Kramer Sabine, Alyakine Hassan, Nolte Ingo
Klinik für Kleintiere, Stiftung Tierärztliche Hochschule Hannover.
Berl Munch Tierarztl Wochenschr. 2008 Jan-Feb;121(1-2):53-65.
The aim of the present study was to compare the safety and efficacy of sevoflurane and isoflurane during low flow anaesthesia (fresh gas flow (FGF) 14 ml/kg/min) as well as to compare the consumption of both anaesthetics. Data were gathered from 60 dogs assigned for surgery under general anaesthesia with an expected duration of 75 minutes or longer. All dogs were induced with 0.6 mg/kg (maximum 25 mg) l-methadone and 1 mg/kg (maximum 25 mg) diazepam i.v.. Anaesthesia was maintained with isoflurane (group 1) or sevoflurane (group 2) in a mixture with 50% O2 and 50% N2O as carrier gases, under controlled ventilation. Monitoring included electrocardiogram, body temperature, the temperature of in- and exspired gases, arterial oxygen saturation, arterial blood pressure as well as a continuous monitoring of inhaled and exhaled gas concentrations (O2, N2O, CO2, isoflurane, sevoflurane). The consumption of isoflurane and sevoflurane as well as the dogs' recovery times were evaluated for both groups. In all groups the inspired oxygen concentrations ranged above the minimum value of 30 Vol% during low flow anaesthesia, with an arterial oxygen saturation above 97%. End tidal concentration of CO2, heart rate and arterial blood pressure were within the physiological ranges and showed no differences between the two groups. Recovery time was significantly shorter after sevoflurane compared to isoflurane anaesthesia, whilst the consumption of sevoflurane was higher than that of isoflurane. Sevoflurane appears to be as clinically safe as isoflurane in low flow anaesthesia. Even considering that sevoflurane is more expensive than isoflurane, the use of the low flow technique decreases the cost of anaesthesia due to the reduced volatile anaesthetic consumption.
本研究的目的是比较七氟醚和异氟醚在低流量麻醉(新鲜气体流量(FGF)14毫升/千克/分钟)时的安全性和有效性,并比较两种麻醉剂的消耗量。数据收集自60只预定接受全身麻醉、预计手术时间为75分钟或更长时间的犬。所有犬均静脉注射0.6毫克/千克(最大25毫克)左旋美沙酮和1毫克/千克(最大25毫克)地西泮诱导麻醉。在控制通气下,异氟醚组(第1组)或七氟醚组(第2组)以50%氧气和50%氧化亚氮的混合气体作为载气维持麻醉。监测包括心电图、体温、吸入气和呼出气温度、动脉血氧饱和度、动脉血压以及持续监测吸入气和呼出气中的气体浓度(氧气、氧化亚氮、二氧化碳、异氟醚、七氟醚)。评估了两组异氟醚和七氟醚的消耗量以及犬的苏醒时间。在所有组中,低流量麻醉期间吸入氧浓度均高于最低值30体积%,动脉血氧饱和度高于97%。呼气末二氧化碳浓度、心率和动脉血压均在生理范围内,两组之间无差异。与异氟醚麻醉相比,七氟醚麻醉后的苏醒时间明显更短,而七氟醚的消耗量高于异氟醚。在低流量麻醉中,七氟醚在临床上似乎与异氟醚一样安全。即使考虑到七氟醚比异氟醚更昂贵,但由于挥发性麻醉剂消耗量减少,采用低流量技术仍可降低麻醉成本。