CAJ | 학술논문

目的观察左旋布比卡因用于肾功能异常患者臂丛神经阻滞时的药效学及药代动力学.方法将60例择期上肢手术患者分为两组:Ⅰ组(30例,肾功能正常组)和Ⅱ组(30例,肾功能异常组).分别给予0.375％左旋布比卡因行肌间沟入路臂丛神经阻滞,观察并记录感觉阻滞的起效时间、完善时间和维持时间.Ⅱ组随机抽取10例患者,高效液相色谱法测定肌间沟注药后10～720 min左旋布比卡因的血药浓度,3P97软件计算药代动力学参数.结果两组患者感觉阻滞起效时间和完善时间相当(P＞0.05),但Ⅱ组维持时间长于Ⅰ组(P＜0.05).Ⅱ组患者左旋布比卡因主要药代动力学参数达峰时间、峰值浓度和消除半衰期分别为(0.45±0.26)h、(0.90±0.13) mg/L和(4.98±0.45)h.结论肾功能异常对左旋布比卡因臂丛神经阻滞的药代动力学无影响,对术后镇痛维持时间有一定影响.
목적 관찰좌선포비잡인용우신공능이상환자비총신경조체시적약효학급약대동역학.방법 장60례택기상지수술환자분위량조:Ⅰ조(30례,신공능정상조)화Ⅱ조(30례,신공능이상조).분별급여0.375％좌선포비잡인행기간구입로비총신경조체,관찰병기록감각조체적기효시간、완선시간화유지시간.Ⅱ조수궤추취10례환자,고효액상색보법측정기간구주약후10～720 min좌선포비잡인적혈약농도,3P97연건계산약대동역학삼수.결과 량조환자감각조체기효시간화완선시간상당(P＞0.05),단Ⅱ조유지시간장우Ⅰ조(P＜0.05).Ⅱ조환자좌선포비잡인주요약대동역학삼수체봉시간、봉치농도화소제반쇠기분별위(0.45±0.26)h、(0.90±0.13) mg/L화(4.98±0.45)h.결론 신공능이상대좌선포비잡인비총신경조체적약대동역학무영향,대술후진통유지시간유일정영향.
Objective To investigate the clinical pharmacodynamics and pharmacokinetics of levobupivacaine for brachial plexus block in patients with renal dysfunction.Methods Sixty patients,underwent selective upper shoulder surgery were divided into two groups:group Ⅰ ( 30 cases,patients with normal renal function) and group Ⅱ (30 cases,patients with renal dysfunction).All patients were injected with levobupivacaine 0.375％ for interscalene brachial plexus block.The onset time,perfect time and recovery time of sensory block were observed and recorded.Ten patients were selected randomly to determine the plasma concentration of levobupivacaine 10 - 720 min after interscalene injection,and 3P97 software package was used to calculate the pharmacokinetic parameters.Results Both groups had the similar onset time and perfect time of sensory block ( P ＞ 0.05),but group Ⅱ had a more longer recovery time than group Ⅰ (P ＜ 0.05).The main pharmacokinetic parameters such as Tmax,Cmax and t1/2β in Group Ⅱ were (0.45 ± 0.26) h,( 0.90 ± 0.13) mg/L and (4.98 ± 0.45 ) h,respectively.Conclusions Renal dysfunction does not affect the pharmacokinetics of levobupivacaine for brachial plexus block,while it has an impact on the duration of postoperative analgesia.