Serum concentrations of local anaesthetics following intraperitoneal administration during laparoscopy

Summary The present study is a comparison of the pharmacokinetics of four local anaesthetics injected double blind in the right subdiaphragmatic area during outpatient laparoscopy performed under standard general anaesthesia in 28 young women. 80 ml of one of the following solutions was injected: Group A 0.5% plain lidocaine (n=7), Group B 0.5% lidocaine with 1/320.000 adrenaline (n=8), Group C 0.5% lidocaine with 1/800.000 adrenaline (n=7), and Group D 0.125% bupivacaine with 1/800.000 adrenaline (n=6). Blood samples were collected over 360 min from an iv catheter and serum concentrations were measured by gas chromatography.No adverse effects occurred in the study period. In Group A (plain lidocaine), C_max was significantly higher and t_max significantly earlier than in Groups B and C (lidocaine with adrenaline). A toxic level was not found after either solution in any patient.The intraperitoneal use of doses of 400 mg lidocaine or 100 mg bupivacaine for perioperative analgesia was safe and solutions of lidocaine containing adrenaline appeared to pose even less risk than plain solutions.Presented in part at the Annual Meeting of the American Society of Anesthesiologists, Las Vegas, October 1990     

Determination of local anaesthetics and their impurities in pharmaceutical preparations using HPLC method with amperometric detection

A method for the determination of local anaesthetics and their impurities – 2,6-dimethylaniline and o-toluidine – by high-performance liquid chromatographic method with amperometric detection has been developed. The analysis was performed in an isocratic mode on a reversed phase Luna column 5 μm C-18 (100 mm × 4.6 mm). A mobile phase [0.01 mol l⁻¹ Tris buffer of pH 7.9:acetonitrile (45:55)] was selected for the separation and determination of studied anaesthetics and their impurities. Chromatograms were recorded for 500 s by means of an amperometric detector at a potential of +1.0 V of the glassy carbon electrode versus the reference electrode Ag/AgCl. The proposed liquid chromatographic method was successfully applied to the analysis of commercially available pharmaceutical preparations. The limit of the detection for 2,6-dimethylaniline and o-toluidine was 0.8 ng ml⁻¹. The limit of qantitation, considering a signal to noise ratio was 1.5 ng ml⁻¹. The method developed in this study is sensitive and selective and can be applied to routine studies of pharmaceuticals in the form of cream and injection.     

Cardiotoxic local anesthetics increasingly interact with biomimetic membranes under ischemia-like acidic conditions

The cardiotoxic effects of local anesthetics increase in cardiac ischemia which is characterized by the tissue pH lowering to 6.5 or less. Apart from the cardiac channel blockade, the membrane interaction has been referred to as another mode of their cardiotoxic action. By using biomimetic membranes, we verified the hypothesis that bupivacaine and lidocaine may increasingly interact with cardiac mitochondrial membranes under ischemia-like acidic conditions. Biomimetic membranes were prepared with different phospholipids and cholesterol to be unilamellar vesicles suspended in buffers of pH 7.4, 6.9, 6.4 or 5.9. Bupivacaine and lidocaine were reacted with the membrane preparations at cardiotoxically relevant concentrations and their membrane interactivities were determined by measuring fluorescence polarization. Both drugs interacted with 100 mol% 1,2-dipalmitoylphosphatidylcholine, peripheral nerve cell-mimetic and cardiomyocyte-mimetic membranes to increase membrane fluidity, although lowering the reaction pH from 7.4 to 5.9 decreased their membrane-fluidizing effects. In cardiomyocyte mitochondria-mimetic membranes containing 20 mol% cardiolipin, however, bupivacaine and lidocaine reversely increased their membrane interactivities at pH 5.9-6.4 compared with pH 7.4. Such increases were greater in anionic phospholipid membranes which consisted of substantial amounts of cardiolipin and phosphatidylserine. Positively charged bupivacaine and lidocaine would form ion-pairs with the negatively charged head-groups of anionic phospholipids under acidic conditions, thereby increasing the induced membrane fluidization. The mitochondrial membrane interactions depending on pH lowering may be, at least in part, responsible for local anesthetic cardiotoxicity enhanced in acidosis associated with cardiac ischemia.     

