Covey-Crump Gwen L, Murison Pamela J
University of Bristol Veterinary School, Bristol, UK.
Vet Anaesth Analg. 2008 Nov;35(6):463-72. doi: 10.1111/j.1467-2995.2008.00408.x. Epub 2008 Jun 19.
Propofol may cause adverse effects (e.g. apnoea, hypotension) at induction of anaesthesia. Co-induction of anaesthesia may reduce propofol requirements. The effect of fentanyl or midazolam on propofol dose requirements and cardiorespiratory parameters was studied.
Randomized, controlled, blinded clinical study.
Sixty-six client owned dogs (35 male, 31 female, ASA I-II, age 6-120 months, body mass 4.7-48.0 kg) were selected.
Pre-medication with acepromazine (0.025 mg kg(-1)) and morphine (0.25 mg kg(-1)) was administered by intramuscular injection. After 30 minutes group fentanyl-propofol (FP) received fentanyl (2 microg kg(-1)), group midazolam-propofol (MP) midazolam (0.2 mg kg(-1)) injected over 30 seconds via a cephalic catheter and in a third group, control-propofol (CP), the IV catheter was flushed with an equivalent volume of heparinized saline. Anaesthesia was induced 2 minutes later, with propofol (4 mg kg(-1)minute(-1)) administered to effect. After endotracheal intubation anaesthesia was maintained with a standardized anaesthetic protocol. Pulse rate, respiratory rate (RR) and mean arterial pressure (MAP) were recorded before the co-induction agent, before induction, and 0, 2 and 5 minutes after intubation. Apnoea >or=30 seconds was recorded and treated. Sedation after pre-medication, activity after the co-induction agent, quality of anaesthetic induction and endotracheal intubation were scored.
Propofol dose requirement was significantly reduced in FP [2.90 mg kg(-1)(0.57)] compared to CP [3.51 mg kg(-1) (0.74)] and MP [3.58 mg kg(-1)(0.49)]. Mean pulse rate was higher in MP than in CP or FP (p = 0.003). No statistically significant difference was found between groups in mean RR, MAP or incidence of apnoea. Activity score was significantly higher (i.e. more excited) (p = 0.0001), and quality of induction score was significantly poorer (p = 0.0001) in MP compared to CP or FP. Intubation score was similar in all groups.
Fentanyl decreased propofol requirement but did not significantly alter cardiovascular parameters. Midazolam did not reduce propofol requirements and caused excitement in some animals.
丙泊酚在麻醉诱导时可能会引起不良反应（如呼吸暂停、低血压）。联合诱导麻醉可能会减少丙泊酚的用量。本研究探讨了芬太尼或咪达唑仑对丙泊酚剂量需求及心肺参数的影响。
随机、对照、双盲临床研究。
选取66只客户拥有的犬（35只雄性，31只雌性，美国麻醉医师协会分级I-II级，年龄6 - 120个月，体重4.7 - 48.0 kg）。
肌肉注射乙酰丙嗪（0.025 mg·kg⁻¹）和吗啡（0.25 mg·kg⁻¹）进行术前用药。30分钟后，芬太尼 - 丙泊酚组（FP）静脉注射芬太尼（2 μg·kg⁻¹），咪达唑仑 - 丙泊酚组（MP）通过头静脉导管在30秒内注射咪达唑仑（0.2 mg·kg⁻¹），第三组为对照 - 丙泊酚组（CP），静脉导管用等量肝素化盐水冲洗。2分钟后用丙泊酚（4 mg·kg⁻¹·分钟⁻¹）诱导麻醉至起效。气管插管后采用标准化麻醉方案维持麻醉。记录联合诱导剂给药前、诱导前以及插管后0、2和5分钟时的心率、呼吸频率（RR）和平均动脉压（MAP）。记录并处理持续≥30秒的呼吸暂停。对术前用药后的镇静情况、联合诱导剂给药后的活动情况、麻醉诱导质量和气管插管情况进行评分。
与CP组[3.51 mg·kg⁻¹（0.74）]和MP组[3.58 mg·kg⁻¹（0.49）]相比，FP组丙泊酚剂量需求显著降低[2.90 mg·kg⁻¹（0.57）]。MP组平均心率高于CP组或FP组（p = 0.003）。各组间平均RR、MAP或呼吸暂停发生率无统计学显著差异。与CP组或FP组相比，MP组活动评分显著更高（即更兴奋）（p = 0.0001），诱导质量评分显著更低（p = 0.0001）。所有组的插管评分相似。
芬太尼降低了丙泊酚的用量，但未显著改变心血管参数。咪达唑仑未降低丙泊酚用量，且在一些动物中引起兴奋。
