目的 研究布比卡因诱导的大鼠心跳骤停的模型中,脂肪乳复合肾上腺素心肺复苏的效果.方法 40只SD大鼠,随机分为两组,每组20只,A组:肾上腺素对照组,L组:肾上腺素联合脂肪乳组.将大鼠麻醉后静脉注射布比卡因20 mg/kg,心跳停搏后行心肺复苏(CPR).A组开始CPR时注入肾上腺素10 μg/kg,共3次,之后每5分钟注入肾上腺素10 μg/kg.同时注入0.9%氯化钠注射液5 ml/kg,然后0.9%氯化钠注射液1 ml·kg-1·min-1;L组肾上腺素的应用与A组相同,并且在注入肾上腺素后注入20%脂肪乳5 ml/kg,接着注入脂肪乳0.25 ml·kg-1·min-1.监测心率、血压和体温.在麻醉后、心肺复苏成功5 min、30 min测量动脉血气.记录大鼠CPR成功的时间、数量,肾上腺素的用量.结果 A组心肺复苏成功11只, 成功率为55%,L组复苏成功16只,成功率为80%,脂肪乳组成功率高(P<0.05).A组用的肾上腺素剂量比L组小(P<0.05).两组大鼠复苏后5 min、30 min心率正常.复苏后30 min,两组的收缩压均在正常范围,L组的收缩压比A组高.L组的PaO2比A组高(P<0.05).结论 布比卡因中毒心跳骤停的大鼠用脂肪乳联合肾上腺素比单纯肾上腺素心肺复苏效果好.%Objective To investigate effect of lipid emulsion on cardiac arrest induced by bupivacain intoxication.Methods Forty SD rats were randomly devided into 2 groups.Group A applied epinephrine (n=20);Group L applied lipid emulsion combinding epinephring(n=20).The rats were administered Lupivacaine 20 mg/kg.Cardiopulmonary resuscitation(CPR) was started. Epinephrine 10 μg/kg were repeated three times followed by epinephrine 10 μg/kg every 5 minutes.Normal saline 5 ml/kg and 1 ml·kg-1·min-1 were administered in group A.20% Lipid emulsion 5 ml/kg and 0.25 ml·kg-1·min-1 were administered in group L.Heart rate,blood pressure, temperature were monitored.Blood gas analysiswere checked at 5 min,30 min after restoration of spontaneous circulation(ROSC).To record the number of successful CPR,time of ROSC and epinephrine dose.Results 11 rats(55%) and 16 rats(80%) were successful resuscitated.The success rate was higher in group L than in group A.Epinephrine dose was higher in group A than in group L.There was no difference in heart rate between the two groups.Systolic blood pressure and PaO2 was higher in group L than in group A(P<0.05).Conclusion There was better effect in lipid emulsion combined epinephrine than soly epinephrine when applied in cardiac arrest induced by bupivacaine intoxication.
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