Solid-state characterization of non-stoichiometric hydrates of ester-type local anaesthetics. Part XI. Crystal polymorphism of local anaesthetic drugs

Three structurally closely related local anaesthetic drugs, hydroxyprocaine hydrochloride (4-butylamino-2-hydroxybenzoic acid 2-dimethylaminoethyl ester hydrochloride, HPCHC), tetracaine hydrochloride (4-butylamino-2-hydroxybenzoic acid 2-dimethylaminoethyl ester hydrochloride, TCHC) and hydroxytetracaine hydrochloride (4-butylamino-2-hydroxybenzoic acid 2-dimethylaminoethyl ester hydrochloride, SLCHC) are found to form hydrated crystals. Those were characterized by thermal analysis (hot stage microscopy, differential scanning calorimetry, thermogravimetry), vibrational spectroscopic methods (FTIR-, FT-Raman-spectroscopy), powder X-ray diffractometry, solid-state NMR and water sorption/desorption analysis. The formation and the stability of the hydrated solid phases are evaluated by sorption isotherms derived from different sorption/desorption analytic methods. The three substances investigated show conformational polymorphism with the anhydrated phases including a high temperature form mod. I, which is highly hygroscopic and isostructural with the hydrate. The hydrated form is present in commercial products at various contents. These hemihydrates crystallize from water, whereas the anhydrates crystallize from all other tested organic solvents. Different methods of water sorption/desorption analysis indicate the formation of non-stoichiometric hydrates. Different methods of drying lead to the same results. Solid-state NMR spectra were used to obtain both structural and molecular level mobility information.     

河豚毒素与局麻药联合应用对家兔齿髓刺激所致疼痛的对抗作用

河豚毒素(tetrodotoxin，TTX)是一种毒性极高的非蛋白神经毒素。具有很强的局麻作用。其效力比目前常用局麻药强万倍以上。持续时间长。将TTX与常用局麻药联合应用于齿髓镇痛。国内外文献尚未报道。我们设想将极微量TTX与常用局麻药利多卡因、丁卡因联合给药，通过齿髓刺激试验，测定其局部镇痛作用，观察是否具有协同或增强局麻效果，以探讨TTX作为协同局麻药应用于临床的可能。     

Effects on atrio-ventricular conduction of calcium-antagonistic coronary vasodilators,local anaesthetics and quinidine injected into the posterior and the anterior septal artery of the atrio-ventricular node preparation of the dog

Summary The effects on atrio-ventricular (A-V) conduction and blood flow of calcium-antagonists (verapamil, nifedipine and diltiazem), local anaesthetics (procaine and lidocaine) and quinidine were investigated in the isolated, cross-circulated A-V node preparation of the dog. The drugs were injected individually into the posterior septal artery (PSA) through which the upper part of the A-V node is mainly perfused or into the anterior septal artery (ASA) through which the lower part of the node and the more distal conduction system are perfused. Single injections into the PSA of nifedipine (0.3–10 g), verapamil (1–30 g), diltiazem (1–30 g), quinidine (30–300 g), lidocaine (100 g–1 mg) and procaine (300 g–3 mg) produced a dose-related increase in the A-V conduction time and with higher doses of these drugs a second or third degree block of A-V conduction occurred. Nifedipine (0.3–30 g) and verapamil (1–100 g) injected into the ASA scarcely affected A-V conduction. Quinidine (30 g–1 mg) and lidocaine (100 g–3 mg) injected into the ASA prolonged the A-V conduction time in a dose-related manner, although the effects were less prominent than those produced upon injection into the PSA. High doses of quinidine (3 mg) and lidocaine (3–10 mg) injected into the ASA altered the shape of ventricular bipolar electrograms and prolonged the time interval between an electrogram of the right bundle branch and that of the ventricle. The results are consistent with the hypothesis that in excitation of A-V nodal cells a slow calcium current rather than a fast sodium current plays an important role and that in the His-Purkinje-ventricular system the fast sodium current is predominant. Single injections of the 6 drugs into the PSA produced a doserelated increase in blood flow through the PSA. All drugs but nifedipine increased the blood flow in almost the same dose range that caused impairment of A-V conduction. Nifedipine was 10 times more potent in increasing the blood flow than in impairing A-V conduction.     

