不同浓度右美托咪定对罗哌卡因行连续股神经阻滞镇痛效果及安全性的动物研究

发布时间：2018-01-11 15:05

本文关键词：不同浓度右美托咪定对罗哌卡因行连续股神经阻滞镇痛效果及安全性的动物研究　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:采用动物行为学和细胞病理学评估右美托咪定联合罗哌因在兔连续股神经阻滞应用中的有效性及安全性。方法:健康新西兰兔30只,体重2~3kg,雌雄不分,采用随机数字表法,将其分为5组(n=6),空白对照组(A组)、罗哌卡因组(B组)、右美托咪定1μg/ml组(C组)右美托咪定2μg/ml组(D组)、右美托咪定3ug/ml组(E组)。A组为生理盐水组,B组为0.25%罗哌卡因组,C、D、E组为0.25%罗哌卡因联合不同浓度的右美托咪定,分别为1μg/ml、2μg/ml、3μg/ml。在兔左下肢股神经旁放置硬膜外导管,固定完善。完成置管后在膝关节髌骨上皮下注射5%福尔马林0.5ml,连续股神经阻滞动物模型制作完成后,经留置导管注入1ml盐酸利多卡因,针刺法及手指触摸法确定导管固定在位,6h后连接电子微量泵开始泵注药物。参数设置:背景剂量1ml,持续剂量0.5ml/h,每6小时单次追加注射1ml。实验兔连续股神经阻滞48小时后将其处死,分离出股神经,进行标本制作。利用光学显微镜图像分析仪软件进行股神经髓鞘面积定量分析,利用透射电镜对股神经髓鞘,细胞器等细胞超微结构进行观察。观察指标:1.动物行为学评分(0分—被注射腿明显能承重,在驱赶或或蹲卧期间前后足及左右足无明显差异;1分—被注射腿几乎不能承重,在运动中有明显跛行;2分—被注射腿抬高,不能承重;3分—搔抓,舔咬或摇被注射腿。观察时间点:T0:髌骨上皮下注射10%福尔马林0.5ml即刻评估兔行为学评分;T1:注射背景剂量2h;T2:给药6h,即第一次单次追加1ml药物后;T3:给药后24h,即第四次单次追加1ml药物后。评估前用福尔马林致痛,观察兔膝关节致痛后行为学表现并记分)2.镇痛起效时间:致痛后即刻到兔子恢复正常行走的时间。3.股神经髓鞘面积定量分析。4.透射电镜股神经细胞结构观察。结果:与A组相比,B、C、D、E组在T1、T2及T3时刻行为学评分相比较差异有统计学意义(P0.05)。在T1、T2及T3时刻,B组与C组相比较差异没有统计学意义(P0.05),B组与D、E组比较差异有统计学意义(P0.05),C组与D、E组比较差异有统计学(P0.05)。T1、T2及T3时刻D组与E组相比较差异无统计学意义(P0.05)。与A组相比较,B、C、D、E组开始恢复行走时间较短,差异具有统计学意义(P0.05),B组和C组相比较差异无统计学意义(P0.05)。C组与D组,E组相比较,恢复时间较长,差异具有统计学意义(P0.05),而D组和E组相比较,差异无统计学意义(P0.05)。空白对照组、罗哌卡因组、右美托咪定组,光镜下髓鞘面积定量分析差异无统计学意义(P0.05)。A、B、C、D组电镜结果显示没有出现脱髓鞘等神经纤维变性的现象,E组电镜结果显示神经纤维髓鞘板层疏松,呈空泡状。结论:右美托咪定联合罗哌卡因行股神经阻滞可缩短起效时间,增强镇痛效果,但高浓度右美托咪定(3μg/ml)联合罗哌卡因行连续股神经阻滞对兔股神经可能存在潜在神经损伤作用。
[Abstract]:Objective: to evaluate the efficacy and safety of dexmetomidine combined with ropipine in the treatment of continuous femoral nerve block in rabbits by animal behavior and cytopathology. Male and female were randomly divided into five groups: group A (control group) and group B (ropivacaine group). Right metoimidine 1 渭 g / ml group (group C) dexmetomidine 2 渭 g / ml group (group D), dexmetomidine group (group 3ug.ml) and group E (group A) were normal saline group. Group B was treated with 0.25% ropivacaine. Group E was treated with 0.25% ropivacaine combined with dexmetomidine at different concentrations (1 渭 g / ml / ml, 2 渭 g / ml, respectively). 3 渭 g / ml. The epidural catheter was placed next to the femoral nerve of the left lower extremity of the rabbit, and the fixation was perfect. 5% formalin 0.5ml was injected subcutaneously into the knee joint after the catheterization. After the establishment of the animal model of continuous femoral nerve block, 1 ml lidocaine hydrochloride was injected through the indwelling catheter, and the catheter was fixed in the position by acupuncture and finger touch. After 6 hours, the drug was pumped by the electronic micropump. The parameters were as follows: the background dose was 1 ml, the continuous dose was 0.5 ml / h. The rabbits were killed after 48 hours of continuous femoral nerve block and the femoral nerves were separated. The area of femoral nerve myelin sheath was quantitatively analyzed by using optical microscope image analyzer software, and the femoral nerve myelin sheath was obtained by transmission electron microscope (TEM). The ultrastructure of cell such as organelle was observed. The observation index was: 1. Animal behavior score (0 score-the injected leg could bear the weight obviously. There was no significant difference between the left and the right feet before and after driving or squatting; 1-the injected leg can hardly bear weight and has obvious limp during exercise; 2 points-raised by injection leg, can not bear weight; 3 points-scratch, lick, bite or shake injected leg. Observe time point: 0: 0: 10% formalin 0.5ml subcutaneously; assess immediately the behavior score of rabbits; T1: background dose 2 h; T2: after 6 hours of administration, 1ml was added for the first time. T3: 24 hours after administration, that is, 4th times a single dose of 1 ml of drugs. Before evaluation with formalin to cause pain. Observation of behavior and score after pain induced by knee joint in rabbits. 2. Analgesic effect time: the time from the immediate after pain to the rabbit to return to normal walk. Quantitative analysis of the area of femoral nerve myelin sheath. 4. Observation of the structure of femoral nerve cells under transmission electron microscope. Results: compared with group A. There were significant differences in behavioral scores at T _ 1 T _ 2 and T _ 3 in group E (P 0.05), and at T _ 2 and T _ 3 in T _ 1T _ 2 and T _ 3. There was no significant difference between group B and group C (P 0.05) and between group B (P 0.05) and group D (D). There was significant difference between group B and group C (P 0.05) and group D (P < 0.05). There was no significant difference between group D and group E at T _ 2 and T _ 3, and there was no significant difference between group E and group E, but there was no significant difference between group D and group A. The time to start walking was shorter in group E, and the difference was statistically significant. There was no significant difference between group B and group C. there was no significant difference between group C and group D. The recovery time was longer and the difference was statistically significant (P 0.05), but there was no significant difference between group D and group E. the blank control group, ropivacaine group and dexmetomidine group had no statistical significance. There was no significant difference in the quantitative analysis of myelin sheath area under light microscope. The electron microscopic results of group A (P0.05) showed no degeneration of nerve fibers such as demyelination. The electron microscopic results of group E showed that the myelin lamina of nerve fibers was loose and vacuolar. Conclusion: dexmetomidine combined with ropivacaine can shorten the onset time and enhance the analgesic effect. However, high concentration of dexmetomidine 3 渭 g / ml combined with ropivacaine for continuous femoral nerve block may have potential nerve injury effect on rabbit femoral nerve.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R614

【相似文献】