左旋布比卡因与罗哌卡因在产科麻醉中的效果比较

目的观察左旋布比卡因在剖宫产手术中的应用效果,并与相同剂量罗哌卡因比较。方法选择ASAIl级,剖宫产手术病人60例行硬膜外阻滞,随机分成两组,0.75%左旋布比卡因组(L组)和0.75%罗哌卡因组(R组),每组30例,L组给予0.75%左旋布比卡因10mL,R组给予0.75%罗哌卡因10mL,观察各组感觉阻滞起效时间、感觉阻滞上界、运动阻滞程度、麻醉满意度、肌松满意度、不良反应及并发症等。结果感觉阻滞起效时间、感觉阻滞上界、运动阻滞程度、麻醉满意度两组间差异无统计学意义(P>0.05),肌松效果L组优于R组。结论左旋布比卡因和罗哌卡因均可用于剖宫产手术并可提供良好的麻醉效果,同等浓度的左旋布比卡因肌松效果优于罗哌卡因。     

罗哌卡因芬太尼在无痛分娩应用的临床效果观察

目的探讨甲磺酸罗哌卡因注射液(以下简称罗哌卡因)联合舒芬太尼注射液(以下简称芬太尼)在无痛分娩应用的临床效果。方法选择我院愿意接受无痛分娩初产妇的90例为研究组,选择自然分娩的初产妇90例作为对照组,研究组采用硬膜外穿刺麻醉。比较2组产妇生产过程中基本生理指标以及宫缩和胎心音、产程、分娩方式以及对新生儿的影响。结果采用甲磺酸罗哌卡因复合舒芬太尼硬膜外镇痛,能显著缩短活跃期,降低剖宫产率,对新生儿评分,产后出血无明显影响。结论甲磺酸罗哌卡因复合舒芬太尼硬膜外镇痛是对母婴影响小,易于给药,起效快,作用可靠,值得推广应用。     

左旋布比卡因与罗哌卡因用于妇科手术腰硬联合麻醉的比较

目的探讨左旋布比卡因与罗哌卡因在腰硬联合麻醉的妇科手术中的应用。方法选择ASAⅠ～Ⅱ级患者156例,其中应用左旋布比卡因行腰硬联合麻醉78例,为A组,应用罗哌卡因行腰硬联合麻醉78例,为B组。观察患者的感觉阻滞时间、术后运动神经恢复时间及Bromage评分。结果 2组在术后运动神经恢复时间及Bromage评分方面比较均具有显著差异性,具有统计学意义(P<0.05),在感觉阻滞时间方面不具有显著差异性,不具有统计学意义(P>0.05)。结论罗哌卡因与左旋布比卡因腰硬联合麻醉均可安全用于妇科手术,但左旋布比卡因效果较好。     

甲磺酸罗哌卡因在硬膜外术后镇痛中的疗效观察

目的 比较甲磺酸罗哌卡因与盐酸布比卡因在硬膜外术后镇痛中的效果及不良反应,初步探讨甲磺酸罗哌卡因的有效性及安全性. 方法择期妇产科手术100 例,随机分为两组,每组50 例(n=50),均采用连续硬膜外阻滞,术毕接镇痛泵(100mL/h,2m1/h).结果 两组病人VAS评分差异无统计学意义(P＞0.05).两组病人Bromage评分及不良反应发生丰差异有统计学意义(P＜0.05). 结论甲磺酸罗哌卡因疗效可靠,安全,是值得推广使用的术后硬膜外镇痛药.     

