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在上呼吸道手术麻醉的马匹中给予吗啡。

Morphine administration in horses anaesthetized for upper respiratory tract surgery.

作者信息

Love Emma J, Lane J Geoffrey, Murison Pamela J

机构信息

Department of Clinical Veterinary Science, University of Bristol, Langford House, Langford, Bristol, UK.

出版信息

Vet Anaesth Analg. 2006 May;33(3):179-88. doi: 10.1111/j.1467-2995.2005.00247.x.

Abstract

OBJECTIVE

To determine the effect of morphine administration on commonly monitored cardio-respiratory variables and recovery quality in horses undergoing anaesthesia and surgery.

STUDY DESIGN

Prospective, randomized clinical study.

ANIMALS

Thirty-eight thoroughbred horses, 32 geldings and six mares, 3-13 years old, weighing 411-600 kg.

MATERIALS AND METHODS

A standard anaesthetic technique was used. Twenty minutes after induction of anaesthesia horses received 0.1 mg kg(-1) (0.1 m) or 0.2 mg kg(-1) (0.2 m) morphine by intravenous injection. A control group did not receive morphine. Heart rate, respiratory rate (fr), mean arterial pressure (MAP) and blood gases were measured before morphine administration and every 10 minutes thereafter. Horses were positioned for 35 minutes in right lateral recumbency for tension palatoplasty by cautery and were then moved into dorsal recumbency for additional intraluminal surgery comprising one or more of aryepiglottic fold resection, sub-epiglottal mucosal resection, ventriculectomy and cordectomy. A subjective recovery score from 0 (worst) to 5 (best) was assigned by a single observer who was unaware of treatment group. Two-way repeated measures anova, one-way anova, Kruskal-Wallis test, Mann-Whitney test, Pearson and Spearman correlation coefficients, and chi-squared tests were used to analyse the data where appropriate.

RESULTS

Arterial partial pressure of oxygen (PaO(2)) decreased significantly over time and was significantly lower in horses that received morphine. One horse in the control group and two horses in each of the morphine groups had a PaO(2) <13 kPa. No other significant cardiopulmonary effects were detected. Recovery scores [median (range)] were higher in morphine recipients: 4 (2-5) in 0.1 m, 4 (3-5) in 0.2 m compared with 3 (2-4) in the control group.

CONCLUSIONS AND CLINICAL RELEVANCE

The lower PaO(2) in morphine recipients did not appear to be of clinical significance in healthy horses because the number of horses with a low PaO(2) was similar between groups. The quality of recovery was significantly better in morphine recipients. These results indicate that morphine may be considered for use in clinical cases although further work is required to assess the analgesic properties of the drug in this species.

摘要

目的

确定给予吗啡对接受麻醉和手术的马匹常用监测的心肺变量及恢复质量的影响。

研究设计

前瞻性随机临床研究。

动物

38匹纯种马,32匹阉马和6匹母马,3至13岁,体重411至600千克。

材料与方法

采用标准麻醉技术。麻醉诱导20分钟后,马匹通过静脉注射接受0.1毫克/千克(0.1 m)或0.2毫克/千克(0.2 m)吗啡。对照组不接受吗啡。在给予吗啡前及之后每10分钟测量心率、呼吸频率(fr)、平均动脉压(MAP)和血气。马匹右侧卧35分钟进行烧灼性张力性腭成形术,然后转为仰卧位进行包括杓会厌襞切除术、会厌下黏膜切除术、心室切除术和声带切除术中的一项或多项的额外腔内手术。由一名不知道治疗组情况的观察者给出从0(最差)到5(最佳)的主观恢复评分。在适当情况下,使用双向重复测量方差分析、单向方差分析、Kruskal-Wallis检验、Mann-Whitney检验、Pearson和Spearman相关系数以及卡方检验来分析数据。

结果

随着时间推移,动脉血氧分压(PaO₂)显著降低,且接受吗啡的马匹中该值显著更低。对照组1匹马以及各吗啡组2匹马的PaO₂<13 kPa。未检测到其他显著的心肺效应。接受吗啡的马匹恢复评分[中位数(范围)]更高:0.1 m组为4(2 - 5),0.2 m组为4(3 - 5),而对照组为3(2 - 4)。

结论及临床意义

接受吗啡的马匹中较低的PaO₂在健康马匹中似乎无临床意义,因为各组中PaO₂低的马匹数量相似。接受吗啡的马匹恢复质量显著更好。这些结果表明,尽管需要进一步研究评估该药物在该物种中的镇痛特性,但吗啡可考虑用于临床病例。

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