肾上腺素对氯普鲁卡因硬膜外阻滞患者药效学和药代动力学的影响

目的观察1:20万肾上腺素对3％盐酸氯普鲁卡因硬膜外阻滞患者药效学和药代动力学的影响。方法择期行下腹部手术患者20例,ASAⅠ或Ⅱ级,随机分为2组(n=10):盐酸氯普鲁卡因组(C组)和盐酸氯普鲁卡因加肾上腺素组(CE组)。分别用3％氯普鲁卡因6 mg·kg-1(C组)和含 1:20万肾上腺素3％氯普鲁卡因6 mg·kg-1(CE组)硬膜外阻滞,记录局麻药的起效时间、运动阻滞起效时间和给药后20min时运动阻滞程度;分别在给药前及给药后3、6、9、11、13、15、17、20、30、45、60、 90min采取桡动脉血1．5ml,高效液相色谱法检测血浆氯普鲁卡因浓度,经计算机软件拟合血药浓度 -时间曲线,并计算各项药代动力学参数。结果两组局麻药的起效时间、运动阻滞起效时间和运动阻滞程度差异无统计学意义。C、CE组血药浓度峰值(Cmax)分别为0．49±0．47、(0．32±0．22)mg· L-1,达峰值时间(Tmax)分别为8±3、(9±4)min;血药浓度曲线下面积(AUC)分别为10±6、(7±4)μg· min·ml-1;清除速率常数(K)分别为0．32±0．21、(0．36±0．32)min-1;两组间Cmax、Tmax、AUC及K比较差异无统计学意义(P>0．05)。结论 1:20万肾上腺素对3％盐酸氯普鲁卡因硬膜外阻滞的药代动力学和药效学没有影响。     

夜来香根茎水提取液局部麻醉作用的研究

目的：研究夜来香(CN)根茎水提取液的局部麻醉作用及其作用机制。方法：采用蟾蜍离体坐骨神经动作电位法、豚鼠皮丘法、椎管麻醉法、表面麻醉法。结果：20％的CN水提取液对蟾蜍离体坐骨神经动作电位可完全消失，但较1％的普鲁卡因稍弱。豚鼠皮丘实验表明，20％CN提取液有浸润麻醉作用，其浸润麻醉效果与1％的普鲁卡因相似，而且盐酸肾上腺素可增强其麻醉强度和明显延长局麻作用时间；家兔椎管麻醉实验表明CN提取液有明显的椎管麻醉作用；CN提取液对家兔角膜也有一定的表麻作用，只是作用强度及持续时间比1％的普鲁卡因稍弱或稍短。结论：CN提取液有明显的局部麻醉作用。     

Comparison of the reinforcing efficacy of cocaine and procaine in rhesus monkeys responding under a progressive-ratio schedule

Rhesus monkeys (n=5) were prepared with chronic IV catheters and trained to lever press under a PR schedule of drug injection. The schedule consisted of five components, each made up of four trials (i.e., 20 trials total). Each trial within a component had the same response requirement. The response requirement in the first component was 120/trial and doubled in successive components to a maximum of 1920 in the fifth. A trial ended with an injection or the expiration of a 12-min limited hold (LH). The inter-trial interval (ITI) was 15 or 30 min. Following an injection or expiration of the LH, all stimulus lights were extinguished and responding had no consequence for the remainder of the trial. A session ended when either all 20 injections were self-administered or the response requirement was not met within the LH for two consecutive trials. The number of injections/session and responses/session increased with dose for cocaine (0.012–0.1 mg/kg per injection) and procaine (0.12–2.0 mg/kg per injection) at both ITI values. At the 15-min ITI, responding decreased again at higher doses in some monkeys with cocaine and in all monkeys with procaine. At maximum, cocaine maintained significantly more injections and responses/session when the ITI was 30 min than when it was 15 min. In contrast, the increase in ITI did not increase the maximum maintained by procaine. Cocaine was approximately 10-fold more potent than procaine and maintained at maximum significantly more injections and responses than procaine when the ITI was 30 min but not when the ITI was 15 min. These results are consistent with previous studies demonstrating that cocaine is a more efficacious positive reinforcer than procaine. Moreover, they extend recent findings suggesting that number of injections/session provides a measure of PR performance that is amenable to statistical analysis and may, therefore, be useful in establishing reliable differences among drugs in terms of relative reinforcing efficacy. Reliable quantification of between-drug differences in reinforcing efficacy can enhance not only estimates of relative abuse liability but also pharmacological analysis of central mechanisms mediating reinforcing effects.     

