预测布皮瓦卡因和罗皮瓦卡因在树干导管中减少剂量的比较方法
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Brittani Bungart1, Lana Joudeh1, Eric S Schwenk2
1Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts; and Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts.
Anesthesiology
|February 5, 2025
概括
罗皮瓦卡因和布皮瓦卡因的临床再剂量与最慢的药理动力学消除率一致. 这项研究为这些局部麻醉剂的安全再剂量实践提供了证据,确保了患者的安全和有效的疼痛管理.
科学领域:
- 麻醉学 麻醉学
- 药理动力学 药理动力学
- 临床药理学 临床药理学
背景情况:
- 在初始玻尿酸注射后,对于重新注射罗皮瓦卡因和布皮瓦卡因存在有限的指导.
- 间歇性重新剂量在神经导管设置中很常见,通常涉及大量剂量.
- 药理动力学研究提供了理论消除率和药物体总含量的估计.
研究的目的:
- 评估布皮瓦卡因和罗皮瓦卡因的临床再剂量实践是否与已确定的药理动力学消除率保持一致.
- 提供基于证据的建议,以安全地重新剂量这些局部麻醉剂.
主要方法:
- 从已发表的关于横腹部平面和准脊椎块的文献中确定了布皮瓦卡因和罗皮瓦卡因的临床再剂量数据.
- 使用最小平方回归,将剂量数据与指数曲线 (Y = YM - (YM - Y0) * e^-k*x) 相匹配.
- 临床再剂量消除常数 (k) 与人类研究中最小和平均的药理动力学消除常数进行比较.
主要成果:
- 布皮瓦卡因的最大制药动力学半衰期为603分钟,罗皮瓦卡因为528分钟.
- 布皮瓦卡因的临床再剂量 (k=0.077h-1) 与最小的药理动力学消除常数的第53.5百分位相对应.
- 罗皮瓦卡因的临床再剂量 (k=0.083h-1) 与最小的药理动力学消除常数的第52百分位相对应.
结论:
- 已发表的布皮瓦卡因和罗皮瓦卡因临床再剂量方案反映了人类研究中观察到的最慢的药理动力学消除率.
- 在分析的数据中没有报告的毒性,支持这些再剂量实践的安全性.
- 这项研究可以为安全的布皮瓦卡因和罗皮瓦卡因再剂量提供实际建议.
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