CAJ | 학술논문

目的探讨阿米替林对大鼠静脉局部麻醉效应的半数有效浓度(EC50).方法健康雄性大鼠90只,体重190～240 g,随机分为3组(n=30):阿米替林组、布比卡因组和利多卡因组.将大鼠鼠尾均分成上段(近心端)、中段、末段(远心端)三部分并做标记.尾静脉穿刺置入套管针并接肝素帽,用驱血带从尾尖驱血至鼠尾上段和中段交界处,于驱血带上缘处固定止血带,随后各组于10 s内分别注入规定浓度的阿米替林、布比卡因和利多卡因各0.5 ml,均以0.9%生理盐水稀释,10 min后松开止血带.采用序贯法进行实验,阿米替林组第1只大鼠尾静脉注射0.05%阿米替林,相邻浓度比值为1.414;布比卡因组第1只大鼠注射0.03%布比卡因,相邻浓度比值为1.667;利多卡因组第1只大鼠注射0.08%利多卡因,相邻浓度比值为1.250.计算各组的EC50和95%可信区间.于给药前1 h(基础状态)、给药后3 min和2 d时测定甩尾反应时间(TFL).观察大鼠是否出现局麻药神经毒性反应(烦躁不安、惊厥、死亡等)和鼠尾局部组织损伤.结果阿米替林组、布比卡因组及利多卡因组的EC50分别为0.111%(95%可信区间0.092%～0.133%)、0.058%(95%可信区间0.048%～0.078%)及0.129%(95%可信区间0.103%～0.160%);与阿米替林组比较,布比卡因组EC50降低(P＜0.01),利多卡因组差异无统计学意义(P＞0.05);与布比卡因组比较,利多卡因组EC50升高(P＜0.01).与基础值比较,各组给药后各时点鼠尾上段TFL差异无统计学意义(P＞0.05),给药后3 min时鼠尾中段TFL升高(P＜0.01),给药后2 d时TFL差异无统计学意义(P＞0.05).各组大鼠均未见神经毒性反应和鼠尾局部组织损伤.结论阿米替林产生的静脉局部麻醉效力低于布比卡因,与利多卡因相似.
목적 탐토아미체림대대서정맥국부마취효응적반수유효농도(EC50).방법 건강웅성대서90지,체중190～240 g,수궤분위3조(n=30):아미체림조、포비잡인조화리다잡인조.장대서서미균분성상단(근심단)、중단、말단(원심단)삼부분병주표기.미정맥천자치입투관침병접간소모,용구혈대종미첨구혈지서미상단화중단교계처,우구혈대상연처고정지혈대,수후각조우10 s내분별주입규정농도적아미체림、포비잡인화리다잡인각0.5 ml,균이0.9%생리염수희석,10 min후송개지혈대.채용서관법진행실험,아미체림조제1지대서미정맥주사0.05%아미체림,상린농도비치위1.414;포비잡인조제1지대서주사0.03%포비잡인,상린농도비치위1.667;리다잡인조제1지대서주사0.08%리다잡인,상린농도비치위1.250.계산각조적EC50화95%가신구간.우급약전1 h(기출상태)、급약후3 min화2 d시측정솔미반응시간(TFL).관찰대서시부출현국마약신경독성반응(번조불안、량궐、사망등)화서미국부조직손상.결과 아미체림조、포비잡인조급리다잡인조적EC50분별위0.111%(95%가신구간0.092%～0.133%)、0.058%(95%가신구간0.048%～0.078%)급0.129%(95%가신구간0.103%～0.160%);여아미체림조비교,포비잡인조EC50강저(P＜0.01),리다잡인조차이무통계학의의(P＞0.05);여포비잡인조비교,리다잡인조EC50승고(P＜0.01).여기출치비교,각조급약후각시점서미상단TFL차이무통계학의의(P＞0.05),급약후3 min시서미중단TFL승고(P＜0.01),급약후2 d시TFL차이무통계학의의(P＞0.05).각조대서균미견신경독성반응화서미국부조직손상.결론 아미체림산생적정맥국부마취효력저우포비잡인,여리다잡인상사.
Objective To determine the median effective concentration (EC50) of amitriptyline for intravenous regional anesthesia (IVRA) in rats.Methods Ninety healthy male SD rata weighing 190-240 g were randomly divided into 3 groups (n=30 each) : amitripryline group,bupivncaine group and lidocaine group.The rat's tail was divided into 3 epual parts: the proximal,middle and distal part.A 24 gauge needle was inserted into vena caudalis in the distal part.Esmarch bandage was applied around the tail from distal to proximal to expel blood from the taft and was removed after a tourniquet was applied between the proximal and middle part of the tail to occlude artery.0.5 ml of amitriptyline,bupivncaine or lidocaine was injected into the taft vein immediately after the application of the tourniquet.Ten minutes after drug administration the tourniquet was released.The ECho was determined by the up-and-down sequence method.The initial concentration of amitriptyline was 0.05%,the consecutive concentration-ratio was 1.4i4; the initial concentration of bupivacaine was 0.03%,the consecutive concoatration-ratio was 1.667 and the initial concentration of lidncaine was 0.08%,the consecutive concentrationratio was 1.250.EC50 and 95% confidence interval were calculated.Tail-flick latency (TFL) was assessed at 1 h before (baseline) and at 3 min and 2 d after drug administration.Central nervous system toxicity (seizure,convulsion,death) and local tissue damage to the tail were also recorded.Results The EC50 for IVRA was 0.111% (95% CI,0.092%-0.133%) in amitripthline group; 0.058% (95% CI,0.048%-0.078%) in bupivacaine group and 0.129% (95% CI,0.103%-0.160%) in lidocaine group respectively.The EC50 was significantly lower in bupivacaine group than in amitriptyline and lidocaine group.There was no significant difference in EC50 between amitriptyline and lidocaine group.The TFL measured at the proximal part of the tail was not significantly different between different time points in each group.The TFL measured at the middle part at 3 rain after drug adminisuation was significantly increased as compared with the baseline in all 3 groups but was not significantly different between the baseline and that measured at 2 d after drug administration.No CNS toxicity and local tissue damage were found during the experiment in all 3 groups.Conclusion Amitriptyline can produce intravenous regional anesthesia.The potency of amitriptyline is significantly lower than that of bupivncaine but is not significantly different from that of lidocaine.