Radioallergosorbent test (RAST) for specific IgE antibody to lidocaine,procaine and methylparaben

Although anaphylactoid reactions to local anesthetics are well known, a radioallergosorbent test (RAST) to detect specific drug reagin (IgE) anti-body has not been developed. We established RAST for local anesthetics by using carboxylic acid derivatives of lidocaine, procaine and methylparaben. Serum samples were taken from 100 volunteers who were regarded to be nonallergic to the drugs used. Negative RAST values obtained from these volunteers were 1653 ± 254(SD) cpm (lidocaine), 2750 ± 264cpm (procaine), and 2805 ± 336cpm (methyl paraben).(Kokubu M, Oda K, Shinya N: Radioallergosorbent test (RAST) for specific IgE antibody to lidocaine, procaine and methylparaben. J Anesth 3: 74–79, 1989)     

Dependence of the anterior olfactory area self-stimulation upon the lateral hypothalamic area

The functional relation between the anterior olfactory area (AO) and the lateral hypothalamic area (LH) was examined in a self-stimulation situation. Bar-pressing responses for AO sitmulation were suppressed by unilateral injection of procaine, and enhanced by glutamate, into LH. Neither procaine nor glutamate injected into AO had any influence upon LH self-stimulation. It is unlikely that the procaine effect was due to motor disturbance because similar injection of procaine into LH did not disturb the performance of a one-way avoidance task. It appears that the rewarding effect of AO stimulation is dependent upon the excitation of the more caudal structures including LH.     

Target sites for the inhibition of prostacyclin effect in guinea-pig ileum

Summary In the guinea-pig terminal ileum a maximally effective concentration of prostacyclin (PGI₂) (1 ol/l) induced contractions that were partially resistant to tetrodotoxin (TTX) 0.1 mol/l, to low temperature (20°C) and to atropine (30 nmol/l). Half maximum contractions evoked by PGI₂ (20 nmol/l) were abolished by TTX and by low temperature, which did not modify the response to exogenous acetylcholine (ACh), as well as by atropine. Procaine (5–500 ol/l) caused a concentration-dependent inhibition of contractions induced by PGI₂ (20 nmol/l and 1 mol/l) and by equieffective concentrations of ACh (20 nmol/l and 0.4 ol/l, respectively). The order of magnitude for this inhibition was ACh 20 nmol/l = PGI₂ 20 nmol/l > PGI₂1 mol/l > ACh 0.4 mol/l. In preparations exposed to TTX or to low temperature procaine (50 mol/l) did not affect the residual response to PGI₂ (1 mol/l). Quercetin (1 and 5 ol/l) inhibited the effect of PGI₂ and, at higher concentrations, it also caused partial depression of the responses to ACh. Quercetin did not alter TTX-resistant and low temperature-resistant contractions induced by PGI₂ 1 mol/l. Carbonyl cyanide-trifluoromethoxyphenyl hydrazone (FCCP) (0.1–1 ol/l) reduced the effect of PGI₂ and of ACh to approximately the same extent and inhibited the residual response to PGI₂ 1 mol/l in preparations treated with TTX or expressed to low temperature. The present results show that PGI₂, besides acting on cholinergic neurons, also exerts a direct effect on smooth muscle cells and FCCP can be used to block this effect. In contrast procaine and quercetin selectively inhibit the ACh-mediated component of PGI₂ action. Send offprint requests to R. M. Gaion     

The role of descending inhibition in the antinociceptive effects of the pyrazolone derivatives,metamizol (dipyrone) and aminophenazone (“Pyramidon”)