Interaction of glucagon with artificial lipid bilayer membranes

The enhancement of fluorescence emission from the tryptophan residue of glucagon, the quenching of that emission with acrylamide and with 5-doxyl and 16-doxyl stearic acid, circular dichroism spectra, the release of 6-carboxytluorescein, and polarized infrared attenuated total reflection (IR-ATR) spectra were used to study the interaction of glucagon with intact lipid vesicles and flat bilayers. Dimyristoylphosphatidylcholine bound the peptide only below the main transition temperature, thus confirming earlier results of Epand et al. (1977). However, the peptide is also bound by vesicles of unsaturated lipids above their transition temperature, suggesting an influence of lipid area on the binding process. Circular dichroism showed that binding to such vesicles also increases the helix content of glucagon. The IR-ATR study and a comparison with dynorphin-A-(I-13)-tridecapeptide revealed profound differences in orientation of the two peptides. The dichroic ratios and the derived order parameters indicated an isotropic orientation of the helical segments of glucagon, but did not exclude a principal orientation of the molecules lying flat on the nienibrane surface. In contrast, the axis of the dynorphin helix is clearly oriented normal to the interface. The two peptides also differ in their rates of 6-carboxyfluorescein release, suggesting a deeper penetration of the primary amphiphilic helix of dynorphin A-(I-13) than of the secondary amphiphilic helix of glucagon.     

Measurement of the affinity of melittin for zwitterionic and anionic membranes using immobilized lipid biosensors

Abstract: The binding of melittin to zwitterionic dimyristyphosphatidylcholine (DMPC) and anionic dimyristylphosphatidylglycerol (DMPG) was analysed using two different immobilized model membrane systems. The first system used surface plasmon resonance (SPR), which monitors the real‐time binding of peptides to an immobilized hybrid bilayer. SPR experiments reflected a stronger binding of melittin for DMPG than for DMPC, while kinetic analysis suggested the existence of at least two distinct binding steps. The second lipid biosensor system involved an immobilized phospholipid monolayer covalently attached to a microporous silica surface. The binding of melittin to the immobilized monolayer was then monitored using dynamic elution chromatography with varied methanol concentrations to analyse the binding of melittin to DMPC and DMPG. The nonlinear binding behaviour observed for melittin with the phosphatidylcholine (PC) and phosphatidylglycerol (PG) monolayers compared with the linear retention plots and Gaussian peak shapes observed for the control molecule demonstrated that melittin undergoes significant conformational and orientational changes upon binding to the immobilized PC and PG ligands. The dependence of log k′ on per cent methanol also demonstrated a bimodal interaction whereby hydrophobic forces predominated at higher temperatures and methanol concentrations, while other forces, presumably electrostatic in nature, also made a contribution to the affinity of the peptides for the lipid monolayer, particularly at lower temperatures. The complementary use of these two lipid biosensors thus allows the role of hydrophobic and electrostatic forces in peptide–membrane interactions to be studied.     

Interaction of local anaesthetics with model phospholipid membranes. The effect of pH and phospholipid composition studied by quenching of an intramembrane fluorescent probe

The interaction of local anaesthetics, tetracaine and procaine, with model phospholipid membranes has been examined by measurement of drug-induced quenching of the fluorescence of a membrane incorporated probe, 12-(9-anthroyl)stearic acid. The pH dependence of quenching curves obtained for neutral phosphatidylcholine and acidic phosphatidylserine bilayers indicates that, contrary to previous suggestions, both charged and uncharged forms of amine local anaesthetics may be incorporated into lipid membranes.     

镉与离体大鼠肾微粒体膜的相互作用

本文利用荧光探剂ANS研究了Cd~(2+)与大鼠肾微粒体膜的相互作用。结果发现,Cd~(2+)能明显增加与膜结合的ANS荧光强度和荧光偏振度。用ANS荧光滴定法研究证实Cd~(2+)能降低膜ANS复合物的表观解离常数(Kd)和增加膜上ANS的结合位点数(n)。上述结果提示,Cd~(2+)能降低大鼠肾微粒体膜流动性和膜表面负电荷密度。     

