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比较兔手术中使用双氯芬酸/丙泊酚与芬太尼/丙泊酚麻醉的效果。

Comparison of dipyrone/propofol versus fentanyl/propofol anaesthesia during surgery in rabbits.

机构信息

Centre of Preclinical Research, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

出版信息

Lab Anim. 2011 Jan;45(1):38-44. doi: 10.1258/la.2010.010091. Epub 2010 Nov 18.

Abstract

In this study, the investigation of the intraoperative effects of dipyrone (metamizol) on heart rate (HR), mean arterial pressure (MAP) and analgesic efficacy in rabbits is described for the first time. This was carried out to evaluate the cardiovascular stability achieved using dipyrone compared with fentanyl. In this prospective study, 17 female New Zealand White rabbits were randomly allocated to either one of two groups: dipyrone/propofol (DP) or fentanyl/propofol (FP). Anaesthesia was induced in both groups using propofol to effect (4.0-8.0 mg/kg intravenously) until the swallowing reflex was lost for intubation. After induction, anaesthesia was maintained with continuous infusion of propofol 1.5-1.7 mg/kg/min intravenously. Analgesics were then injected in defined boluses of either dipyrone 65 mg/kg or fentanyl 0.0053 mg/kg. After surgical tolerance, defined as loss of the ear pinch reflex and loss of the anterior and posterior pedal withdrawal reflex, was achieved, two surgical procedures were performed. The surgical procedures (implantation of either a pacemaker or an electrocardiogram transmitter), both require a comparable level of analgesic depth. During and after surgery, clinical variables, such as MAP, HR, peripheral arterial oxygen saturation (SpO₂) and end-tidal CO₂ (P(E')CO₂) were recorded simultaneously every 2 min. Eight time points were chosen for comparison: baseline, surgical tolerance (ST), values at 10, 20 and 30 min after reaching ST, values at the end of propofol infusion (EI) and data at 10 and 20 min after EI. Both FP and DP combinations provided effective anaesthesia and analgesia in rabbits. In both groups a significant decrease of HR and MAP was measured. The results of this study indicate that the non-opioid drug dipyrone produces similar analgesic and even better cardiovascular effects by trend in rabbits. Therefore we conclude that dipyrone in combination with propofol can be used as an alternative to FP for intraoperative analgesia.

摘要

在这项研究中,首次描述了在兔子体内研究双氯芬酸(美他佐辛)对心率(HR)、平均动脉压(MAP)和镇痛效果的术中作用。这是为了评估与芬太尼相比,使用双氯芬酸达到的心血管稳定性。在这项前瞻性研究中,将 17 只雌性新西兰白兔随机分配到以下两组之一:双氯芬酸/丙泊酚(DP)或芬太尼/丙泊酚(FP)。两组均使用丙泊酚诱导麻醉,直至吞咽反射消失进行插管(静脉注射 4.0-8.0 mg/kg)。诱导后,通过静脉内持续输注丙泊酚 1.5-1.7 mg/kg/min 维持麻醉。然后以定义的剂量注射双氯芬酸 65 mg/kg 或芬太尼 0.0053 mg/kg 作为镇痛药。在达到手术耐受(定义为失去耳夹反射和失去前后足退缩反射)后,进行了两种手术。这两种手术(植入起搏器或心电图发射器)都需要相当的镇痛深度。在手术过程中和手术结束后,每隔 2 分钟同时记录 MAP、HR、外周动脉血氧饱和度(SpO₂)和呼气末二氧化碳(P(E')CO₂)等临床变量。选择了 8 个时间点进行比较:基线、手术耐受(ST)、达到 ST 后 10、20 和 30 分钟的值、丙泊酚输注结束(EI)的值以及 EI 后 10 和 20 分钟的值。FP 和 DP 组合均为兔子提供了有效的麻醉和镇痛。两组 HR 和 MAP 均显著降低。本研究结果表明,非阿片类药物双氯芬酸在兔子体内产生类似的镇痛作用,甚至在心血管方面的效果更好。因此,我们得出结论,双氯芬酸联合丙泊酚可作为 FP 用于术中镇痛的替代药物。

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