Marcilla Miguel G, Schauvliege Stijn, Segaert Stefanie, Duchateau Luc, Gasthuys Frank
Department of Surgery and Anaesthesia of Domestic Animals, Faculty of Veterinary Medicine, University of Ghent, Merelbeke, Belgium.
Vet Anaesth Analg. 2012 Jan;39(1):49-58. doi: 10.1111/j.1467-2995.2011.00672.x.
To investigate the influence of a dexmedetomidine constant rate infusion (CRI) in horses anaesthetized with isoflurane.
Prospective, randomized, blinded, clinical study.
Forty adult healthy horses (weight mean 491 ± SD 102 kg) undergoing elective surgery.
After sedation [dexmedetomidine, 3.5 μg kg(-1) intravenously (IV)] and induction IV (midazolam 0.06 mg kg(-1), ketamine 2.2 mg kg(-1)), anaesthesia was maintained with isoflurane in oxygen/air (FiO(2) 55-60%). Horses were ventilated and dobutamine was administered when hypoventilation [arterial partial pressure of CO(2) > 8.00 kPa (60 mmHg)] and hypotension [arterial pressure 70 mmHg] occurred respectively. During anaesthesia, horses were randomly allocated to receive a CRI of dexmedetomidine (1.75 μg kg(-1) hour(-1) ) (D) or saline (S). Monitoring included end-tidal isoflurane concentration, cardiopulmonary parameters, and need for dobutamine and additional ketamine. All horses received 0.875 μg kg(-1) dexmedetomidine IV for the recovery period. Age and weight of the horses, duration of anaesthesia, additional ketamine and dobutamine, cardiopulmonary data (anova), recovery scores (Wilcoxon Rank Sum Test), duration of recovery (t-test) and attempts to stand (Mann-Whitney test) were compared between groups. Significance was set at p < 0.05.
Heart rate and arterial partial pressure of oxygen were significantly lower in group D compared to group S. An interaction between treatment and time was present for cardiac index, oxygen delivery index and systemic vascular resistance. End-tidal isoflurane concentration and heart rate significantly increased over time. Packed cell volume, systolic, diastolic and mean arterial pressure, arterial oxygen content, stroke volume index and systemic vascular resistance significantly decreased over time. Recovery scores were significantly better in group D, with fewer attempts to stand and significantly longer times to sternal position and first attempt to stand.
A dexmedetomidine CRI produced limited cardiopulmonary effects, but significantly improved recovery quality.
研究右美托咪定持续输注（CRI）对异氟烷麻醉马匹的影响。
前瞻性、随机、双盲临床研究。
40匹接受择期手术的成年健康马匹（平均体重491±标准差102千克）。
在镇静（静脉注射右美托咪定，3.5微克/千克）和静脉诱导（咪达唑仑0.06毫克/千克、氯胺酮2.2毫克/千克）后，用异氟烷在氧气/空气（FiO₂ 55 - 60%）中维持麻醉。马匹进行通气，分别在出现通气不足[动脉血二氧化碳分压>8.00千帕（60毫米汞柱）]和低血压[动脉压<70毫米汞柱]时给予多巴酚丁胺。麻醉期间，马匹被随机分配接受右美托咪定CRI（1.75微克/千克·小时）（D组）或生理盐水（S组）。监测包括呼气末异氟烷浓度、心肺参数以及对多巴酚丁胺和额外氯胺酮的需求。所有马匹在恢复期静脉注射0.875微克/千克右美托咪定。比较两组马匹的年龄、体重、麻醉持续时间、额外使用的氯胺酮和多巴酚丁胺、心肺数据（方差分析）、恢复评分（Wilcoxon秩和检验）、恢复持续时间（t检验）以及站立尝试次数（Mann-Whitney检验）。显著性设定为p<0.05。
与S组相比，D组的心率和动脉血氧分压显著降低。治疗与时间之间存在心脏指数、氧输送指数和全身血管阻力的相互作用。呼气末异氟烷浓度和心率随时间显著增加。血细胞比容、收缩压、舒张压和平均动脉压、动脉血氧含量、每搏量指数和全身血管阻力随时间显著降低。D组的恢复评分显著更好，站立尝试次数更少，达到胸骨位和首次站立的时间显著更长。
右美托咪定CRI产生的心肺效应有限，但显著改善了恢复质量。
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