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对接受颅骨切除术以切除肿瘤的犬所使用的麻醉技术的评估。

Evaluation of an anaesthetic technique used in dogs undergoing craniectomy for tumour resection.

作者信息

Raisis Anthea L, Leece Elizabeth A, Platt Simon R, Adams Vicki J, Corletto Federico, Brearley Jackie

机构信息

Department of Veterinary and Biomedical Sciences, Murdoch University, Perth, WA, Australia.

出版信息

Vet Anaesth Analg. 2007 May;34(3):171-80. doi: 10.1111/j.1467-2995.2006.00318.x.

Abstract

OBJECTIVE

To evaluate a total intravenous anaesthetic technique in dogs undergoing craniectomy.

STUDY DESIGN

Prospective clinical study.

ANIMALS

Ten dogs admitted for elective surgical resection of rostro-tentorial tumours.

METHODS

All dogs were premedicated with methadone, 0.2 mg kg(-1) intramuscularly 30 minutes prior to induction of anaesthesia. Anaesthesia was induced with propofol administered intravenously (IV) to effect, following administration of lidocaine 1 mg kg(-1) IV and maintained with a continuous infusion of propofol at < or =0.4 mg kg(-1) minute(-1) during instrumentation and preparation and during movement of the animals to recovery. During surgery, anaesthesia was maintained using a continuous infusion of propofol at <or =0.4 mg kg(-1) minute(-1) and alfentanil < or =1 microg kg(-1) minute(-1). Lidocaine was administered at 1 mg kg(-1) IV immediately prior to extubation. Arterial blood pressure and heart rate (HR) were recorded prior to induction and every 5 minutes throughout preparation and surgery. Central venous pressure was recorded every 5 minutes throughout surgery.

RESULTS

Administration of propofol and lidocaine prevented significant increases in mean arterial blood pressure (MAP) and HR during endotracheal intubation and extubation. Adequate MAP was maintained throughout anaesthesia. Recovery was smooth and excitement free. There was no association between duration of anaesthesia, total drugs administered, or severity of neurological disease and recovery times. Postoperatively there was no deterioration in neurological function in the immediate postoperative period with complete resolution of pre-existing neurological deficits within 7 days of surgery.

CONCLUSION

This technique provided minimal response to intubation and extubation, adequate arterial blood pressure and a smooth predictable recovery. All animals were neurologically improved by the time of discharge, suggesting that this technique had not caused significant neuronal damage.

CLINICAL RELEVANCE

Total intravenous anaesthesia with propofol and alfentanil appears to be a satisfactory anaesthetic technique for use in dogs undergoing surgery for debulking/removal of rostro-tentorial tumours.

摘要

目的

评估全静脉麻醉技术在接受颅骨切除术的犬类中的应用效果。

研究设计

前瞻性临床研究。

动物

十只因择期手术切除颅顶幕上肿瘤而入院的犬。

方法

所有犬在麻醉诱导前30分钟肌肉注射美沙酮,剂量为0.2毫克/千克。在静脉注射1毫克/千克利多卡因后,静脉注射丙泊酚诱导麻醉至起效,在器械操作、准备过程以及动物转移至恢复阶段,以≤0.4毫克/千克·分钟⁻¹的速度持续输注丙泊酚维持麻醉。手术期间,以≤0.4毫克/千克·分钟⁻¹的速度持续输注丙泊酚,并以≤1微克/千克·分钟⁻¹的速度输注阿芬太尼维持麻醉。拔管前立即静脉注射1毫克/千克利多卡因。诱导麻醉前以及整个准备和手术过程中每5分钟记录一次动脉血压和心率(HR)。整个手术过程中每5分钟记录一次中心静脉压。

结果

丙泊酚和利多卡因的使用可防止气管插管和拔管期间平均动脉血压(MAP)和HR的显著升高。整个麻醉过程中维持了足够的MAP。恢复过程顺利且无兴奋现象。麻醉持续时间、所用药物总量或神经疾病严重程度与恢复时间之间无关联。术后即刻神经功能无恶化,术前存在的神经功能缺损在术后7天内完全恢复。

结论

该技术对插管和拔管反应极小,能维持足够的动脉血压且恢复过程顺利可预测。所有动物出院时神经功能均有改善,表明该技术未造成明显的神经元损伤。

临床意义

丙泊酚和阿芬太尼全静脉麻醉似乎是用于接受颅顶幕上肿瘤减瘤/切除手术的犬类的一种令人满意的麻醉技术。

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