聚乙二醇修饰的羟基喜树碱纳米脂质载体的制备及其小鼠组织分布

本研究采用熔融乳化-高压均质法制备了聚乙二醇(PEG)修饰的羟基喜树碱(HCPT)纳米脂质载体(HCPT-PEG-NLC)及非修饰的羟基喜树碱纳米脂质载体(HCPT-NLC)，并考察了其形态、粒径及包封率。测定了HCPT注射液、HCPT-PEG-NLC及HCPT-NLC 3种制剂经小鼠尾静脉注射后在血浆、心、肝、脾、肺、肾及卵巢等主要组织的浓度，评价了HCPT-PEG-NLC及HCPT-NLC在各组织的靶向性效果。透射电镜下观察，HCPT-PEG-NLC及HCPT-NLC呈球形；测得平均粒径分别为(88.6±22.5)和(127.2±43.4)nm；包封率分别为(90.51±3.29)%和(84.37±2.81)%。经小鼠尾静脉注射后，HCPT-PEG-NLC及HCPT-NLC在多数取样时间点的血药浓度较HCPT注射液有所提高，HCPT在各组织中的消除半衰期明显延长。HCPT-NLC蓄集于网状内皮系统(RES)，在肝、脾的相对摄取率(R_e)和峰浓度比(C_e)明显高于HCPT-PEG-NLC。HCPT-PEG-NLC延长了药物在血浆中的滞留时间，提高了生物利用度，MRT及AUC_{0-24 h}分别为注射液的19.80和17.02倍，并且与HCPT-NLC比较显著降低了RES的吞噬作用，在肺部表现出明显的靶向作用(R_e及C_e分别为14.51，41.35)。综上，HCPT-PEG-NLC可延长HCPT的体内循环时间，呈现明显的肺靶向性，有望作为HCPT肺癌治疗的理想载体。     

罗哌卡因复合利多卡因在椎间孔镜局麻手术中的疗效分析

目的探讨罗哌卡因复合利多卡因在椎间孔镜局部麻醉(局麻)手术中的麻醉镇痛疗效。方法 40例L4~5腰椎间盘突出症患者,按随机方法分为观察组与对照组,各20例。观察组采用罗哌卡因复合利多卡因进行局麻,对照组采用利多卡因进行局麻。两组患者均采取椎间孔镜下椎间孔入路行椎间盘摘除、神经减压松解术。对比两组患者术中穿刺、关节突成形、置入套管、镜下操作、术后首次起床、术后2 d的疼痛情况,不良反应发生情况,辅助强化使用情况。结果 40例患者手术均顺利完成,术中未出现手术并发症,术后腰腿疼痛症状得到明显缓解,患者睡眠质量得到明显改善。观察组患者关节突成形、术后首次起床时的视觉模拟评分法(VAS)评分分别为(3.70±0.86)、(1.10±0.55)分,均低于对照组的(4.86±1.36)、(2.05±0.76)分,差异均具有统计学意义(P<0.05);两组患者术中穿刺、置入套管、镜下操作、术后2 d时的VAS评分比较,差异均无统计学意义(P>0.05)。观察组不良反应发生率为5.00%,与对照组的20.00%比较,差异无统计学意义(P>0.05)。观察组患者术中麻醉辅助强化使用率为15.00%(3/20),低于与对照组的45.00%(9/20),差异具有统计学意义(χ~2=4.286, P=0.038<0.05)。结论罗哌卡因在椎间孔镜手术复合局部麻醉中的镇痛效果确切,是一种安全有效的麻醉方式。     

右美托咪定联合氟比洛芬酯用于局麻下甲状腺切除术患者的临床观察

目的 观察右美托咪定（Dexmedetomidine,DEX）联合氟比洛芬酯（Flurbiprofen axetil,FA）用于局麻下甲状腺部分切除术患者辅助镇静镇痛的安全性和有效性.方法 选择局部浸润麻醉下甲状腺部分切除术成年患者60例,ASA分级为Ⅰ或Ⅱ级,随机分为2组,每组30例.DF组患者在开通静脉通路后FA 50 mg经静脉滴注,之后DEX负荷量1μg/（kg·min） 10 min泵入,后改为0.5μg/（kg·h）泵注维持;D组患者在开通静脉通路后DEX负荷量1μug/（kg·min）10 min泵入,后改为0.5 μg/（kg·h）泵注维持.记录患者入室开通静脉通路10 min基础值（T0）、DEX负荷量泵入10 min时（T1）、术区局麻时（T2）、切皮时（T3）、甲状腺部分切除时（T4）和缝皮时（T5）的收缩压（SBP）、舒张压（DBP）、心率（HR）、呼吸频率（RR）、脉搏血氧饱和度（SpO2）,以及VAS评分、Ramsay评分、OAA/S评分和术后并发症等情况.结果 术中DF组多时间点SBP、HR较D组同期值低（P＜0.05）,DBP、RR和SpO2组间比较差异无统计学意义（P＞0.05）.术中VAS、Ramsay评分DF组优于D组（P＜0.05）;而OAA/S评分与D组比较差异无统计学意义（P＞0.05）.术后VAS、Ramsay评分DF组优于D组（P＜0.05）;DF组满意度优秀率高于D组（P＜0.05）.结论 DEX联合FA用于局麻下甲状腺部分切除术,患者生命体征平稳,能辅助提供良好的术中镇静、镇痛效果,FA术后仍然具有镇痛效应,未见明显不良反应,DEX联合FA用于局麻下甲状腺部分切除术患者辅助镇静镇痛安全、有效.     

