硬膜外阻滞时罗哌卡因和布比卡因的药代动力学

目的 研究国人在硬腊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，分别注产哌卡因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＝时曲线均会合二室开放模型。ｔ１／２ｋａ分别为０．２２小时和０．１４小时，Ｔ分别为０．５１和０．４７小时，Ｃａｍｘ分别１．０６ｍｇ．／ｋｇ．Ｌ＾１和１．４４ｍｇ．Ｌ＾

Hemodynamics and stress response changes during laparoscopic cholecystectomy under general anesthesia or combination of general and epidural anesthesia

Objective To observe the hemodynamic and concentration of plasma catecholamines changes during laparoscopic cholecystectomy (LC) under general anesthesia or combined with epidural anesthesia Methods Twenty patients,scheduled for LC,were randomly divided into general anesthesia group (A group,n=11) and general anesthesia combined with epidural anesthesia group (B group,n=9) The hemodynamic changes after peritoneal insufflation of CO 2 were measured with Swan Ganz catheterization,and the plasma concentration of epinepherine (E) and nonepinepherine (NE) were measured before and after CO 2 being insufflated into peritoneal cavity with high performance liquid chromatography electrochemical method Results (1) Both concentraitons of NE and E were increased significantly after peritoneal insufflation in A group (P<0 05),while no obvious changes in B group (P>0 05) (2)HR,MAP,CVP,SVR and CI were increased significantly while SV had no obvious change after peritoneal insufflation in A group; in B group, all parameters had no significant changes except CVP was significantly increased Conclusion The combination of general and epidural anesthesia can suppress the stress response and stablize the hemodynamics during LC