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在马匹中,等效麻醉剂量的七氟醚单独使用与七氟醚加静脉输注利多卡因的心血管效应比较。

Comparison of the cardiovascular effects of equipotent anesthetic doses of sevoflurane alone and sevoflurane plus an intravenous infusion of lidocaine in horses.

作者信息

Wagner Ann E, Mama Khursheed R, Steffey Eugene P, Ferreira Tatiana H, Rezende Marlis L

机构信息

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.

出版信息

Am J Vet Res. 2011 Apr;72(4):452-60. doi: 10.2460/ajvr.72.4.452.

Abstract

OBJECTIVE

To compare cardiovascular effects of sevoflurane alone and sevoflurane plus an IV infusion of lidocaine in horses. Animals-8 adult horses.

PROCEDURES

Each horse was anesthetized twice via IV administration of xylazine, diazepam, and ketamine. During 1 anesthetic episode, anesthesia was maintained by administration of sevoflurane in oxygen at 1.0 and 1.5 times the minimum alveolar concentration (MAC). During the other episode, anesthesia was maintained at the same MAC multiples via a reduced concentration of sevoflurane plus an IV infusion of lidocaine. Heart rate, arterial blood pressures, blood gas analyses, and cardiac output were measured during mechanical (controlled) ventilation at both 1.0 and 1.5 MAC for each anesthetic protocol and during spontaneous ventilation at 1 of the 2 MAC multiples.

RESULTS

Cardiorespiratory variables did not differ significantly between anesthetic protocols. Blood pressures were highest at 1.0 MAC during spontaneous ventilation and lowest at 1.5 MAC during controlled ventilation for either anesthetic protocol. Cardiac output was significantly higher during 1.0 MAC than during 1.5 MAC for sevoflurane plus lidocaine but was not affected by anesthetic protocol or mode of ventilation. Clinically important hypotension was detected at 1.5 MAC for both anesthetic protocols.

CONCLUSIONS AND CLINICAL RELEVANCE

Lidocaine infusion did not alter cardiorespiratory variables during anesthesia in horses, provided anesthetic depth was maintained constant. The IV administration of lidocaine to anesthetized nonstimulated horses should be used for reasons other than to improve cardiovascular performance. Severe hypotension can be expected in nonstimulated horses at 1.5 MAC sevoflurane, regardless of whether lidocaine is administered.

摘要

目的

比较七氟醚单独使用及七氟醚联合静脉输注利多卡因对马心血管系统的影响。动物——8匹成年马。

程序

每匹马通过静脉注射赛拉嗪、地西泮和氯胺酮进行两次麻醉。在一次麻醉过程中,通过给予氧中七氟醚,使其浓度为最低肺泡浓度(MAC)的1.0倍和1.5倍来维持麻醉。在另一次麻醉过程中,通过降低七氟醚浓度并联合静脉输注利多卡因,以相同的MAC倍数维持麻醉。在每种麻醉方案的1.0和1.5 MAC机械(控制)通气期间以及在2个MAC倍数之一的自主通气期间,测量心率、动脉血压、血气分析和心输出量。

结果

两种麻醉方案的心肺变量无显著差异。对于任何一种麻醉方案,自主通气时血压在1.0 MAC时最高,控制通气时在1.5 MAC时最低。七氟醚加利多卡因时,心输出量在1.0 MAC时显著高于1.5 MAC时,但不受麻醉方案或通气模式影响。两种麻醉方案在1.5 MAC时均检测到具有临床意义的低血压。

结论及临床意义

在维持麻醉深度恒定的情况下,输注利多卡因不会改变马麻醉期间的心肺变量。给麻醉状态下未受刺激的马静脉注射利多卡因应用于改善心血管性能以外的其他原因。无论是否给予利多卡因,在七氟醚1.5 MAC时,未受刺激的马预计会出现严重低血压。

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