罗比卡因用于小儿骶管阻滞时的药代动力学特征

Pharmacokinetics of ropivacaine during sacrul block in infant

目的 研究罗比卡因用于幼儿骶管阻滞时药代动力学特征,为临床应用提供理论依据。方法 选择先天性巨结肠根治术患儿14例,随机分为两组,在骶管阻滞时分别注入0.25％罗比卡因0.75 ml/kg或0.2％布比卡因0.75 ml/kg。用气相色谱法测定血浆药物浓度,并监测呼吸和循环指标,观察麻醉效果。结果 罗比卡因和布比卡因的药-时曲线均符合一室开放模型,t_(1/2)分别为0.16h和0.11h,T_(peak)分别为0.53h和0.49h,C_(max)分别为0.81mg/L和1.08mg/L。另外发现其主要药代动力学参数、血药浓度-时间曲线下面积(AUC)分别为2.0 mg·L^(-1)·h^(-1)和3.9mg·L^(-1)·h^(-1),t_(1/2)β分别为1.21h和2.2h,总清除率(CL)分别为567 ml/min和287 ml/min,两组间均有显著差异(P<0.05);呼吸、循环各指标均平稳,麻醉效果满意。结论 罗比卡因比布比卡因较少发生中枢神经系统及心血管的蓄积,用于小儿骶管阻滞是安全可行的。

Objective This trial was designed to investigate the pharmacokinetics characteristic of ropivacaine during sacrul block in children, so it could supply the theoretic for clinic. Methods Fourteen Hirschsprung's disease patients were randomly divided into two groups under sacrul block anesthesia. Seven patients were given a does of 0. 75 ml/kg 0. 25% ropivacaine, the other patients at a does of 0. 75 ml/kg 0.2% bupivacaine. The plasma concentrations were measured using gas chroma-tography. We also monitored the breath and circulation marker to investigate the anesthetic effect. Results The plasma concentration-time curves of ropivacaine and bupivacaine were fitted to a one compartment open model. The t1/2ka were 0. 16 h and 0. 11 h. Tpeak were 0. 53 h and 0. 49 h,Cmsx were 0.81 mg/L and 1.08 mg/L respectively. The main pharmacokinetics parameters were as followed: AUC were 2. 0 mg · L-1 · h-1 and 3. 9 mg · L-1 · h-1 , t1/2β were 1. 21 h and 2. 2 h,CL were 567 ml/min and 287 ml/min,respectively. There were significant differences between both groups(P<0. 05). The breath and circulution marker were steady, the anesthetic effect was satisfying. Conclusion Ropivacaine has less central nervous and cardiovascular system accumulation than bupivacaine can be used as a safe anesthetic in infant during sacrul block.