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阿托品与氢溴酸东莨菪碱在逆转马替米定引起的心动过缓中的比较研究。

Comparative study between atropine and hyoscine-N-butylbromide for reversal of detomidine induced bradycardia in horses.

机构信息

Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista, São Paulo, Brazil.

出版信息

Equine Vet J. 2011 May;43(3):332-40. doi: 10.1111/j.2042-3306.2010.00165.x. Epub 2010 Sep 14.

Abstract

REASONS FOR PERFORMING STUDY

Bradycardia may be implicated as a cause of cardiovascular instability during anaesthesia.

HYPOTHESIS

Hyoscine would induce positive chronotropism of shorter duration than atropine, without adversely impairing intestinal motility in detomidine sedated horses.

METHODS

Ten minutes after detomidine (0.02 mg/kg bwt, i.v.), physiological saline (control), atropine (0.02 mg/kg bwt) or hyoscine (0.2 mg/kg bwt) were randomly administered i.v. to 6 horses, allowing one week intervals between treatments. Investigators blinded to the treatments monitored cardiopulmonary data and intestinal auscultation for 90 min and 24 h after detomidine, respectively. Gastrointestinal transit was assessed for 96 h via chromium detection in dry faeces.

RESULTS

Detomidine significantly decreased heart rate (HR) and cardiac index (CI) from baseline for 30 and 60 min, respectively (control). Mean ± s.d. HR increased significantly 5 min after atropine (79 ± 5 beats/min) and hyoscine (75 ± 8 beats/min). After this time, HR was significantly higher after atropine in comparison to other treatments, while hyoscine resulted in intermediate values (lower than atropine but higher than controls). Hyoscine and atropine resulted in significantly higher CI than controls for 5 and 20 min, respectively; but this effect coincided with significant hypertension (mean arterial pressures >180 mmHg). Auscultation scores decreased from baseline in all treatments. Time to return to auscultation scores ≥12 (medians) did not differ between hyoscine (4 h) and controls (4 h) but atropine resulted in significantly longer time (10 h). Atropine induced colic in one horse. Gastrointestinal transit times did not differ between treatments.

CONCLUSION

Hyoscine is a shorter acting positive chronotropic agent than atropine, but does not potentiate the impairment in intestinal motility induced by detomidine. Because of severe hypertension, routine use of anticholinergics combined with detomidine is not recommended.

POTENTIAL RELEVANCE

Hyoscine may represent an alternative to atropine for treating bradycardia.

摘要

研究目的

心动过缓可能是麻醉期间心血管不稳定的一个原因。

假设

莨菪碱比阿托品引起的正性变时作用持续时间更短,而不会在镇静的马中对肠道蠕动产生不利影响。

方法

在给予地托咪定(0.02mg/kg bwt,iv)后 10 分钟,随机向 6 匹马静脉内给予生理盐水(对照)、阿托品(0.02mg/kg bwt)或氢溴酸东莨菪碱(0.2mg/kg bwt),治疗之间允许间隔一周。分别在给予地托咪定后 90 分钟和 24 小时,对盲法治疗的调查员监测心肺数据和肠道听诊。通过在干燥粪便中检测铬来评估 96 小时的胃肠道转运。

结果

与基线相比,地托咪定显著降低心率(HR)和心输出量(CI)分别在 30 分钟和 60 分钟(对照)。HR 在给予阿托品后 5 分钟显著增加(79 ± 5 次/分钟)和氢溴酸东莨菪碱(75 ± 8 次/分钟)。从那时起,与其他治疗相比,阿托品后 HR 显著升高,而氢溴酸东莨菪碱则导致中间值(低于阿托品但高于对照)。氢溴酸东莨菪碱和阿托品分别使 CI 显著高于对照,分别为 5 分钟和 20 分钟;但这种作用伴随着显著的高血压(平均动脉压>180mmHg)。所有治疗均使听诊评分从基线下降。氢溴酸东莨菪碱(4 小时)和对照(4 小时)返回听诊评分≥12(中位数)的时间无差异,但阿托品导致的时间明显延长(10 小时)。阿托品引起一匹马绞痛。治疗之间的胃肠道转运时间无差异。

结论

与阿托品相比,氢溴酸东莨菪碱是一种作用时间更短的正性变时药,但不会增强地托咪定引起的肠道蠕动障碍。由于严重的高血压,不建议常规使用抗胆碱能药物与地托咪定联合使用。

潜在相关性

氢溴酸东莨菪碱可能是治疗心动过缓的阿托品替代物。

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