异氟烷、氯胺酮-地西泮或丙泊酚-地西泮麻醉诱导对低血容量犬心肺功能的影响。

The cardiopulmonary effects of anesthetic induction with isoflurane, ketamine-diazepam or propofol-diazepam in the hypovolemic dog.

作者信息

Fayyaz Sima, Kerr Carolyn L, Dyson Doris H, Mirakhur Kuldip K

机构信息

Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.

出版信息

Vet Anaesth Analg. 2009 Mar;36(2):110-23. doi: 10.1111/j.1467-2995.2008.00437.x.

DOI:10.1111/j.1467-2995.2008.00437.x

PMID:19239649

Abstract

OBJECTIVE

To evaluate and compare the cardiopulmonary effects of induction of anesthesia with isoflurane (Iso), ketamine-diazepam (KD), or propofol-diazepam (PD) in hypovolemic dogs. Study design Prospective randomized cross-over trial.

ANIMALS

Six healthy intact, mixed breed, female dogs weighing 20.7 +/- 4.2 kg and aged 22 +/- 2 months. Methods Dogs had 30 mL kg(-1) of blood removed at a rate of 1.5 mL kg(-1) minute(-1) under isoflurane anesthesia. Following a 30-minute recovery period, anesthesia was reinduced. Dogs were assigned to one of three treatments: isoflurane via facemask using 0.5% incremental increases in the delivered concentration every 30 seconds, 1.25 mg kg(-1) ketamine and 0.0625 mg kg(-1) diazepam intravenously (IV) with doses repeated every 30 seconds as required, and 2 mg kg(-1) propofol and 0.2 mg kg(-1) diazepam IV followed by 1 mg kg(-1) propofol increments IV every 30 seconds as required. Following endotracheal intubation all dogs received 1.7% end-tidal isoflurane in oxygen. Cardiopulmonary variables were recorded at baseline (before induction) and at 5 or 10 minute intervals following endotracheal intubation.

RESULTS

Induction time was longer in Iso (4.98 +/- 0.47 minutes) compared to KD (3.10 +/- 0.47 minutes) or PD (3.22 +/- 0.45 minutes). To produce anesthesia, KD received 4.9 +/- 2.3 mg kg(-1) ketamine and 0.24 +/- 0.1 mg kg(-1) diazepam, while PD received 2.2 +/- 0.4 mg kg(-1) propofol and 0.2 mg kg(-1) diazepam. End-tidal isoflurane concentration immediately following intubation was 1.7 +/- 0.4% in Iso. Arterial blood pressure and heart rate were significantly higher in KD and PD compared to Iso and in KD compared to PD. Arterial carbon dioxide partial pressure was significantly higher in PD compared to KD and Iso immediately after induction.

CONCLUSIONS AND CLINICAL RELEVANCE

In hypovolemic dogs, KD or PD, as used in this study to induce anesthesia, resulted in less hemodynamic depression compared to isoflurane.

摘要

目的

评估并比较异氟烷（Iso）、氯胺酮 - 地西泮（KD）或丙泊酚 - 地西泮（PD）对低血容量犬诱导麻醉时的心肺效应。研究设计：前瞻性随机交叉试验。

动物

6只健康、未绝育、混种雌性犬，体重20.7±4.2千克，年龄22±2个月。方法：在异氟烷麻醉下，以1.5毫升/千克·分钟⁻¹的速率从犬体内抽取30毫升/千克的血液。经过30分钟的恢复期后，再次诱导麻醉。将犬分为三种处理组之一：通过面罩吸入异氟烷，每隔30秒将输送浓度递增0.5%；静脉注射1.25毫克/千克氯胺酮和0.0625毫克/千克地西泮（IV），必要时每隔30秒重复给药；静脉注射2毫克/千克丙泊酚和0.2毫克/千克地西泮，随后必要时每隔30秒静脉递增1毫克/千克丙泊酚。气管插管后，所有犬均吸入含1.7%异氟烷的氧气。在基线（诱导前）以及气管插管后每隔5或10分钟记录心肺变量。

结果

与KD（3.10±0.47分钟）或PD（3.22±0.45分钟）相比，Iso组的诱导时间更长（4.98±0.47分钟）。为产生麻醉效果，KD组使用了4.9±2.3毫克/千克氯胺酮和0.24±0.1毫克/千克地西泮，而PD组使用了2.2±0.4毫克/千克丙泊酚和0.2毫克/千克地西泮。插管后即刻，Iso组的呼气末异氟烷浓度为1.7±0.4%。与Iso组相比，KD组和PD组的动脉血压和心率显著更高；与PD组相比，KD组的也更高。诱导后即刻，与KD组和Iso组相比，PD组的动脉二氧化碳分压显著更高。