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持续输注右美托咪定对马心血管功能、异氟烷需求量及恢复质量的影响。

Effects of a constant rate infusion of detomidine on cardiovascular function, isoflurane requirements and recovery quality in horses.

作者信息

Schauvliege Stijn, Marcilla Miguel Gozalo, Verryken Kirsten, Duchateau Luc, Devisscher Lindsey, Gasthuys Frank

机构信息

Department of Surgery and Anaesthesia of Domestic Animals, Faculty of Veterinary Medicine, University of Ghent, Merelbeke, Belgium.

出版信息

Vet Anaesth Analg. 2011 Nov;38(6):544-54. doi: 10.1111/j.1467-2995.2011.00659.x.

Abstract

OBJECTIVE

To examine the influence of a detomidine constant rate infusion (CRI) on cardiovascular function, isoflurane requirements and recovery quality in horses undergoing elective surgery.

STUDY DESIGN

Prospective, randomized, blinded, clinical trial.

ANIMALS

Twenty adult healthy horses.

METHODS

After sedation (detomidine, 10 μg kg(-1) intravenously [IV]) and induction of anaesthesia (midazolam 0.06 mg kg(-1) , ketamine 2.2 mg kg(-1) IV), anaesthesia was maintained with isoflurane in oxygen/air (inspiratory oxygen fraction 55%). When indicated, the lungs were mechanically ventilated. Dobutamine was administered when MAP<70 mmHg. The horses were randomly allocated to one of two groups and throughout anaesthesia, received either a detomidine (5 μg kg(-1)  hour(-1) ) (D) or saline (S) CRI, with the anaesthetist unaware of the treatment. Monitoring included end-tidal isoflurane concentration, arterial pH, PaCO(2) , PaO(2) , dobutamine administration rate, heart rate (HR), arterial pressure, cardiac index (CI), systemic vascular resistance (SVR), stroke index and oxygen delivery index (ḊO(2) I). For recovery from anaesthesia, all horses received 2.5 μg kg(-1) detomidine IV. Recovery quality and duration were recorded in each horse. For statistical analysis, anova, Pearson chi-square and Wilcoxon rank sum tests were used as relevant.

RESULTS

Heart rate (p=0.0176) and ḊO(2) I (p= 0.0084) were lower and SVR higher (p=0.0126) in group D, compared to group S. Heart rate (p=0.0011) and pH (p=0.0187) increased over time. Significant differences in isoflurane requirements were not detected. Recovery quality and duration were comparable between treatments.

CONCLUSIONS AND CLINICAL RELEVANCE

A detomidine CRI produced cardiovascular effects typical for α(2) -agonists, without affecting isoflurane requirements, recovery duration or recovery quality.

摘要

目的

研究右美托咪定持续输注(CRI)对择期手术马匹心血管功能、异氟醚需求量及苏醒质量的影响。

研究设计

前瞻性、随机、双盲临床试验。

动物

20匹成年健康马。

方法

在给予镇静剂(右美托咪定,静脉注射10μg/kg)和诱导麻醉(咪达唑仑0.06mg/kg、氯胺酮2.2mg/kg,静脉注射)后,用异氟醚在氧气/空气(吸入氧分数55%)中维持麻醉。必要时,进行机械通气。当平均动脉压(MAP)<70mmHg时给予多巴酚丁胺。将马匹随机分为两组,在整个麻醉过程中,一组接受右美托咪定(5μg/kg·小时)(D组)持续输注,另一组接受生理盐水(S组)持续输注,麻醉医生不知道具体治疗分组。监测指标包括呼气末异氟醚浓度、动脉血pH值、二氧化碳分压(PaCO₂)、氧分压(PaO₂)、多巴酚丁胺给药速率、心率(HR)、动脉压、心脏指数(CI)、全身血管阻力(SVR)、每搏指数和氧输送指数(ḊO₂I)。所有马匹在麻醉苏醒时静脉注射2.5μg/kg右美托咪定。记录每匹马的苏醒质量和苏醒持续时间。进行统计分析时,根据情况使用方差分析、Pearson卡方检验和Wilcoxon秩和检验。

结果

与S组相比,D组心率(p=0.0176)和ḊO₂I(p=0.0084)较低,SVR较高(p=0.0126)。心率(p=0.0011)和pH值(p=0.0187)随时间增加。未检测到异氟醚需求量的显著差异。各治疗组间苏醒质量和苏醒持续时间相当。

结论及临床意义

右美托咪定持续输注产生了α₂-激动剂典型的心血管效应,而不影响异氟醚需求量、苏醒持续时间或苏醒质量。

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