摘要目的 评价脂肪乳剂复合肾上腺素对布比卡因诱发兔心脏停搏的复苏效果.方法 雄性新西兰大白兔24只,体重2.0～2.5 kg,随机分为4组(n=6),麻醉下行气管插管,开胸暴露心脏,麻醉给药后60 min,经耳缘静脉注射布比卡因10 mg/kg,心跳停搏后行胸内心脏按压,限定按压时限30 min,同时Ⅰ组静脉输注乳酸钠林格氏液8 ml/ks 10 min;Ⅱ组静脉输注长链脂肪乳剂8 ml/kg 10 min;Ⅲ组静脉输注乳酸钠林格氏液8 ml/ks 10 min,同时静脉注射0.1%肾上腺素25 μg/kg后静脉输注0.1%肾上腺素120 min,维持MAP 80～90 mm Hg;Ⅳ组静脉输注长链脂肪乳剂8 ml/kg 10 min,同时静脉注射0.1%肾上腺素25 μg/kg后静脉输注0.1%肾上腺素120 min,维持MAP 80～90mm Hg.肾上腺素极量为8μg·kg~(-1)·min~(-1).记录开始复苏后30 min内和120 min内兔生存情况,记录Ⅲ组和Ⅳ组肾上腺素用量.结果 Ⅰ组和Ⅱ组复苏全部失败.与Ⅲ组比较,Ⅳ组开始复苏后120 min内的生存率升高,生存时间延长,肾上腺素用量降低(P＜0.05或0.01).结论 脂肪乳剂不仅可有效复苏布比卡因诱发的兔心脏停搏,还可降低肾上腺素用量.

abstractsObjective To investigate the resuscitation of bupivacaine-induced cardiac arrest with lipid emulsion(LE)combined with epinephrine(EP)in rabbits.Methods Twenty-four male New Zealand rabbits weighing 2.0-2.5 kg were randomly divided into 4 groups(n = 6 each): group Ⅰ lactated Ringer's solution(LR); group Ⅱ LE; group Ⅲ LR+EP and group Ⅳ LE+EP.The animals were anesthetized with 20%urethane 1.0-1.2 g/kg,tracheostomized and mechanically ventilated(V_T 15-18 ml/kg,RR 40 bpm,FiO_2 100%).Right femoral artery was cannulated.ECG,MAP and P_(ET) CO_2 were continuously monitored.Thoracotomy was performed and heart was exposed.0.75% bupivacaine 10 mg/kg was infused iv over 6 min.At the end of bupivacaine infusion,LR and LE 8 ml/kg were infused over 10 min in group Ⅰ and Ⅱ respectively.A bolus of0.1% epinephrine 25 μg/kg was given iv followed by 0.1% EP infusion to maintain MAP at 80-90 mm Hg in addition to LR or LE infusion in group Ⅲ and Ⅳ.The amount of EP(in group Ⅲ and Ⅳ)and the outcome of resuscitation were recorded.Results Resuscitation failed in all animals in group Ⅰ and Ⅱ.Survival rate was significantly higher,survival time longer while the amount of EP was significantly lower in group Ⅳ than in groupⅢ.Conclusion Lipid emulsion increases the survival rate of resuscitation of bupivacaine-induced cardiac arrest in rabbits and reduces the amount of epinephrine needed.