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不同量的任氏液灌注对利多卡因阻滞蛙离体坐骨神经时效的影响
The effection of different perfusion of Ringer on the duration of lidocaine used for frog sciatic nerve block in vitro

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DOI:
作者:
甘宁
Ganning
作者单位:
上海市第六人民医院
Department of Anesthesiology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiaotong University
关键词:
神经阻滞；灌注；任氏液；坐骨神经；牛蛙；时效；利多卡因
Nerve block; perfusion; Ringer; sciatic nerve; bull frog; duration; lidocaine
摘要:
摘要】 目的 通过蛙离体坐骨神经灌注模型，观察不同量的任氏液灌注对利多卡因阻滞蛙离体坐骨神经时效的影响，从而阐明组织局部血液灌注量的大小对神经阻滞时效的影响程度。方法 20只牛蛙，体重250 g-300 g。将每只蛙的左、右侧坐骨神经分离后随机分入A、B两组。测量每根神经的最大神经干复合电位（CAPMAX）及刺激强度，在此刺激强度下用1.5%利多卡因浸泡坐骨神经的中间部分，直至神经干复合动作电位（CAP）完全消失，记录消失时间(t0)。然后A、B两组分别以任氏液1 ml/min 和10 ml/min 灌注。记录两组的CAP开始恢复时间（t1）及完全恢复时间（t2）；每隔10分钟采集一次CAP振幅，至120分为止，并与CAPMAX比较，计算恢复百分比。结果 B组的t2和A组相比缩短了15%，差异有显著统计学意义（92.19±16.46 mins 对108.39±24.43 mins，p<0.01）。B组的t1比A组的t1有缩短的趋势，但差异无统计学意义（p>0.05）。时间因素p<0.01（Greenhouse-Geisser），CAP恢复有随时间变化的趋势；时间和分组交互作用p=0.028（Greenhouse-Geisser），说明时间因素随分组的不同而不同；两组间p=0.011，说明两种灌注速率对CAP恢复的影响不同。结论 在蛙离体坐骨神经灌注模型中，增加任氏液灌洗量可缩短利多卡因阻滞蛙离体坐骨神经后的恢复时间。提示组织局部血液量对神经阻滞的时效有显著影响，其程度在15%左右。
Objective To observe the effection of different perfusion on the duration of frog sciatic nerve blocked by lidocaine by means of using frog sciatic nerve in vitro perfusion model, and then expound the extent to which the duration of nerve block is implicated in local blood flow of tissue. Methods 20 bullfrogs weight 250-300 g. The sciatic nerve of each side of each frog was randomly divided into group A or group B. The maximum amplitude of the compound action potential (CAPMAX)and the stimulus intensity of each nerve were measured. And the center section of each nerve was bathed with 1.5% lidocaine in this stimuli intensity until the compound action potential (CAP) was fully suppressed. For each nerve the duration of the CAP being suppressed (t0) was recorded. After that, every nerve of group A and group B were respectively perfused with the Ringer at the rate of 1ml/min and 10ml/min. Recorded the time of start restore (t1) and full-recovery (t2) of two groups. The amplitude of CAP was measured in every 10 minutes at beginning of the perfusion and calculated the percentage of CAPMAX until 120 minutes. Results Compared with group A, the time of full-recovery (t3) of group B was reduced by 15%, and there was significant difference of statistical significance between two groups (92.19±16.46 mins compared with 108.39±24.43 mins, p<0.01). The time of start restore (t1) of group B trended to shorten than that of group A, but there was no statistical significance between two groups (p>0.05). The recovery of the CAP went goes time ( p<0.01, Greenhouse-Geisser); and there are different effects with the time factor and groups ( p=0.028, Greenhouse-Geisser). Two rates of perfusion have different effects on the recovery of CAP ( p=0.011) . Conclusion In the frog sciatic nerve in vitro perfusion model, the restoring time of frog sciatic nerve in vitro blocked by lidocaine could be reduced by means of increasing perfusion of Ringer. It prompts that the local blood flow of tissue has appreciable impact on the duration of nerve block, and the degree is 15%.

 

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