CAJ | 학술논문

目的探讨不同浓度丁卡因和罗哌卡因对大鼠臂从神经的毒性.方法成年雄性SD大鼠48只,体重410 ～ 430 g,采用随机数字表法,将其随机分为8组(n=6):生理盐水组(NS组)、0.25％、0.50％、1.00％丁卡因组(T1-3组)、0.25％、0.50％、1.00％、2.00％罗哌卡因组(R1-4组).随机选取一侧腋鞘,NS组注射生理盐水1.0 ml,T1-3组分别注射0.25％、0.50％、1.00％丁卡因0.5 ml,R1-3组分别注射0.25％、0.50％、1.00％罗哌卡因1.0 ml,R4组注射2.00％罗哌卡因0.5 ml.另一侧腋鞘作为对照.于注药后5d时检测臂从神经复合动作电位及其传导速度(NCV),并采用光镜和透射电镜观察臂从神经的病理学结果.结果与对照侧和NS组比较,T2-3组和R3-4组臂丛神经复合动作电位降低,NCV减慢(P＜0.05)；T1组、T2组和T3组臂从神经复合动作电位位依次降低,NCV依次减慢(P＜0.05)；与R1-3组比较,R4组臂丛神经复合动作电位降低,NCV减慢(P＜0.05).病理学改变:T2组、T3组和R4组神经束膜明显水肿,髓鞘板层分离、断裂、重度脱髓鞘,轴突萎缩；R3组为“脱髓鞘”现象,髓鞘板层分离、断裂、重度脱髓鞘,轴突萎缩.结论 0.50％、1.00％丁卡因和1.00％、2.00％罗哌卡因可导致大鼠臂从神经产生病理性损伤,且损伤程度与其浓度有关.
목적 탐토불동농도정잡인화라고잡인대대서비종신경적독성.방법 성년웅성SD대서48지,체중410 ～ 430 g,채용수궤수자표법,장기수궤분위8조(n=6):생리염수조(NS조)、0.25％、0.50％、1.00％정잡인조(T1-3조)、0.25％、0.50％、1.00％、2.00％라고잡인조(R1-4조).수궤선취일측액초,NS조주사생리염수1.0 ml,T1-3조분별주사0.25％、0.50％、1.00％정잡인0.5 ml,R1-3조분별주사0.25％、0.50％、1.00％라고잡인1.0 ml,R4조주사2.00％라고잡인0.5 ml.령일측액초작위대조.우주약후5d시검측비종신경복합동작전위급기전도속도(NCV),병채용광경화투사전경관찰비종신경적병이학결과.결과 여대조측화NS조비교,T2-3조화R3-4조비총신경복합동작전위강저,NCV감만(P＜0.05)；T1조、T2조화T3조비종신경복합동작전위위의차강저,NCV의차감만(P＜0.05)；여R1-3조비교,R4조비총신경복합동작전위강저,NCV감만(P＜0.05).병이학개변:T2조、T3조화R4조신경속막명현수종,수초판층분리、단렬、중도탈수초,축돌위축；R3조위“탈수초”현상,수초판층분리、단렬、중도탈수초,축돌위축.결론 0.50％、1.00％정잡인화1.00％、2.00％라고잡인가도치대서비종신경산생병이성손상,차손상정도여기농도유관.
Objective To investigate the neurotoxic effects of different concentrations of tetracaine and ropivacaine on the brachial plexus nerve in rats.Methods Forty-eight male Sprague-Dawley rats,weighing 410-430 g,were randomly divided into 8 groups (n =6 each):normal saline group (group NS),0.25％,0.50％ and 1.00％ tetracaine groups (groups T1-3 ),and 0.25％,0.50％,1.00％ and 2.00％ ropivacaine groups (groups R1-4 ).The rats received injection of normal saline 1.0 ml,0.25％,0.50％ and 1.00％ tetracaine 0.5 ml,0.25％,0.50％,and 1.00％ ropivacaine 1.0 ml and 2.00％ ropivacaine 0.5 ml in groups NS,T1-3 and R1-4 respectively through one side of the axillary sheath.The other side of the axillary sheath served as control side.Five days later,compound action potential and nerve conduction velocity (NCV) of the brachial plexus nerve were measured.Tne brachial plexus nerve was obtained as the specimen for microscopic examination with light and transmission electron microscope.Results Compared with the control side and group NS,the compound action potential and NCV of the brachial plexus nerve were significantly decreased in groups T2,3 and R3,4 ( P ＜ 0.05 ).The compound action potential and NCV of the brachial plexus nerve were gradually decreased with the increasing concentrations of tetracaine in groups T1 3 ( P ＜ 0.05 ).The compound action potential and NCV of the brachial plexus nerve were significantly decreased in group R4 as compared with groups R1-3 (P ＜ 0.05).The microscopic examination showed that the pathologic changes were more severe in groups T2,3 and R3,4 than those on the control side and than in group NS.Conclusion 0.50％ and 1.00％ tetracaine,and 1.00％ and 2.00％ ropivacaine can result in pathologic damage to the brachial plexus nerve in rats and the degree of damage is related to the concentration.