesthesia and reversed central nervous system symptoms induced by local anesthetic intoxication. The mechanism of lipid rescue is probably a combination of reduced tissue binding local anesthetic and a beneficial cardiac cell energetic-metabolic effect.