Enouri Saad S, Kerr Carolyn L, McDonell Wayne N, Dyson Doris H
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1H 2W1, Canada.
Am J Vet Res. 2008 May;69(5):586-95. doi: 10.2460/ajvr.69.5.586.
OBJECTIVE: To evaluate the cardiopulmonary effects of anesthetic induction with thiopental, propofol, or ketamine hydrochloride and diazepam in dogs sedated with medetomidine and hydromorphone. ANIMALS: 6 healthy adult dogs. PROCEDURES: Dogs received 3 induction regimens in a randomized crossover study. Twenty minutes after sedation with medetomidine (10 microg/kg, IV) and hydromorphone (0.05 mg/kg, IV), anesthesia was induced with ketamine-diazepam, propofol, or thiopental and then maintained with isoflurane in oxygen. Measurements were obtained prior to sedation (baseline), 10 minutes after administration of preanesthetic medications, after induction before receiving oxygen, and after the start of isoflurane-oxygen administration. RESULTS: Doses required for induction were 1.25 mg of ketamine/kg with 0.0625 mg of diazepam/kg, 1 mg of propofol/kg, and 2.5 mg of thiopental/kg. After administration of preanesthetic medications, heart rate (HR), cardiac index, and PaO(2) values were significantly lower and mean arterial blood pressure, central venous pressure, and PaCO(2) values were significantly higher than baseline values for all regimens. After induction of anesthesia, compared with postsedation values, HR was greater for ketamine-diazepam and thiopental regimens, whereas PaCO(2) tension was greater and stroke index values were lower for all regimens. After induction, PaO(2) values were significantly lower and HR and cardiac index values significantly higher for the ketamine-diazepam regimen, compared with values for the propofol and thiopental regimens. CONCLUSIONS AND CLINICAL RELEVANCE: Medetomidine and hydromorphone caused dramatic hemodynamic alterations, and at the doses used, the 3 induction regimens did not induce important additional cardiovascular alterations. However, administration of supplemental oxygen is recommended.
目的:评估在接受美托咪定和氢吗啡酮镇静的犬中,硫喷妥钠、丙泊酚或氯胺酮与地西泮进行麻醉诱导对心肺的影响。 动物:6只健康成年犬。 方法:在一项随机交叉研究中,犬接受3种诱导方案。在用美托咪定(10微克/千克,静脉注射)和氢吗啡酮(0.05毫克/千克,静脉注射)镇静20分钟后,分别用氯胺酮-地西泮、丙泊酚或硫喷妥钠进行麻醉诱导,然后用异氟醚维持在氧气中。在镇静前(基线)、给予麻醉前用药后10分钟、诱导后吸氧前以及异氟醚-氧气给药开始后进行测量。 结果:诱导所需剂量分别为氯胺酮1.25毫克/千克加地西泮0.0625毫克/千克、丙泊酚1毫克/千克和硫喷妥钠2.5毫克/千克。给予麻醉前用药后,所有方案的心率(HR)、心脏指数和动脉血氧分压(PaO₂)值均显著低于基线值,而平均动脉血压、中心静脉压和动脉血二氧化碳分压(PaCO₂)值均显著高于基线值。麻醉诱导后,与镇静后值相比,氯胺酮-地西泮和硫喷妥钠方案的HR更高,而所有方案的PaCO₂张力更高且每搏指数值更低。诱导后,与丙泊酚和硫喷妥钠方案相比,氯胺酮-地西泮方案的PaO₂值显著更低,HR和心脏指数值显著更高。 结论及临床意义:美托咪定和氢吗啡酮引起显著的血流动力学改变,在所使用的剂量下,3种诱导方案未引起重要的额外心血管改变。然而,建议补充氧气。
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