CAJ | 학술논문

目的观察临床常用浓度0.375%与0.5%的罗哌卡因对糖尿病大鼠坐骨神经电生理的影响.方法健康及链脲佐菌素(STZ)糖尿病大鼠各12只,分别随机分为二组.全麻下解剖、暴露双侧坐骨神经,在右侧坐骨神经附近给予0.5 ml的0.375%或0.5%罗哌卡因作为实验,在左侧坐骨神经附近均给予0.5 ml的0.9%生理盐水作为对照.在注药前、注药后即刻至15 min(每分钟1次)以及注药48 h后检测坐骨神经的运动神经传导速度(MNCY)、动作电位波幅(AMP)、潜伏期(LAT).结果所有健康大鼠及糖尿病大鼠的生理盐水对照组,其MNCV、AMP、LAT在注药前后各观察时点比较均没有变化.健康大鼠给予0.375%罗哌卡因后,其MNCV、 AMP在平均4 min开始降低,在平均10 min变为0;给予0.5%罗哌卡因后,其MNCV、AMP在平均3 min开始降低,在平均9 min变为0;48 h后其MNCV、AMP都恢复到基础值水平.而糖尿病大鼠给予0.375%罗哌卡因后,其MNCV、AMP在平均1 min开始降低,在平均7 min变为0;给予0.5%罗哌卡因后,其MNCV、AMP在平均1 min开始降低,在平均6 min变为0;其变化时间与健康大鼠相比,差异具有统计学意义(P＜0.05).LAT在变化时间上与MNCV、AMP一致.48 h后糖尿病大鼠0.375%罗哌卡因组MNCV较基础值没有明显变化(P＞0.05),但AMP、LAT较基础值有明显变化(P＜0.05);而0.5%罗哌卡因组MNCV、AMP、LAT较基础值及0.375%罗哌卡因组均有明显变化(P＜0.05).结论0.375%与0.5%的罗哌卡因对糖尿病大鼠行坐骨神经阻滞时均可加重其神经损伤,后者更为严重.
목적 관찰림상상용농도0.375%여0.5%적라고잡인대당뇨병대서좌골신경전생리적영향.방법 건강급련뇨좌균소(STZ)당뇨병대서각12지,분별수궤분위이조.전마하해부、폭로쌍측좌골신경,재우측좌골신경부근급여0.5 ml적0.375%혹0.5%라고잡인작위실험,재좌측좌골신경부근균급여0.5 ml적0.9%생리염수작위대조.재주약전、주약후즉각지15 min(매분종1차)이급주약48 h후검측좌골신경적운동신경전도속도(MNCY)、동작전위파폭(AMP)、잠복기(LAT).결과 소유건강대서급당뇨병대서적생리염수대조조,기MNCV、AMP、LAT재주약전후각관찰시점비교균몰유변화.건강대서급여0.375%라고잡인후,기MNCV、 AMP재평균4 min개시강저,재평균10 min변위0;급여0.5%라고잡인후,기MNCV、AMP재평균3 min개시강저,재평균9 min변위0;48 h후기MNCV、AMP도회복도기출치수평.이당뇨병대서급여0.375%라고잡인후,기MNCV、AMP재평균1 min개시강저,재평균7 min변위0;급여0.5%라고잡인후,기MNCV、AMP재평균1 min개시강저,재평균6 min변위0;기변화시간여건강대서상비,차이구유통계학의의(P＜0.05).LAT재변화시간상여MNCV、AMP일치.48 h후당뇨병대서0.375%라고잡인조MNCV교기출치몰유명현변화(P＞0.05),단AMP、LAT교기출치유명현변화(P＜0.05);이0.5%라고잡인조MNCV、AMP、LAT교기출치급0.375%라고잡인조균유명현변화(P＜0.05).결론0.375%여0.5%적라고잡인대당뇨병대서행좌골신경조체시균가가중기신경손상,후자경위엄중.
Objective To observe the effects of clinical routine dasages 0.375% and 0.5% ropivacaine on electrophysiologic of changes of the sciatic nerve in diabetic rats. Methods Twelve healthy rsts and 12 rats with streptozotocin (STZ) induced diabetic peripheral,neuropathy were:used and further divided to 2 groups.Both sciatic nerves were exposed under general anesthesia.0.5 ml of either 0.375% or 0.5% ropivacaine was iniected in close proximity to the right seiatic nerve which was the experimental side.0.5 ml of 0.9% sodium chloride was iniected in close proximity to the left sciatic nerve which served as control.Motor nerve conduction velocity(MNCV),amplitude (AMP) and latency (LAT) of compound muscle action potential were recorded before injection,at the moment of injection,at one minute intervals for to 15 minutes and 48 hours after the injection. Results MNCV,AMP and LAT didn't change at all the observed time points of the 0.9% sodium chloride iniected control side in either healthy rats or diabetic rats.MNCV and AMP in normal rats injected with 0.375% ropivaeaine began to decrease at average 4 minutes and became zero at 10 minutes,while they began to decrease at average 3 minutes and dropled to zero at average 9 minutes while injected with 0.5% ropivacaine.These parameters returned to baseline levels after 48 hours.MNCV and AMP in diabetic rats injected with 0.375% ropivacaine began to decrease at average one minute and became zero at 7 minutes,while they began to decrease at average one minute and dropped to zero at 6 minutes with 0.5% ropivacaine injection.The time course had statistically significant difference between diabetic and normal rats.LAT had the same change pattern as MNCV and AMP.After 48 hours.MNCV in 0.375% ropivacaine diabetic group was not different from baseline value(P＜0.05),but AMP and LAT Were still significantly different from baseline levels.MNCV, AMP and LAT in 0.5% ropivacaine diabetic group had significant difference comparing to baseline levels and levels of 0.375% ropivaeaine diabetic group(P＜0.05). Conclusion Either 0.375% or 0.5% ropivacaine may deteriorate the diabetic peripheral nerve injury,the latter more remarkable.