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硬膜外阻滞时罗哌卡因和布比卡因的药代动力学 |
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解大建 吴新民 许幸 胡晓华
【摘要】 目的 研究国人在硬膜外阻滞时罗哌卡因和布比卡因的药代动力学特征。方法 选择14例手术病人、随机分为两组。硬膜外阻滞时，分别注入罗哌卡因2.0mg/kg或布比卡因2.0mg/kg。用气相色谱法测定血浆药物浓度。结果 罗哌卡因和布比卡因的药-时曲线均符合二室开放模型。t1/2ka分别为0.22小时和0.14小时，Tpeak分别为0.51小时和0.47小时，Camx分别为1.06mg.L－1和1.44mg.L－1。另外发现，其主要药代动力学参数，AUC分别为2.6mg.L－1.h－1和5.2mg.L－1.h－1，t1/2β分别为1.7小时和2.8小时，CL分别为757ml.min－1和382ml.min－1，两组间均具有显著差异(P＜0.05)。结论 罗哌卡因比布比卡因较少发生中枢神经系统及心血管的蓄积，主要是由于罗哌卡因在体内消除代谢能力较强所致。
【关键词】 罗哌卡因 布比卡因 麻醉，硬膜外 药代动力学
Pharmacokinetics of ropivacaine and bupivacaine during epidural anesthesia
XIE Dajian，WU Xinmin，XU Xing，et al.
Department of Anesthesia，First Hopsital，Beijing Medical University，Beijing 100034
【Abstract】 Objecitve This trial was designed to investigate the profile of the pharmacokinetics of ropivacaine and bupivacaine during epidural anesthesia in Chinese.Methods Fourteen patients were randomized into two groups.Under epidural anesthesia seven patients were given a does of 2.0mg/kg ropivacaine，the other patients at a does of 2.0mg/kg bupivacaine.The plasma concentrations were measured using gas chromatography.Results The plasma concentration-time curves of ropivacaine and bupivacaine were fitted to a two-compartment open model.The tl/2ka were 0.22h and 0.14h，Tpeak were 0.51h and 0.47h，Cmax were 1.06mg.L－1 and 1.44mg.L－1 respectively.The main pharmacokinetics parameters were as followed：AUC were 2.6mg.L－1 and 5.2mg.L－1.h－1，t1／2β were 1.7h and 2.8h，CL were 757 ml.min－1 and 382ml.min－1，respectively.There were significant differences between both groups (P＜0.05).Conclusion Ropivacaine has less central nervous and cardiovascular system accumulation than bupivacaine，which may be due to fast eliminating metabolism of ropivacaine.
【Key word】 Ropivacaine Bupivacaine Anesthesia，epidural Pharmacokinetics
罗哌卡因(ropivacaine)是一种新型、长效的局部麻醉药。本研究拟通过对罗哌卡因和布比卡因在硬膜外阻滞时药代动力学的研究，探讨罗哌卡因进入硬膜外腔后在体内的吸收、分布、消除规律，以期为临床麻醉合理用药，提供参考性理论依据。
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