盐酸利多卡因缓释胶丸对术后切口镇痛作用的实验研究

EXPERIMENTAL STUDY ON THE ANALGESIC EFFECT PRODUCED BY LIDOCAINE HYDROCHLORIDE SLOW RELEASING GELATIN PILLS ON POSTOPERATIVE PAIN

目的：研究盐酸利多卡因缓释胶丸（ 简称缓释胶丸） 的缓释局麻镇痛作用及其量效和时效关系，确定适合临床需要的每丸剂量。方法：用仿豚鼠皮丘法、大鼠光热刺激法和大鼠电刺激法三种实验模型，分别观察缓释胶丸的缓释局麻镇痛作用。结果：仿豚鼠皮丘法，每只大鼠经切口皮下植入缓释胶丸一丸，内含１０ 、２０ 、４０ ｍ ｇ 盐酸利多卡因，针刺局麻范围随剂量增加而扩大，但不成比例。其中植入４０ ｍ ｇ／ 丸，术后１ 、６ 、１２ 和２４ｈ ，局麻作用直径分别为２０ ．１ ±３ ．４ ，１８ ．０ ±３ ．４ ，１５ ．４ ±２ ．６ 和７ ．６ ±１ ．７ ｍ ｍ ，作用持续２４ｈ 以上；大鼠激光热刺激法，７ ．５ 、１５ 、３０ ｍｇ／ 丸的镇痛作用１ｈ 内起效，持续４８ｈ 以上；大鼠电刺激法，７ ．５ ｍ ｇ／ 丸镇痛作用持续３６ｈ 以上，１５ ｍ ｇ／ 丸持续４８ｈ 以上，３０ ｍ ｇ／ 丸持续时间更长。而盐酸利多卡因水溶液７ ．５ ｍ ｇ 局麻作用持续２ｈ以上，不到６ｈ 。结论：缓释胶丸剂量与缓释局麻镇痛作用有明显量效和时效依赖关系，每丸剂量４０ ｍ ｇ 可以达到术后切口镇痛的目的。

Aim: The analgesic effect produced by Lidocaine hydrochloride slow releasing gelatin pills (slow releasing gelatin pills,SRGP), and their dose response and time dependent relationship were studied. The optimal doses per pill to suit the clinical needs were determined. Methods: Three methods were used for pain assessment: pin pricking on guinea pig skin, laser heat stimulation and subcutaneous (SC) electrical stimulation. One SRGP was implanted subcutaneously through an incision on the skin of the back of the guinea pig or the rat, and the pain assessment was performed at different time periods up to 48h. Results: 6 different doses(40,30,20,15,10,7.5mg)were used. The optimal dose was found to be 40 mg lidocaine per pill. The analgesic effect of the SRGP could last for 36 48h when 7.5mg dose was used, whereas SC injection of 7.5mg of lidocaine water solution could last only 2～6h. Conclusion: SRGP containing 40mg of lidocaine hydrocloride can fulfill the clinical reguirement for preventing post operative pain.