曲马多丙泊酚复合罗哌卡因臂丛阻滞在小儿上肢手术中的应用

目的突破小儿上肢手术传统上常采用氯胺酮静脉麻醉[1],探讨曲马多丙泊酚复合罗哌卡因臂丛阻滞在小儿上肢手术中的临床效果分析。方法对28例小儿上肢手术中采用曲马多丙泊酚复合罗哌卡因臂丛阻滞麻醉,术中对一系列经常性指标进行观测。结果术后各例均表现正常,无一例患儿出现情绪焦躁,深度睡眠等情况。结论臂丛神经阻滞麻醉复合曲马多丙泊酚复合罗哌卡因用于婴幼儿上肢手术具有镇静、镇痛效果好,呼吸、循环平稳,全麻苏醒迅速,麻醉并发症少等优点,是一种安全性高、可行性强的婴幼儿上肢手术的麻醉方法。     

2种麻醉方法对剖宫产新生儿Apgar评分的影响

目的通过剖宫产术对新生儿Apgar评分的分析,探讨七氟醚吸入麻醉与罗哌卡因腰-硬联合麻醉用于剖宫产术对胎儿安全性的影响。方法选2007年1月至2009年11月260例ASAⅠ或Ⅱ级、择期剖宫产的足月孕妇随机分为2组:七氟醚组吸入8%七氟醚加3L/min氧吸入诱导后,插入气管导管,维持麻醉至胎儿娩出;罗哌卡因腰-硬联合麻醉组L2～3穿刺,蛛网膜下腔给予0.5%罗哌卡因10～15mg,记录2组产妇的ECG、BP、SPO2等生命体征,记录给药至胎儿娩出的时间以及出生后即刻、5～10分、10分的Apgar评分。结果给药至胎儿娩出的时间2组均在5～10min。2组新生儿Apgar评分差异无统计学意义。七氟醚组有4例新生儿Apgar评分≤7分;罗哌卡因腰-硬联合麻醉组有5例,经吸氧简单处理10分Apgar评分2组均为10分。结论七氟醚吸入麻醉与罗哌卡因腰-硬联合麻醉均可安全用于剖宫产。     

甲磺酸罗哌卡因用于产科硬膜外术后镇痛的观察

目的甲磺酸罗哌卡因与临床常用的盐酸左布比卡因硬膜外术后镇痛效果观察作比较。方法择期足月单胎产妇60例,年龄21～32岁,ASAI～II级,所有患者均无呼吸循环系统,无椎管内麻醉禁忌证,均有术后镇痛的要求,随机均分两组,每组30例。结果两组患者年龄、身高、ASA分级,术中出血及尿量比差异无统计学意义。结论甲磺酸罗哌卡因术中对产妇运动神经阻滞轻,对子宫血流无明显影响,对新生儿有良好的耐受性。     

拆分法制L-2-哌啶酸

以dl-2-哌啶酸为原料通过拆分制得L-2-哌啶酸.用D-(-)-酒石酸与dl-2-哌啶酸成盐的化学法,结合选择吸附法和晶种结晶法制得纯度较高的单一异构体.制得L-2-哌啶酸总收率为70.8%,纯度为99.4%,可作为合成纯左旋体罗哌卡因的起始原料.化学成盐拆分法结合选择吸附法和晶种结晶法能制得高纯单一异构体.     

哈萨克族妊娠高血压疾病剖宫产麻醉临床观察

我区属边远贫困地区,且主要居住人口是以哈族为主,整体文化结构偏低,因此,相当一部分人群对围产保健知识缺乏,特别是公社、乡、林区的哈萨克族多数孕妇未接受过孕前、孕期保健检查。哈族饮食习惯同汉族差异很大,食物以肉食、面食为主,包括日常饮用的奶茶均加入大量的盐,蔬菜、水果摄入少,与妊娠高血压疾病发生率增高有一定关系。妊娠高血压疾病在本区是妊娠晚期常见的并发症,又因交通不便及本身的就医条件差,送往本院时常需急诊剖宫产结束分娩,挽救产妇及胎儿生命。给麻醉科增加风险。本科多年来,使用连续硬膜外麻醉,常用麻醉药甲磺酸罗哌卡因,国产甲磺酸罗哌卡因是将盐酸罗哌卡因的盐酸根改为甲磺酸根后,仅改变其理化性质而未改变其药理作用的新型酰胺类局麻药。其特点是对心脏和神经系统毒性低,影响循环小,对感觉与运动阻滞分离。由于与胎儿血浆蛋白结合程度低胎儿总血浆浓度也比母体低,尚无对胎儿新生儿有害的报道。对胎儿新生儿不易造成呼吸抑制及其它不良反应。现将其对哈萨克族妊娠高血压疾病产妇剖宫产麻醉情况报道如下。     

