本文選題：利多卡因　切入點(diǎn)：硬膜外麻醉　出處：《山西醫(yī)科大學(xué)》2006年碩士論文　論文類型：學(xué)位論文

【摘要】：目的 1 建立犬利多卡因硬膜外麻醉和靜脈注射動(dòng)態(tài)分布模型； 2 研究利多卡因在硬膜外麻醉(硬膜外麻醉、靜脈注射)犬體內(nèi)各臟器的動(dòng)態(tài)分布規(guī)律； 3 比較利多卡因在動(dòng)態(tài)分布模型犬體內(nèi)各臟器中的分布特點(diǎn)，為利多卡因硬膜外麻醉意外致死案件的檢材采取、檢測(cè)、結(jié)果分析、死因判定及法醫(yī)學(xué)鑒定提供科學(xué)依據(jù)。 方法 1 動(dòng)物模型 硬膜外麻醉動(dòng)物模型用犬36只，隨機(jī)分為1倍麻醉極量實(shí)驗(yàn)組(18只)和0.5倍麻醉極量實(shí)驗(yàn)組(18只)兩組，，實(shí)驗(yàn)組犬5分鐘內(nèi)經(jīng)硬膜外腔勻速注入利多卡因15mg／kg(7.5mg／kg)，分別于不同時(shí)間點(diǎn)空氣栓塞致死。 靜脈注射動(dòng)物模型用犬18只，實(shí)驗(yàn)組犬5分鐘內(nèi)經(jīng)股靜脈勻速注入利多卡因15mg／kg，分別于不同時(shí)間點(diǎn)空氣栓塞致死。 2 生命體征記錄方法 BL-生物機(jī)能實(shí)驗(yàn)系統(tǒng)全程記錄死后再分布模型從開(kāi)始給藥到動(dòng)物死亡的心電、血壓和呼吸等主要生命體征的變化。 3 樣品采集與處理 每種動(dòng)物模型分別于給藥后5、15、30、60、120、360分鐘空氣栓塞致死，迅速解剖動(dòng)物，取大腦、側(cè)腦室腦脊液、不同節(jié)段脊髓(頸段脊髓、胸段脊髓、腰段脊髓、骶段脊髓)、心、肺、肝、脾、腎、膽汁、尿、心血、周圍血和注射部位20cm以外肌肉等組織臟器和體液，即刻檢測(cè)實(shí)驗(yàn)犬各組織和體液中利多卡因含量。 檢測(cè)樣品經(jīng)酸、堿化處理后，乙醚萃取，保留時(shí)間和特征離子峰氣相色譜-質(zhì)譜聯(lián)用定性，內(nèi)標(biāo)法、工作曲線法氣相色譜定量。結(jié)果 1 癥狀 硬膜外麻醉實(shí)驗(yàn)組犬在注藥開(kāi)始后5～8min即出現(xiàn)興奮狀態(tài)消失，呼吸頻率減慢，胸式呼吸漸弱，腹式呼吸增強(qiáng)，肌肉松弛，無(wú)疼痛反應(yīng)，隨時(shí)間延長(zhǎng)癥狀減輕，未見(jiàn)死亡。 靜脈注射麻醉實(shí)驗(yàn)組犬在注藥開(kāi)始后5～8min即出現(xiàn)陣發(fā)性抽搐，呼吸困難，胸式呼吸漸弱，腹式呼吸增強(qiáng)，呼吸頻率加快，肌肉松弛，無(wú)疼痛反應(yīng)，隨時(shí)間延長(zhǎng)癥狀減輕，未見(jiàn)死亡。 2 動(dòng)態(tài)分布研究 2．1 1倍麻醉極量利多卡因在硬膜外麻醉犬體內(nèi)的動(dòng)態(tài)分布 給藥后不同時(shí)間點(diǎn)犬體內(nèi)利多卡因分布趨勢(shì)一致，均為先升高，達(dá)到峰值后下降。含量順序?yàn)椋焊鞫渭顾瑁灸I臟、腦和腦脊液＞其它組織。脊髓含量遠(yuǎn)遠(yuǎn)高于其它組織臟器，
[Abstract]:Purpose. 1 the dynamic distribution model of epidural anesthesia and intravenous injection of lidocaine in dogs was established. (2) to study the dynamic distribution of lidocaine in the organs of dogs under epidural anesthesia (epidural anesthesia, intravenous injection); 3 the distribution characteristics of lidocaine in the organs of dynamic distribution model dogs were compared, which provided the scientific basis for the examination, detection, analysis of results, cause of death and forensic identification of lidocaine in cases of accidental death under epidural anesthesia. Method. 1 animal model. Thirty-six dogs with epidural anesthesia were randomly divided into two groups: experimental group (n = 18) and experimental group (n = 18). In the experimental group, lidocaine 15 mg / kg and 7.5 mg / kg were injected into the epidural cavity within 5 minutes and died of air embolization at different time points. Eighteen dogs were injected intravenously with lidocaine 15 mg / kg in 5 minutes. The dogs in the experimental group died from air embolization at different time points. 2 vital sign recording method. The changes of vital signs, such as electrocardiogram, blood pressure and respiration, were recorded in BL- biological function experiment system from the beginning of administration to the death of animals. 3 sampling and processing. Each animal model was killed by air embolization (ACE) for 360 minutes, 5 minutes after administration. The animals were rapidly dissected, brain, lateral ventricle cerebrospinal fluid (CSF), different segments of spinal cord (cervical spinal cord, thoracic spinal cord, lumbar spinal cord, sacral spinal cord, heart, lung, liver, spleen, kidney) were removed. Bile, urine, heart blood, peripheral blood and muscle 20 cm away from the injection site were measured for lidocaine content. After acid and alkali treatment, ether extraction, retention time and characteristic ion peak gas chromatography-mass spectrometry were used for qualitative analysis, internal standard method and work curve method. Results. 1 symptom. In the epidural anesthesia group, the excitatory state disappeared at 5min after injection, the respiratory rate slowed down, the chest breathing weakened, the abdominal breathing increased, the muscles relaxed, and there was no pain response. The symptoms were alleviated and no death was seen with the prolongation of time. The dogs in the intravenous anesthesia group developed paroxysmal convulsions, dyspnea, weakened chest breathing, enhanced abdominal breathing, rapid respiratory rate, muscle relaxation, no pain response, and reduced symptoms over time. There was no death. 2 study on dynamic distribution. 2.1 dynamic Distribution of Lidocaine in epidural Anesthesia Dogs. The distribution trend of lidocaine in dogs at different time points was the same, which increased first, reached the peak and then decreased. The order of content was as follows: spinal cord > kidney, brain and cerebrospinal fluid > other tissues. The content of spinal cord was much higher than that of other tissues and organs.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類號(hào)】：D919

【引證文獻(xiàn)】

相關(guān)碩士學(xué)位論文 前4條

1 李云;利多卡因、普魯卡因和布比卡因在生物樣品中的分解動(dòng)力學(xué)研究[D];山西醫(yī)科大學(xué);2007年

2 張高勤;布比卡因在硬膜外麻醉意外致死犬體內(nèi)的死后再分布研究[D];山西醫(yī)科大學(xué);2007年

3 關(guān)培英;擬除蟲(chóng)菊酯類農(nóng)藥法醫(yī)毒物動(dòng)力學(xué)研究（一）[D];山西醫(yī)科大學(xué);2008年

4 王振華;利多卡因硬膜外麻醉意外法醫(yī)毒物動(dòng)力學(xué)研究（八）[D];山西醫(yī)科大學(xué);2008年

本文編號(hào)：1561769