Bettschart-Wolfensberger Regula, Kalchofner Karin, Neges Karin, Kästner Sabine, Fürst Anton
Equine Clinic, Vetsuisse Faculty University of Zürich, Zürich, Switzerland.
Vet Anaesth Analg. 2005 Nov;32(6):348-54. doi: 10.1111/j.1467-2995.2005.00202.x.
To examine the clinical suitability of medetomidine-propofol infusions for total intravenous anaesthesia in horses.
Fifty client-owned horses of mixed breed, age [mean +/- SD (range)] 6.6 +/- 4.4 (0.04-18) years, mass 478 +/- 168.3 (80-700) kg presented for a range of operations requiring general anaesthesia.
Pre-anaesthetic medication was intravenous (IV) medetomidine 7 mug kg(-1). Anaesthesia was induced with IV ketamine (2 mg kg(-1)) and diazepam (0.02 mg kg(-1)). After endotracheal intubation, O2 was delivered (FiO2 > 0.85). Positive pressure ventilation was initiated if breath-holding in excess of 1 minute occurred. Anaesthesia was maintained with a constant rate medetomidine infusion (3.5 microg kg(-1) hour(-1)) and propofol infused IV to effect (initial dose 0.1 mg kg(-1) minute(-1)). Heart (HR) respiratory (fr) and propofol administration rates, and systemic arterial blood pressures were recorded at 5-minute intervals. Arterial blood gas (O2 and CO2) tensions and pH values were recorded every 15 minutes. Ten minutes after ending medetomidine-propofol infusion, medetomidine (2 microg kg(-1); IV) was given. Cardiopulmonary data were analysed using descriptive statistical techniques.
Thirty-three orthopaedic, seven integumentary and 10 elective abdominal operations were performed. Cardiopulmonary data, presented as range of mean individual (and absolute individual minimum and maximum values) were: HR: 28.0-39.2 (16-88) beats minute(-1); mean arterial blood pressure: 74.0-132.5 (42-189) mmHg; PaO2: 22.1-42.9 (4.9-67.8) kPa; [166-322 (37-508) mmHg], PaCO2: 6.7-8.1 (4.2-11.8) kPa [50-61 (32-88) mmHg] and pH 7.35-7.39 (7.15-7.48). Positive pressure ventilation was required in 23 horses. In three horses, HR values below 20 beats minute(-1) were treated with 20 microg kg(-1) atropine (IV). Mean propofol infusion rates were 98-108 microg kg(-1) minute(-1). During anaesthesia, movement occurring in 14 horses was controlled with thiopental. Duration of anaesthesia was 111.6 +/- 41.4 (46-225) minutes. Recovery in all horses was uneventful and completed within 42.2 +/- 19.8 (12-98) minutes.
Medetomidine-propofol infusion produces adequate conditions for a range of surgical procedures. Cardiovascular function was adequate, as no pressor agents were required. Positive pressure ventilation was required in 23 horses.
研究美托咪定 - 丙泊酚输注用于马匹全静脉麻醉的临床适用性。
50匹客户拥有的杂种马，年龄[平均值±标准差（范围）]为6.6±4.4（0.04 - 18）岁，体重478±168.3（80 - 700）kg，因一系列需要全身麻醉的手术前来就诊。
麻醉前用药为静脉注射（IV）美托咪定7μg/kg。麻醉诱导采用静脉注射氯胺酮（2mg/kg）和地西泮（0.02mg/kg）。气管插管后，给予氧气（FiO₂>0.85）。如果屏气超过1分钟，则开始进行正压通气。通过持续输注美托咪定（3.5μg/kg·小时⁻¹）和静脉注射丙泊酚至起效（初始剂量0.1mg/kg·分钟⁻¹）维持麻醉。每隔5分钟记录心率（HR）、呼吸频率（fr）和丙泊酚给药速率以及体循环动脉血压。每隔15分钟记录动脉血气（O₂和CO₂）张力及pH值。停止美托咪定 - 丙泊酚输注10分钟后，静脉注射美托咪定（2μg/kg）。采用描述性统计技术分析心肺数据。
进行了33例骨科手术、7例皮肤手术和10例择期腹部手术。心肺数据以个体均值范围（以及个体绝对最小值和最大值）表示为：HR：28.0 - 39.2（16 - 88）次/分钟；平均动脉血压：74.0 - 132.5（42 - 189）mmHg；PaO₂：22.1 - 42.9（4.9 - 67.8）kPa [166 - 322（37 - 508）mmHg]，PaCO₂：6.7 - 8.1（4.2 - 11.8）kPa [50 - 61（32 - 88）mmHg]，pH值7.35 - 7.39（7.15 - 7.48）。23匹马需要进行正压通气。3匹马心率值低于20次/分钟，静脉注射20μg/kg阿托品进行治疗。丙泊酚平均输注速率为98 - 108μg/kg·分钟⁻¹。麻醉期间，14匹马出现的运动用硫喷妥钠控制。麻醉持续时间为111.6±41.4（46 - 225）分钟。所有马匹恢复顺利，在42.2±19.8（12 - 98）分钟内完成恢复。
美托咪定 - 丙泊酚输注可为一系列外科手术提供充分条件。心血管功能良好，无需使用升压药。23匹马需要进行正压通气。