肝移植术后患者环孢素A药物动力学与红细胞膜脂流动性的动态观察

目的探讨肝移植术后患者细胞膜脂流动性与环孢素A(CsA)药物动力学相关性,减少药物引起的不良反应.方法采用FPLA法测定CsA全血药物浓度,DPH荧光探针法测定红细胞膜脂流动性.结果红细胞膜脂流动性的动态改变与血中CsA药物浓度的变化呈负相关.结论CsA可使细胞膜脂流动性降低,长期低水平的膜脂流动性是导致肝损害的病理学基础.     

Potential impact of inorganic nanoparticles on macronutrient digestion: titanium dioxide nanoparticles slightly reduce lipid digestion under simulated gastrointestinal conditions

Titanium dioxide (TiO₂) particles are used in some food products to alter their optical properties, such as whiteness or brightness. These additives typically contain a population of TiO₂ nanoparticles (d?2 particles on the gastrointestinal fate of oil-in-water emulsions using a simulated gastrointestinal tract (GIT) that includes mouth, stomach, and small intestine phases. Theoretical predictions suggested that TiO₂ nanoparticles might inhibit lipid digestion through two physicochemical mechanisms: (i) a fraction of the lipase adsorbs to TiO₂ particle surfaces, thereby reducing the amount available to hydrolyze lipid droplets; (ii) some TiO₂ particles adsorb to the surfaces of lipid droplets, thereby reducing the lipid surface area exposed to lipase. The importance of these mechanisms was tested by passing protein-coated lipid droplets (2%, w/w) through the simulated GIT in the absence and presence of TiO₂ (0.5%, w/w) nanoparticles (18?nm) and fine particles (167?nm). Changes in particle characteristics (size, organization, and charge) and lipid digestion were then measured. Both TiO₂ nanoparticles and fine particles had little impact on the aggregation state and charge of the lipid droplets in the different GIT regions, as well as on the rate and extent of lipid digestion. This suggests that the theoretically predicted impact of particle size on lipid digestion was not seen in practice.     

局麻下普理灵疝装置修补45例老年患者腹股沟疝临床效果分析

目的：总结局麻下应用普理灵疝装置（PHs）治疗老年腹股沟疝的效果。方法：应用1％利多卡因进行腹股沟区浸润阻滞麻醉，对45例老年（〉65岁）腹股沟疝行PHS开放式无张力疝修补术。结果：45例均治愈，平均手术ININ46min，平均住院5d。术后出现尿潴留5例，阴囊积液1例，无术后切口及深部感染、慢性疼痛、睾丸萎缩等并发症发生。随访5～24个月（平均12个月）无复发，无明显异物感。结论：局麻下应用PHS治疗老年腹股沟疝简单、安全、可靠。     

Hyaluronidase inhibitors (sodium cromoglycate and sodium auro-thiomalate) reduce the local tissue damage and prolong the survival time of mice injected with Naja kaouthia and Calloselasma rhodostoma venoms.

Experiments have been carried out to find potent inhibitors of hyaluronidases of Naja kaouthia (NK) and Calloselasma rhodostoma (CR) venoms with the aim of reducing local tissue damage and systemic toxicities caused by the venoms. Seven drugs/chemicals known to inhibit hyaluronidases were tested for their activity on venom enzymes. These were: sodium cromoglycate (SC), sodium aurothiomalate (SAT), apigenin, kaemferol, phenylbutazone, oxyphenbutazone and fenoprofen. The results showed that SC or SAT at 10 mM, completely inhibited the enzymes of both venoms. In in vivo experiments, SC or SAT, when incubated with NK venom prior to injection, significantly reduced edema and myonecrosis. In the case of CR venom, hemorrhage, in addition to edema and myonecrosis, was also significantly reduced. In the independent type experiment, SC or SAT were effective if injected within 1 min after the injection of venom. At longer time intervals of 3 and 10 min the inhibitors were effective in reducing some parameters of local tissue necrosis but the extent of inhibition was lower. SC and SAT at 256 and 195 microg/mouse, respectively, significantly prolonged the survival time of mice receiving lethal doses of NK. In the case of CR venoms, the two inhibitors not only prolonged the survival time but also prevented death of mice receiving lethal doses of the venom. The other inhibitors were poorly soluble in water and were studied only on enzyme inhibition and prolongation of survival time; they were mostly ineffective. Thus, SC and SAT when injected immediately at the sites of bites can reduce the systemic and local toxicity of NK and CR venoms. These results suggest that administration of these drugs at the site of venom injection may be useful in reducing venom-induced local tissue damage.     

