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|本期目录/Table of Contents|

罗哌卡因硬膜外腔阻滞对老年患者心肌毒性的研究

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第6期
页码:
925-927
栏目:
临床研究
出版日期:
2010-08-23

文章信息/Info

Title:
Myocardial toxicity of ropivacaine in elderly patients during epidural anesthesia
作者:
梁琪; 金梅生
西安市中医医院麻醉科，陕西 西安 710001
Author(s):
LIANG Qi;  JIN Mei-sheng
Department of Anesthesiology, Xi'an Chinese Traditional Medicine Hospital, Xi’an 710001, Shaanxi, China
关键词:
罗哌卡因; 心肌酶谱; 硬膜外腔阻滞
Keywords:
ropivacaine;  myocardial enzymes;  epidural anesthesia
分类号:
R614.42
DOI:
-
文献标识码:
A
摘要:
目的: 探讨罗哌卡因硬膜外腔阻滞时对老龄患者心肌的毒性。方法： 60例ASA Ⅱ～Ⅲ级拟硬膜外阻滞下择期手术的老龄患者，随机分成试验组和对照组（各30例）。试验组和对照组硬膜外腔阻滞分别使用罗哌卡因和利多卡因。分别于麻醉前、术毕和术后24 h检测AST、CK、CK-MB和LDH。结果： 试验组术毕和手术后24 h心肌酶谱值分别与麻醉前相比均升高（P<0.05）。对照组分别在同一时间点的心肌酶谱值亦较麻醉前升高（P<0.05）。试验组和对照组间相应时间点心肌酶谱值变化无明显差异。结论： 与临床常用药物利多卡因相比，罗哌卡因硬膜外腔阻滞并不增加对老龄患者心肌的毒性。
Abstract:
AIM: To investigate myocardial toxicity of ropivacaine in elderly patients during epidural anesthesia. METHODS: Sixty elderly patients undergoing selective surgery were randomly divided into experimental group (ropivacaine) and control group (lidocaine). Blood samples were obtained from the 60 patients at different intervals to determine their AST, CK, CKMB and LDH. RESULTS: Significant differences were observed between groups in the values of myocardial enzymes before anesthesia and at the end of the surgery or 24 h after surgery (P<0.05), whereas the values of myocardial enzymes of the group of elderly patients were not significantly different between groups at the end of the surgery and 24 h after surgery. CONCLUSION: Compared with lidocaine, administration of ropivacaine has no greater myocardial toxicity during epidural anesthesia. The changes in myocardial enzymes of elderly patients may be mainly related to the surgery process.

参考文献/References

［1］Casati A, Putzu M. Bupivacaine, levobupivacaine and ropivacaine: are they clinically different?［J］. Best Pract Res Clin Anaesthesiol, 2005, 19(2):247-268.

［2］Albright GA. Cardiac arrest following regional anesthesia with etidocaine or bupivacaine［J］. Anesthesiology, 1979, 51(4):285-287.

［3] 魏美芳,吴翔,李静,等. 血清TpP、CRP、CK-MB、cTnI在急性心肌梗死中的诊断意义［J］. 中国心血管病研究杂志， 2005， 3(2):86-87.

［4]潘柏申. 心肌损伤标志物的研究进展与心肌梗死诊断标准的修订［J］. 临床检验杂志， 2002, 20(3):129-132.

［5］王元松,刘成玉. 血清cTnI、CK-MB和Mb浓度动态变化对急性心肌梗死的诊断价值［J］. 青岛大学医学院学报， 2008， 44(2):150-155.

[6]祝祥,张宏. 局麻药心肌毒性的研究进展［J］. 中国药物应用与监测， 2004, 1(2):25-27.

备注/Memo

备注/Memo:
收稿日期：2009-11-03.作者简介：梁琪，副主任医师，硕士Email:dawn@mail.xjtu.edu.cn
更新日期/Last Update: 2010-08-22