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猫24小时机械通气的三种麻醉方案比较。

A comparison of 3 anesthetic protocols for 24 hours of mechanical ventilation in cats.

作者信息

Boudreau Ainsley E, Bersenas Alexa M E, Kerr Carolyn L, Holowaychuk Marie K, Johnson Ron J

机构信息

Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.

出版信息

J Vet Emerg Crit Care (San Antonio). 2012 Apr;22(2):239-52. doi: 10.1111/j.1476-4431.2012.00722.x.

Abstract

OBJECTIVE

To compare the recovery times, recovery quality, and cardiovascular (CV) effects of 3 anesthetic protocols during 24 hours of mechanical ventilation (MV) in healthy cats.

DESIGN

Prospective, randomized, crossover study.

SETTING

Research laboratory at a veterinary teaching hospital.

ANIMALS

Six healthy intact male purpose-bred cats.

INTERVENTIONS

Each cat was randomly assigned to receive 3 anesthetic protocols for 24 hours of MV; Protocol K consisted of ketamine, Protocol P, propofol; and Protocol PK, propofol plus fixed-rate low-dose ketamine. Each infusion drug dose was adjusted using a sedation scoring system. All protocols included fixed doses of fentanyl (10 μg/kg/h) and midazolam (0.5 mg/kg/h).

MEASUREMENTS AND MAIN RESULTS

Drug doses and recovery times were recorded. Recovery quality was scored. Blood gas results, CV parameters, and frequency of bradycardia or hypotension requiring interventions were recorded. The mean d dose ± standard error of K was 81.3 ± 3.3 μg/kg/m. The median dose (95% cardiac index) of propofol (μg/kg/m) in PK was 16.0 (13.1, 19.6) and in P was 48.1 (39.3, 58.9). P necessitated significantly more propofol than PK (P < 0.05). Protocol K (35.6 ± 3.2 hours) had significantly longer times to full recovery compared to P (18.2 ± 3.2 hours). Protocol K had significantly longer times to head up, crawling, and standing compared to P and PK. Cats sedated with PK (2.33 ± 0.47) required significantly more interventions for hypotension than K (0.50 ± 0.47). Protocol P (3.2 ± 0.4) and PK (1.4 ± 0.3) required significantly more interventions for bradycardia compared to K (0.8 ± 0.3). When comparing protocol K to P and PK, significant differences in blood pressure, lactate, oxygen delivery, and oxygen consumption were noted.

CONCLUSIONS

Cats anesthetized with P had shorter times to full recovery compared to K. Cats anesthetized with K required fewer interventions for bradycardia or hypotension but had longer recovery times compared to P or PK. Protocol PK reduced the propofol dose required to maintain optimal anesthesia.

摘要

目的

比较3种麻醉方案在健康猫机械通气(MV)24小时期间的恢复时间、恢复质量及心血管(CV)效应。

设计

前瞻性、随机、交叉研究。

地点

一家兽医教学医院的研究实验室。

动物

6只健康的未阉割雄性专用繁殖猫。

干预措施

每只猫随机分配接受3种麻醉方案进行24小时的MV;方案K由氯胺酮组成,方案P由丙泊酚组成,方案PK由丙泊酚加固定速率低剂量氯胺酮组成。每种输注药物剂量使用镇静评分系统进行调整。所有方案均包括固定剂量的芬太尼(10μg/kg/h)和咪达唑仑(0.5mg/kg/h)。

测量指标及主要结果

记录药物剂量和恢复时间。对恢复质量进行评分。记录血气结果、CV参数以及需要干预的心动过缓或低血压的频率。方案K的平均剂量±标准误为81.3±3.3μg/kg/m。方案PK中丙泊酚的中位剂量(95%心脏指数)(μg/kg/m)为16.0(13.1,19.6),方案P中为48.1(39.3,58.9)。方案P所需的丙泊酚显著多于方案PK(P<0.05)。与方案P(18.2±3.2小时)相比,方案K完全恢复的时间显著更长(35.6±3.2小时)。与方案P和PK相比,方案K抬头、爬行和站立的时间显著更长。用方案PK镇静的猫(2.33±0.47)因低血压需要干预的次数显著多于方案K(0.50±0.47)。与方案K(0.8±0.3)相比,方案P(3.2±0.4)和方案PK(1.4±0.3)因心动过缓需要干预的次数显著更多。在比较方案K与方案P和PK时,观察到血压、乳酸、氧输送和氧消耗存在显著差异。

结论

与方案K相比,用方案P麻醉的猫完全恢复的时间更短。与方案P或PK相比,用方案K麻醉的猫因心动过缓或低血压需要干预的次数更少,但恢复时间更长。方案PK减少了维持最佳麻醉所需的丙泊酚剂量。

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