布比卡因在硬膜外麻醉致死犬体内的分布

Study on the postmortem distribution of bupivacaine in epidural anesthesia death dogs

目的建立布比卡因硬膜外麻醉致死的动物模型,探讨其在致死犬体内的分布规律。方法雄性比格犬15只,随机分为1倍极量组(6只)3、倍极量组(6只)和对照组(3只),硬膜外穿刺给药,用BL-机能生物仪监测犬的生命体征,犬死后迅速解剖并提取心、肝、脾、肺、脑、心血、周围血、胆汁、尿液、各段脊髓和脑脊液,气相色谱(GC)法、气相色谱-质谱联用仪(GC/MS)法检测其中布比卡因含量,使用SPSS 11.5统计软件,采用均数两两比较的SNK法,比较致死犬体内各脏器或体液中布比卡因的含量。结果实验犬体内布比卡因含量较高的脏器或体液,硬膜外3倍极量组为:各段脊髓>肾>大脑>CSF>心、肺和脾;硬膜外1倍组为各段脊髓>CSF>肝脏>周围血>心血>大脑>肺和肾。结论布比卡因硬膜外麻醉意外时的中毒症状、死后药物在体内分布等均与给药剂量有一定的相关性,此可为疑似布比卡因硬膜外麻醉意外案件的鉴定提供一定的依据。

Objective To establish the model of bupivacayne epidural anesthesia death,and investigate the distribution of bupivacayne in epidural anesthesia death dogs.Methods Eighteen male dogs were randomly allocated to three groups.Six dogs were given a dose of 5 mg/kg body weight of bupivacaine hydrochloride by the subarachonid anesthesia tube at an even speed in five minutes,while the other six in the second group were given 15 mg/kg,the last three dogs in control group were given 15 mg/kg weight of physiological salt solution.The vital signs from beginning of the administration to the death were recorded by a biological function system.The cerebrum,cerebrospinal fluid（CSF） in lateral ventricle,spinal cord（cervical spinal cord,thoracic spinal cord,lumbar spinal cord and sacrum spinal cord）,heart,lung,liver,spleen,kidney,bile,urine,heart blood, peripheral blood,muscle in injection location and muscle in no injection location were collected and analyzed immediately after the death.These samples were extracted by ethyl ether.Analysis was performed with a GC equipped with a NPD and a GC/MS.The qualitative analysis was based on retention time in the chromatographic system coupled with the ion fragmentation spectrum in the mass spectrometer.The quantitative analysis was on an internal standard method.Results The bupivacaine concentrations detected in sacrum spinal cord,cervical spinal cord,thoracic spinal cord,lumbar spinal cord,kidney,cerebrum and CSF were much higher in the 5mg/kg group.While in 15mg/kg group the concentrations detected in cervical spinal cord,thoracic spinal cord,lumbar spinal cord,sacrum spinal cord and CSF were much higher.Conclusion There was a relationship between the poisoning symptom,postmortem distribution and the administration dose,which may provide some evidences for the investigation of suspected epidural anesthesia accident case.