罗哌卡因腰-硬联合麻醉用于高龄患者下肢手术的临床观察

罗哌卡因是一种在化学结构、药理特性上与布比卡因相似的新型长效局麻药,具有中枢神经和心血管毒性低、感觉和运动分离的特性[1]。近年来,随着腰-硬联合麻醉(CSEA)技术的开展与应用,提高了临床手术的麻醉质量和安全性,大大减少了手术及麻醉并发症的产生。高龄手术患者常伴多种并发症,其麻醉方法的实施直接关系到手术的顺利与预后。     

Hyaluronic Acid as a Carrier Supports the Effects of Glucocorticoids and Diminishes the Cytotoxic Effects of Local Anesthetics in Human Articular Chondrocytes In Vitro

The current study aimed to investigate the cytotoxicity of co-administrating local anesthetics (LA) with glucocorticoids (GC) and hyaluronic acid (HA) in vitro. Human articular cartilage was obtained from five patients undergoing total knee arthroplasty. Chondrocytes were isolated, expanded, and seeded in 24-well plates for experimental testing. LA (lidocaine, bupivacaine, ropivacaine) were administered separately and co-administered with the following substances: GC, HA, and GC/HA. Viability was confirmed by microscopic images, flow cytometry, metabolic activity, and live/dead assay. The addition of HA and GC/HA resulted in enhanced attachment and branched appearance of the chondrocytes compared to LA and LA/GC. Metabolic activity was better in all LA co-administered with HA and GC/HA than with GC and only LA. Flow cytometry revealed the lowest cell viability in lidocaine and the highest cell viability in ropivacaine. This finding was also confirmed by live/dead assay. In conclusion, HA supports the effect of GC and reduces chondrotoxic effects of LA in vitro. Thereby, the co-administration of HA to LA and GC offers an alternative less chondrotoxic approach for treating patients with symptomatic osteoarthritis of the knee.     

超声辐射下合成盐酸罗哌卡因

在超声辐射下,以(S)-2-哌啶甲酸(Ⅱ)为原料,依次与氯化亚砜、2,6-二甲基苯胺反应制得(S)-N-(2,6-二甲基苯基)-2-哌啶甲酰胺(Ⅴ),而后,Ⅴ与溴丙烷发生N-丙基化反应,经盐酸成盐得到目标化合物手性纯的盐酸盐罗哌卡因(Ⅰ)。该文考察了超声辐射条件下反应溶剂、反应温度和反应时间等因素对反应收率的影响。优化后的工艺条件与传统加热方法相比,具有条件温和、反应时间短、收率高等优点。得到的最佳反应条件为:以甲苯为酰氯和酰胺反应溶剂,酰氯化反应条件为40℃超声反应1.5 h,丙基化反应条件为40℃超声反应1 h,盐酸罗哌卡因的收率为57.8%,[α]2D5=-6.7°(c2,H2O)。部分中间体和目标产物的结构通过熔点和核磁共振波谱进行了表征。     

Effect of Partially Fluorinated N‐Alkyl‐Substituted Piperidine‐2‐carboxamides on Pharmacologically Relevant Properties

