本文就关于医学行为学的研究与理论探讨做一些相关内容的分析。

目的:观察大鼠鞘内(蛛网膜下腔)间断给予不同浓度剂量的罗哌卡因行为学及脊髓组织钙含量变化。方法:雄性SD大鼠24只,按改良Yaksh法置入microspinal导管至脊髓腰段8 cm,随机分为4组(每组6只)。N组(对照组)经microspinal导管注入0. 9%氯化钠40μ,l每间隔1. 5 h一次,共3次。R1,R2,R3 3组:注药方式同N组,注入药物分别为0. 5%, 0. 75%, 1%罗哌卡因40μl。注药开始同期观察大鼠行为学变化, 6 h后取腰段脊髓测定钙离子含量变化。结果:R1,R2,R3 3组注药后30 s双下肢麻痹; 30~90min双下肢肌张力恢复,R1组较R2组快,R2组较R3组快,组间比较差异有显著性(P<0. 05)。R3组脊髓组织钙离子含量明显高于N, R1和R2 3组(P<0. 05)。结论: 0. 5%, 0. 75%和1%罗哌卡因用于连续蛛网膜下腔运动神经完全阻滞时间无差异,恢复时间与剂量有关。1%罗哌卡因能使脊髓组织钙含量明显增高。

[关键词]　罗哌卡因 连续腰麻 运动神经 脊髓 钙

Abstract:　Objective　To observe the behaviourand Ca2+contentofspinal cord in rats after con-tinuous spinal anesthesia administration ofdifferentdensities and doses of ropivacaine in SD rats.M eth-ods　Twenty-fourmale SD ratsweighing220~280 gwere anesthetized.A polyurethanemicrospinal cath-eterwas inserted into the lumbar subarachnoid space 8 cm according to themethod ofYaksh’s. The ani-malswere randomly divided into 4 groups of6 each: in group N the ratswere given normal saline 40μlintrathecally every one and halfhours for3 times; in group R1, 0. 5% ropivacainewas given; in groupR2 0. 75% ropivacaine and in group R3 1% ropivacaine was given. The activity of ratswas observed.After6 hours ratswere perfusedwith 4% formamint through the ascending aorta. The ratswere sacrificedand L1~2segmentofspinalcordwas immediately removed forCa2+contentexamination.Results　A totalhind limbs paralysiswas seen at30 seconds and intramuscular strain gradually came back from 30 to 90minutes after the intrathecal administration of ropivacaine in all rats. The recovery ofmotorblackwas re-markably different in group R1, R2, and R3(P<0. 05). The Ca2+content of spinal cord was signifi-cantly higher in group R3 than that in group R1 and R2 (P<0. 05).Conclusion　There is no signifi-cant change ofmotorblack time and it is related to drug dose for0. 5%, 0. 75% and 1% ropivacaine incontinuous spinal anesthesia. 1% ropivacainemay increase Ca2+content in spinal cord.

Key words:　ropivacaine;　continuous spinal anesthesia;　neurimotor;　spinal cord;　calcium

罗哌卡因是一种新型酰胺类局麻药,有明显感觉运动神经阻滞分离现象[1, 2]。罗哌卡因能否用于腰麻仍不能定论[3~5],只能用实验探讨鞘内注射罗哌卡因对脊髓毒性的影响。细胞内钙离子浓度的升高是局麻药引起脊髓、神经根损伤的主要原因[6]。本试验拟将不同浓度剂量罗哌卡因用于大鼠连续腰麻,观察大鼠行为学及脊髓组织钙含量,为不同浓度剂量罗哌卡因能否用于连续腰麻阻滞提供依据。

1　材料与方法

1. 1材料(1)动物: SD雄性大鼠24只,体重220~280 g,购于本校实验动物中心。(2)主要仪器与试剂: Polyurethane microspinal catheters (内径0. 12mm,外径0. 35mm,美国),微量注射器(100μ,l 50μ,l 10μ,l无锡东升仪器厂),AA—680型原子吸收分光光度计(日本岛津), 40%多聚甲醛粉末(500 /瓶,天津化学试剂研究所), 0. 5%, 0. 75%,1%罗哌卡因(每支10m,l Zeneca阿斯利康公司)。

1. 2方法

1. 2. 1大鼠鞘内置管于大鼠腹腔注射10%水合氯醛溶液(300 ~350 mg/kg)后,按改良Yaksh法[7]鞘内置入microspinal导管于脊髓腰段8 cm。取置管后无运动障碍的动物于置管3 d后鞘内注射2%利多卡因20μ,l如注药后30 s未出现双下肢麻痹,则舍去不用。动物均再单独饲养7 d,即可用于实验。

1. 2. 2实验动物分组和注药选择符合实验要求的置管后无运动障碍,且经利多卡因实验证实导管确实在鞘内大鼠24只,随机分为4组(n=6):N组(对照组)经microspinal导管注入0. 9%氯化钠40μ,l每间隔1. 5 h一次,共3次。R1,R2,R3 3组:注药方式同N组。注入药物分别为0. 5%, 0. 75%,1%的罗哌卡因40μl。各组每次注药完毕用0. 9%

以上是对医学行为学的研究与理论探讨

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