Liehmann Lea, Mosing Martina, Auer Ulrike
Clinical Department for Small Animals and Horses, Clinic for Surgery, Ophthalmology and Dentistry, University of Veterinary Medicine Vienna, Veterinärplatz 1, A-1210 Vienna, Austria.
Vet Anaesth Analg. 2006 May;33(3):158-68. doi: 10.1111/j.1467-2995.2005.00251.x.
To compare haemodynamic and respiratory variables during isoflurane-fentanyl (IF) and propofol-fentanyl (PF) anaesthesia for surgery in injured cats.
Prospective, randomized, controlled clinical study.
Thirty-three client-owned injured cats undergoing orthopaedic surgery.
Pre-anaesthetic medication was intravenous midazolam 1 mg kg(-1), butorphanol 0.4 mg kg(-1) and ketamine 2 mg kg(-1). Anaesthesia was induced with propofol (P) and maintained with either: (a) a continuous rate infusion (CRI) of fentanyl (F) 0.02 mg kg(-1) hour(-1) and isoflurane (initial end-tidal concentration of 1%), (b) a fentanyl CRI (dose as before) and sevoflurane (initial end-tidal concentration of 2%) or (c) a CRI of propofol (12 mg kg(-1) hour(-1)). All three techniques were given to effect until surgical anaesthesia was achieved. Heart rate and rhythm (ECG), mean arterial blood pressure, respiratory rate, tidal volume and end-tidal CO(2) concentration were recorded. Venous blood gas analysis was performed before and after sedation, and at the end of anaesthesia. Blood chemistry and blood cell counts were assessed before, at the end of, and 24 hours after anaesthesia. The variables recorded from cats anaesthetized with IF and PF were compared.
Mean end-expiratory isoflurane concentration was 1.19 +/- 0.19%. The propofol infusion rate was 11.4 +/- 0.8 mg kg(-1) hour(-1). No significant differences between the two groups in heart rate were identified; no cardiac dysrhythmias were recorded. Mean arterial blood pressure was significantly lower in IF cats during skin incision (p = 0.01), during surgery without intense surgical stimulation (p < 0.01) and during surgery with intense surgical stimulation (p = 0.01). Nine of 11 cats in the IF group were markedly hypotensive (34-49 mmHg) while seven of 11 cats in group PF were mildly hypotensive (49-59 mmHg). One of 11 cats in group IF and nine of 11 cats in group PF required intermittent positive pressure ventilation (IPPV) to maintain end-tidal CO(2) levels below 6.66 kPa (50 mmHg).
Despite the necessity to ventilate the lungs of cats in the PF group, arterial blood pressure was better maintained. Propofol-fentanyl anaesthesia is better for surgery in injured cats providing the means to impose IPPV are available.
比较异氟烷-芬太尼（IF）和丙泊酚-芬太尼（PF）麻醉用于受伤猫手术时的血流动力学和呼吸变量。
前瞻性、随机、对照临床研究。
33只客户拥有的接受骨科手术的受伤猫。
麻醉前用药为静脉注射咪达唑仑1mg/kg、布托啡诺0.4mg/kg和氯胺酮2mg/kg。用丙泊酚（P）诱导麻醉，并维持如下：（a）芬太尼（F）以0.02mg/kg·小时⁻¹的速率持续输注（CRI）和异氟烷（初始呼气末浓度为1%），（b）芬太尼CRI（剂量同前）和七氟烷（初始呼气末浓度为2%），或（c）丙泊酚CRI（12mg/kg·小时⁻¹）。三种技术均给予至达到手术麻醉效果。记录心率和心律（心电图）、平均动脉血压、呼吸频率、潮气量和呼气末二氧化碳浓度。在镇静前、镇静后及麻醉结束时进行静脉血气分析。在麻醉前、麻醉结束时及麻醉后24小时评估血液化学和血细胞计数。比较IF组和PF组麻醉猫记录的变量。
平均呼气末异氟烷浓度为1.19±0.19%。丙泊酚输注速率为11.4±0.8mg/kg·小时⁻¹。两组心率无显著差异；未记录到心律失常。在皮肤切开时（p = 0.01）、无强烈手术刺激的手术期间（p < 0.01）和有强烈手术刺激的手术期间（p = 0.01），IF组猫的平均动脉血压显著更低。IF组11只猫中有9只明显低血压（34 - 49mmHg），而PF组11只猫中有7只轻度低血压（49 - 59mmHg）。IF组11只猫中有1只，PF组11只猫中有9只需要间歇性正压通气（IPPV）以维持呼气末二氧化碳水平低于6.66kPa（50mmHg）。
尽管PF组的猫需要进行肺通气，但动脉血压维持得更好。如果有进行IPPV的手段，丙泊酚-芬太尼麻醉对受伤猫的手术更好。