Summary The study was carried out to provide further evidence that the two pyrazolone derivatives, metamizol and aminophenazone, produce central antinociceptive effects by stimulating inhibition descending from the periaqueductal grey (PAG) to the spinal cord. Experiments were carried out on rats in which the tail-flick response to radiant heat, nociceptive activity in ascending axons of the spinal cord, and activity of neurones in the PAG and the substantia nigra were studied. Microinjection of procaine (10 g) into the PAG reduced the tail-flick latency and abolished the increase in latency caused by i.p. injection of metamizol (40 mg/kg) and aminophenazone (150 mg/kg); it did not significantly reduce the antinociceptive effect of i.p. injection of morphine (2 mg/kg). Threshold doses of morphine (1 and 2 g) administered by intrathecal (i.t.) injection potentiated the effect of threshold doses of metamizol injected i.p. (10 mg/ kg) or into the PAG (10 g) in the tail-flick test. Morphine (2 g) injected i.t. potentiated the effect of i.v. injection of metamizol (80 mg/kg) on nociceptive activity in ascending axons by eliminating the stimulant effect of metamizol on about one third of the axons. Threshold doses of morphine injected i.t. failed to potentiate the antinociceptive effect of aminophenazone (50 mg/kg) injected i.p. in the tail-flick test. The results support the view that metamizol and aminophenazone activate pathways descending from the PAG and exerting an inhibitory effect on nociceptive impulse transmission at the spinal level.Supported by the Schwerpunkt Nociception and Schmerz of the Deutsche Forschungsgemeinschaft Send offprint requests to I. Jurna at the above address     

Analytical studies on illicit heroin

The recovery of heroin in fumes was investigated. In the Netherlands the common mode of heroin smoking is the chasing the dragon procedure: heroin is heated on an aluminium foil by a lighter and the fumes are inhaled. The efficiency of the volatilization of heroin using this procedure was studied under laboratory conditions using thin layer chromatography, gas chromatography and high pressure liquid chromatography. A considerable influence of the form (salt or base) of the heroin was found as well as strong influences of other substances that may be present in illicit heroin samples as diluents. The danger of the inhalation of fumes containing unknown pyrolysis products is mentioned and a hypothesis is given for the phenomenon of heroin-leucoencephalopathy that was observed in heroin smokers in Amsterdam in 1981. The types of heroin encountered in the Netherlands are discussed with regard to their suitability for smoking.     

Inhibitory effects of procaine on the contractile responses of the guinea-pig Taenia caecum to acetylcholine,substance P and potassium chloride

Summary The effect of procaine on the contractile responses to acetylcholine, substance P and KCl was investigated using the isolated guinea-pig taenia caecum. In normal Tyrode solution (37°C), procaine (10–100 mol/l) caused a parallel shift to the right of only the dose-response curve of acetylcholine (pA₂ value, 5.11). The pA₂ value of procaine against acetylcholine was not significantly affected by increasing the Ca concentration in the bathing solution from 0.9 to 7.2 mmol/l. On the other hand, a high concentration of procaine (10 mmol/l) caused a transient contraction of the taenia caecum, but completely suppressed contractions to all concentrations of the agonists. In K-depolarized preparations, procaine (1–10 mmol/l) shifted the dose-response curve for the CaCl₂-induced contraction to the right. Substance P (3 mol/l)-induced contraction of the taenia caecum incubated with Ca-free EGTA (0.1 mmol/l) solution (20°C) was markedly reduced by procaine (10 mmol/l). Using the single sucrose-gap technique, it was found that procaine (10 mmol/l) produced a membrane depolarization and increases in both amplitude and frequency of spontaneous spike discharge. These potential changes were still observed even after the procaine-induced contraction had disappeared. The spike discharges and contraction caused by procaine were abolished in the presence of a Ca-entry blocker, verapamil (10 mol/l). From these observations, it is concluded that at low concentrations procaine acts as a competitive antagonist of muscarinic receptors in the guinea-pig taenia caecum while high concentrations of procaine may depress the contractile responses to acetylcholine, substance P and KCl by inhibiting the Ca-induced Ca release from the intracellular store site or by reducing the transmembrane Ca influx during depolarization.