阿托伐他汀对血脂水平正常的急性冠状动脉综合征患者早期炎症因子的影响

目的:观察正常血脂水平的急性冠状动脉综合征(ACS)患者早期白介素-6(IL-6)和高效C反应蛋白(hs-CRP)水平变化及阿托伐他汀早期治疗对其干预效果。方法:将血脂水平正常的ACS患者随机分为阿托伐他汀治疗组(20 mg/d×4周)和常规治疗对照组(各40例),另选择同期健康对照者40例作为健康对照组。分析比较组间及两组ACS患者治疗前后血清IL-6和hs-CRP水平变化。结果:两组ACS患者血脂水平与健康对照组比较差异无显著性,但其IL-6和hs-CRP水平均显著高于健康对照组(P<0.01);阿托伐他汀治疗2周时血脂水平无显著变化,但IL-6和hs-CRP水平显著降低(P<0.01),治疗4周时血清总胆固醇和低密度脂蛋白胆固醇及IL-6、hs-CRP水平均显著降低(P<0.05,P<0.01),且显著低于常规对照组(P<0.05)。结论:血脂水平正常的ACS患者同样存在明显的炎症反应,阿托伐他汀具有独立于调脂的抗炎作用,其快速抗炎作用在ACS患者早期治疗中可能具有重要意义。     

Interaction of phenylbutazone with racemic phenprocoumon and its enantiomers in rats

The interaction of phenylbutazone with the enantiomers and racemic [ ³ H]phenprocoumon was studied in male inbred Wistar-Lewis rats following a single i.v. dose of the three forms of phenprocoumon and chronic oral treatment with phenylbutazone (average plasma concentration of about 60 g/ml). Phenylbutazone augmented the anticoagulant effect of R(+), S(–), and R, S (±) phenprocoumon to a similar extent. The free fraction of drug in the plasma of the enantiomers and racemic phenprocoumon increased in the presence of phenylbutazone. However, the rate of elimination of total drug from plasma and liver and the distribution between liver and plasma of all three forms of phenprocoumon remained nearly unaffected by phenylbutazone. Thus there is no evidence for a stereoselective drug interaction between phenprocoumon and phenyl-butazone. For racemic [ ³ H]phenprocoumon it was possible to follow the kinetics of free drug in plasma and liver along with the time course of anticoagulant activity. In these studies, free drug concentrations in plasma and liver increased during treatment with phenylbutazone, but the elimination rate constant of free racemic phenprocoumon in plasma and liver remained essentially unchanged. Phenylbutazone markedly decreased the volume of distribution referenced to free drug and the clearance of free phenprocoumon (i.e., intrinsic metabolic clearance). Whereas the total (bound and unbound) drug concentration-effect relationship in plasma and liver was shifted to the left in rats treated with phenylbutazone, such shift was not seen in the free drug concentration-response relationship. In conclusion, the increase in the free concentration of phenprocoumon in plasma and liver and the concomitant decrease in the clearance of free drug are the mechanisms responsible for the marked and sustained enhancement of the anticoagulant effect which follows treatment with phenbutazone.This work was supported by the Deutsche Forschungsgemeinschaft.     

局麻下无张力疝修补术368侵临床观察及并发症分析

目的分析局麻下无张力疝修补术疗效及相关并发症发生的原因。方法回顾性分析2006年1月～2012年6月在本科进行该项手术的368例患者的临床资料。结果349例患者术后痊愈。19例患者出现术后并发症,其中术中血压降低、心律减慢1例,术后尿潴留1例,术后局部疼痛5例,术后切口感染2例,阴囊水肿、血肿3例,均经对症治疗后好转;复发7例,再次行无张力疝修补术后治愈。结论局麻下行无张力疝修补术可获得良好的术后疗效,但仍应注意并发症的发生。平时认真学习相关的局部解剖知识,术中进行严格手术标准操作及术后采取正确的治疗方法是防治无张力疝修补术后并发症发生的关键。