Bosmans Tim, Schauvliege Stijn, Gasthuys Frank, Duchateau Luc, Steblaj Barbara, Gadeyne Caroline, Polis Ingeborgh
Department of Medicine and Clinical Biology of Small Animals, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, Belgium.
Vet Anaesth Analg. 2011 Sep;38(5):494-504. doi: 10.1111/j.1467-2995.2011.00633.x.
To evaluate the cardiovascular effects of a preload of hydroxyethylstarch 6% (HES), preceding an epidural administration of ropivacaine 0.75% in isoflurane anaesthetized dogs.
Six female, neutered Beagle dogs (mean 13.3 ± SD 1.0 kg; 3.6 ± 0.1 years).
Randomized experimental cross-over study (washout of 1 month).
Anaesthesia was induced with propofol and maintained with isoflurane in oxygen/air. All dogs were anaesthetized twice to receive either treatment HESR (continuous rate infusion [CRI] of 7 mL kg(-1) HES started 30 minutes [T-30] prior to epidural administration of ropivacaine 0.75% 1.65 mg kg(-1) at T0) or treatment R (no HES preload and similar dose and timing of epidural ropivacaine administration). Baseline measurements were obtained at T-5. Heart rate (HR), mean (MAP), diastolic (DAP) and systolic (SAP) invasive arterial pressures, cardiac output (Lithium dilution and pulse contour analysis) and derived parameters were recorded every 5 minutes for 60 minutes. Statistical analysis was performed on five dogs, due to the death of one dog.
Clinically relevant decreases in MAP (<60 mmHg) were observed for 20 and 40 minutes following epidural administration in treatments HESR and R respectively. Significant decreases in MAP and DAP were present after treatment HESR for up to 20 minutes following epidural administration. No significant within-treatment and overall differences were observed for other cardiovascular parameters. A transient unilateral Horner's syndrome occurred in two dogs (one in each treatment). One dog died after severe hypotension, associated with epidural anaesthesia.
A CRI of 7 mL kg(-1) HES administered over 30 minutes before epidural treatment did not prevent hypotension induced by epidural ropivacaine 0.75%. Epidural administration of ropivacaine 0.75% in isoflurane anaesthetized dogs was associated with a high incidence of adverse effects in this study.
评估在异氟烷麻醉的犬中，于硬膜外给予0.75%罗哌卡因前预充6%羟乙基淀粉（HES）对心血管系统的影响。
6只雌性绝育比格犬（平均体重13.3±标准差1.0千克；3.6±0.1岁）。
随机实验性交叉研究（洗脱期1个月）。
用丙泊酚诱导麻醉，并用异氟烷维持氧/空气麻醉。所有犬均接受两次麻醉，分别接受治疗HESR（在硬膜外给予0.75%罗哌卡因1.65毫克/千克于T0时间点前30分钟[T-30]开始以7毫升/千克的速度持续输注[CRI]HES）或治疗R（无HES预充且硬膜外罗哌卡因给药剂量和时间相似）。在T-5时间点进行基线测量。在60分钟内，每5分钟记录一次心率（HR）、平均（MAP）、舒张压（DAP）和收缩压（SAP）有创动脉压、心输出量（锂稀释法和脉搏轮廓分析法）及衍生参数。由于一只犬死亡，对五只犬进行了统计分析。
在治疗HESR和R中，硬膜外给药后分别在20分钟和40分钟观察到具有临床意义的MAP下降（<60 mmHg）。在治疗HESR中，硬膜外给药后长达20分钟MAP和DAP显著下降。其他心血管参数在治疗内和总体上未观察到显著差异。两只犬（每种治疗各一只）出现短暂性单侧霍纳综合征。一只犬在严重低血压后死亡，与硬膜外麻醉有关。
在硬膜外治疗前30分钟内以7毫升/千克的速度持续输注HES并不能预防0.75%硬膜外罗哌卡因引起的低血压。在本研究中，异氟烷麻醉的犬硬膜外给予0.75%罗哌卡因不良反应发生率较高。
