天津医药

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异丙酚抑制长效酰胺类局麻药致大鼠中毒惊厥作用的比较

韩倩1,张山2,乔玉敏1,王春平1,张志强1   

  1. 1. 河北医科大学第二医院
    2. 河北医科大学第二医院麻醉科
  • 收稿日期:2010-07-08 修回日期:2010-10-21 出版日期:2011-05-15 发布日期:2011-05-15
  • 通讯作者: 张山

Anticonvulsant action of propofol against convulsion induced by long-acting amide local anesthetics in rats

  • Received:2010-07-08 Revised:2010-10-21 Published:2011-05-15 Online:2011-05-15

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摘要： 目的：比较异丙酚抑制左旋布比卡因、罗哌卡因和布比卡因致惊厥的作用。方法：64只Wistar大鼠，随机分为对照组（C组），左旋布比卡因组(L组)，罗哌卡因组（R组），布比卡因组（B组），四组再分为实验组（EG）和异丙酚处理组（PG）两个亚组（n=8）。L组、R组和B组的实验组（EG）分别经尾静脉泵入0.75%左旋布比卡因、0.75%罗哌卡因以和0.75%布比卡因，速度均为2mg?kg-1? min-1，异丙酚处理组(PG)按实验组给药出现惊厥反应后静推2mg/kg异丙酚。C组的实验组（EG）泵入生理盐水，异丙酚处理组（PG）泵入生理盐水后静推异丙酚。惊厥2小时后，测定海马CA1区c-fos阳性细胞数， NO含量和NOS活性表达变化。结果：除C组外各组均见惊厥出现。各异丙酚处理组在给予异丙酚后很快抑制惊厥。与C组的实验组比较，L组、R组和B组的实验组海马CA1区c-fos阳性细胞数、NO含量和NOS活性均显著增加（P<0.01）。在L组、R组和B组中，与对应的实验组比较，异丙酚处理组海马CA1区c-fos阳性细胞数、NO含量和NOS活性均明显减少（P<0.01）。与B组c-fos阳性细胞数、NO含量和NOS活性的K值相比，L组与R组K值明显减小（P<0.01）。结论：异丙酚在一定程度上均能抑制左旋布比卡因、罗哌卡因和布比卡因引起的惊厥。从c-fos、NO和NOS活性变化观察，异丙酚抑制布比卡因致惊厥的作用强于抑制左旋布比卡因和罗哌卡因致惊厥的作用。

关键词: 异丙酚, 局麻药, 惊厥, c-fos, 一氧化氮（NO）, 一氧化氮合酶（NOS）

Abstract: Abstract Objective: To compare the effect of propofol on the convulsion induced by levobupivacaine, ropivacaine and bupivacaine. Methods: Sixty-four male Wistar rats were randomly divided into Control group (group C), Levobupivacaine group (group L), Ropivacaine group (group R), Bupivacaine group (group B). Each group was divided into two sub-groups (n=8): experimental group (EG) and propofol treatment group (PG). Group EG of Group L, group R and group B were infused with 0.75% levobupivacaine, 0.75%ropivacain or 0.75% bupivacaine at a same rate of 2mg?kg-1? min-1 respectively. Normal saline was infused in Group EG of Group C, propofol was infused in Group PG. Two hours after convulsion developed, the expression of c-fos, the concentration of NO and NOS activity were measured. Results：Convulsion appeared in every group except group C. The emergency time of convulsion was 10.63±4.809min, 12.63±7.836min and 7.75±3.919min in sub-group EG of group L, R and B respectively. Rats which developed convulsion could quickly be suppressed mostly within 15 seconds in group PG after rats were given an i.v. bolous of propofol, From the overall performance and the duration of convulsion, there were not significantly differences of propofol against convulsion among group PG .Compared with group C, the expression of c-fos, the concentration of NO and the activity of NOS in hippocampus was significantly higher in group EG of group L, group R and groupB (P<0.05). Compared with group EG, the expression of c-fos, the concentration of NO and the activity of NOS in hippocampus was significantly higher in group EG group L, group R and groupB (P<0.05). The K-value of the expression of c-fos, the concentration of NO and the activity of NOS in group L and group R was less than group B(P<0.05), and whereas the K-value of group L was not much bigger than that in group B（P＞0.05）. Conclusions: Propofol may inhibit the convulsion induced by levobupivacaine, ropivacaine and bupivacaine to a certain degree. From the change of the expression of c-fos, the concentration of NO and the activity of NOS, propofol may more effective to inhibit convulsion induced by bupivacaine than levobupivacaine and ropivacaine.

Key words: propofol, local anesthetic, seizure, c-fos, nitric oxide (NO), nitric oxide synthase (NOS)