The modulation of pharmacologically relevant properties of N‐alkyl‐piperidine‐2‐carboxamides was studied by selective introduction of 1–3 fluorine atoms into the n‐propyl and n‐butyl side chains of the local anesthetics ropivacaine and levobupivacaine. The basicity modulation by nearby fluorine substituents is essentially additive and exhibits an exponential attenuation as a function of topological distance between fluorine and the basic center. The intrinsic lipophilicity of the neutral piperidine derivatives displays the characteristic response noted for partially fluorinated alkyl groups attached to neutral heteroaryl systems. However, basicity decrease by nearby fluorine substituents affects lipophilicities at neutral pH, so that all partially fluorinated derivatives are of similar or higher lipophilicity than their non‐fluorinated parents. Aqueous solubilities were found to correlate inversely with lipophilicity with a significant contribution from crystal packing energies, as indicated by variations in melting point temperatures. All fluorinated derivatives were found to be somewhat more readily oxidized in human liver microsomes, the rates of degradation correlating with increasing lipophilicity. Because the piperidine‐2‐carboxamide core is chiral, pairs with enantiomeric N‐alkyl groups are diastereomeric. While little response to such stereoisomerism was observed for basicity or lipophilicity, more pronounced variations were observed for melting point temperatures and oxidative degradation.     

Stability of granules of solid solutions of poly-pehnyleneterephthalamide

Conclusions Studies of starting solutions of PPTA in sulfuric acid and of granules obtained under pressrue at low temperature, and of granules stored in a hermetic package, have been carried out by the methods of differential thermal analysis, turbidity spectrum and viscometry.On granulation of a solidified PPTA solution, short-term storage of the granules in a hermetic package, or short contanct of the granulated mass with air, no appreciable change in melting point or of the intrinsic viscosity of the system takes place.Long storage of a granulated solution, even in hermetic packages, can lead to a considerable decrease in the melting point of the crystal solvates, caused by an increase in defectiveness of crystal structure under the effect of moisture.Translated from Khimicheskie Volokna, No. 3, pp. 25–26, May–June, 1986.     

Rate of propagation and of damping of ultrasound in polycaproamide fibres of elastics

Conclusions The change in propagation rate and in damping of ultrasound in elastic polycaproamide yarns has been studied. It has been found that the change in these figures is determined by the same mechanism as in yarns from the press chamber method of preparation.A region of high values of the damping coefficient (25–33) has been found for elastic yarns.Texturizing yarns by the false twist method exerts a more intense action on the polymer than the compression and bending deformation in chamber pressing.The dependence between the rate of propagation of ultrasonic waves and the damping coefficient for elastic yarns reflects the effect of molecular orientation in the polymer itself and the geometric orientation of sections of the crimp relative to the sonication direction.Translated from Khimicheskie Volokna, No. 3, pp. 46–48, May–June, 1984.     

Photoinduced changes of the rate of dissolution of bilayer films of chalcogenide glasses

The change of the rate of dissolution upon the exposure of bilayer As₃₉S₆₁/As₃₆S₄₄Se₂₀ films to light of wavelength 380 nm and more than 470 nm from the sulfo-selenide layer side has been investigated. Although light of wavelength 380 nm is absorbed in the first layer, in the second layer photoinduced structural changes are observed, which are assumed to occur as a result of the diffusion of electron-hole pairs from the illuminated selenium-containing layer to the nonexposed arsenic sulfide in contact. The excess charge carriers induce structural changes in the As₃₉S₆₁ film that are registered as dissolution rate changes. The calculated value of the drift mobility of the slowest charge carriers (electrons) of 10^?11 cm²/(V s) is in agreement with the literature data. Studies of the Raman spectra of the films of interest confirmed that the diffusion of excess electrons and holes into the sulfide layer resulted in structural changes that manifested themselves in a decrease in the intensities and widths of the bands corresponding to vibrations of structural groups containing homopolar bonds.     

预中和度对磷酸二铵产品氮含量的影响分析

针对预中和反应槽-管式反应器混合工艺生产磷酸二铵(DAP)产品时产品氮含量时常波动的现象进行了分析.由实际生产情况分析可知,进入预中和槽洗涤液及预中和槽料浆中和度的大小及波动是造成产品氮含量波动的原因之一,预中和槽的中和度应控制在1.45～1.58.