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西班牙犬类麻醉死亡:一项对2012例病例的多中心前瞻性队列研究。

Canine anaesthetic death in Spain: a multicentre prospective cohort study of 2012 cases.

作者信息

Gil Laura, Redondo José I

机构信息

Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Instituto de Ciencias Biomédicas, Universidad CEU Cardenal Herrera, Valencia, Spain.

出版信息

Vet Anaesth Analg. 2013 Nov;40(6):e57-67. doi: 10.1111/vaa.12059. Epub 2013 Jul 6.

Abstract

OBJECTIVE

To study current perianaesthetic mortality in dogs in Spain and to identify the main risk factors predisposing to perianaesthetic mortality in our country.

STUDY DESIGN

A multicentre prospective cohort study.

ANIMAL POPULATION

Dogs anaesthetised for different surgical and diagnostic procedures at 39 Spanish veterinary clinics between February 2007 and March 2008.

METHODS

Data of patients, procedures and anaesthetic management were recorded. Anaesthetic death was defined as perioperative death within 24 hours of the procedure end. A multivariate study evaluated perinanaesthetic death using logistic binary regression models with the Wald technique.

RESULTS

2012 animals were included in the analyses. Twenty-six dogs died. The global mortality rate was 1.29% (95% Confidence interval (95% CI): 0.88-1.89%). ASA I-II was 0.33% (95 CI: 0.14-0.78%); ASA III-V was 4.06% (95% CI: 2.67-6.13%). Most deaths occurred during the post-operative period (20 dogs, 77%). The multivariate analysis revealed that high ASA grade was associated with an increased risk of mortality. The use of opioids plus NSAIDs during anaesthesia was related with a decrease of the risk.

CONCLUSIONS

Perianaesthetic mortality in dogs in Spain was 1.29% (95% CI: 0.88-1.89%). ASA grade was the main prognostic factor of likelihood of death. The use of some analgesics (opioids and NSAIDs) in the perioperative period was associated with reduced odds of death and may be protective.

CLINICAL RELEVANCE

Evaluation and stabilisation of patients before interventions may help lower risk of death during the anaesthesia. In addition to their use for welfare purposes, analgesics may be beneficial in reducing anaesthetic-related deaths.

摘要

目的

研究西班牙犬类围麻醉期死亡率,并确定我国围麻醉期死亡的主要危险因素。

研究设计

多中心前瞻性队列研究。

动物群体

2007年2月至2008年3月间在西班牙39家兽医诊所接受不同手术和诊断操作麻醉的犬类。

方法

记录患者、操作和麻醉管理的数据。麻醉死亡定义为手术结束后24小时内的围手术期死亡。多变量研究使用Wald技术的逻辑二元回归模型评估围麻醉期死亡情况。

结果

2012只动物纳入分析。26只犬死亡。总体死亡率为1.29%(95%置信区间(95%CI):0.88 - 1.89%)。美国麻醉医师协会(ASA)分级I-II级为0.33%(95%CI:0.14 - 0.78%);ASA III-V级为4.06%(95%CI:2.67 - 6.13%)。大多数死亡发生在术后阶段(20只犬,77%)。多变量分析显示,高ASA分级与死亡风险增加相关。麻醉期间使用阿片类药物加非甾体抗炎药与风险降低有关。

结论

西班牙犬类围麻醉期死亡率为1.29%(95%CI:0.88 - 1.89%)。ASA分级是死亡可能性的主要预后因素。围手术期使用某些镇痛药(阿片类药物和非甾体抗炎药)与死亡几率降低相关,可能具有保护作用。

临床意义

干预前对患者进行评估和稳定病情可能有助于降低麻醉期间的死亡风险。除了用于福利目的外,镇痛药可能有助于减少与麻醉相关的死亡。

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