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丁丙诺啡联合乙酰丙嗪或右美托咪定用于猫和狗择期手术前的镇静和镇痛作用。

Sedative and analgesic effects of buprenorphine, combined with either acepromazine or dexmedetomidine, for premedication prior to elective surgery in cats and dogs.

作者信息

Hunt James R, Grint Nicola J, Taylor Polly M, Murrell Joanna C

机构信息

Morley Veterinary Centre, Taunton, Somerset, UK.

出版信息

Vet Anaesth Analg. 2013 May;40(3):297-307. doi: 10.1111/vaa.12003. Epub 2012 Dec 24.

Abstract

OBJECTIVE

To evaluate the sedative and analgesic effects of intramuscular buprenorphine with either dexmedetomidine or acepromazine, administered as premedication to cats and dogs undergoing elective surgery.

STUDY DESIGN

Prospective, randomized, blinded clinical study.

ANIMALS

Forty dogs and 48 cats.

METHODS

Animals were assigned to one of four groups, according to anaesthetic premedication and induction agent: buprenorphine 20 μg kg(-1) with either dexmedetomidine (dex) 250 μg m(-2) or acepromazine (acp) 0.03 mg kg(-1), followed by alfaxalone (ALF) or propofol (PRO). Meloxicam was administered preoperatively to all animals and anaesthesia was always maintained using isoflurane. Physiological measures and assessments of pain, sedation and mechanical nociceptive threshold (MNT) were made before and after premedication, intraoperatively, and for up to 24 hours after premedication. Data were analyzed with one-way, two-way and mixed between-within subjects anova, Kruskall-Wallis analyses and Chi squared tests. Results were deemed significant if p ≤ 0.05, except where multiple comparisons were performed (p ≤ 0.005).

RESULTS

Cats premedicated with dex were more sedated than cats premedicated with acp (p < 0.001) and ALF doses were lower in dex cats (1.2 ± 1.0 mg kg(-1) ) than acp cats (2.5 ± 1.9 mg kg(-1)) (p = 0.041). There were no differences in sedation in dogs however PRO doses were lower in dex dogs (1.5 ± 0.8 mg kg(-1) ) compared to acp dogs (3.3 ± 1.1 mg kg(-1) ) (p < 0.001). There were no differences between groups with respect to pain scores or MNT for cats or dogs.

CONCLUSION

Choice of dex or acp, when given with buprenorphine, caused minor, clinically detectable, differences in various characteristics of anaesthesia, but not in the level of analgesia.

CLINICAL RELEVANCE

A combination of buprenorphine with either acp or dex, followed by either PRO or ALF, and then isoflurane, accompanied by an NSAID, was suitable for anaesthesia in dogs and cats undergoing elective surgery. Choice of sedative agent may influence dose of anaesthetic induction agent.

摘要

目的

评估肌肉注射丁丙诺啡联合右美托咪定或乙酰丙嗪作为择期手术的猫和狗术前用药的镇静和镇痛效果。

研究设计

前瞻性、随机、双盲临床研究。

动物

40只狗和48只猫。

方法

根据麻醉前用药和诱导剂,将动物分为四组之一:丁丙诺啡20μg/kg⁻¹联合右美托咪定(dex)250μg/m⁻²或乙酰丙嗪(acp)0.03mg/kg⁻¹,随后使用阿法沙龙(ALF)或丙泊酚(PRO)。所有动物术前均给予美洛昔康,麻醉始终使用异氟烷维持。在术前用药前、术中以及术前用药后长达24小时进行生理指标测量以及疼痛、镇静和机械性伤害感受阈值(MNT)评估。数据采用单因素、双因素和受试者内-间混合方差分析、Kruskal-Wallis分析和卡方检验进行分析。如果p≤0.05,则结果被认为具有统计学意义,进行多重比较时除外(p≤0.005)。

结果

用dex进行术前用药的猫比用acp进行术前用药的猫更镇静(p<0.001),dex组猫的ALF剂量(1.2±1.0mg/kg⁻¹)低于acp组猫(2.5±1.9mg/kg⁻¹)(p=⒈041)。然而,狗的镇静情况没有差异,但dex组狗的PRO剂量(1.5±0.8mg/kg⁻¹)低于acp组狗(3.3±1.1mg/kg⁻¹)(p<0.001)。猫或狗的疼痛评分或MNT在组间没有差异。

结论

丁丙诺啡与dex或acp联合使用时,在麻醉的各种特征上会引起轻微的、临床上可检测到的差异,但在镇痛水平上没有差异。

临床意义

丁丙诺啡与acp或dex联合使用,随后使用PRO或ALF,再使用异氟烷,并伴有非甾体抗炎药,适用于接受择期手术的猫和狗的麻醉。镇静剂的选择可能会影响麻醉诱导剂的剂量。

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