Hopster K, Ohnesorge B, von Borstel M, Rohn K, Kästner S
Dr. Klaus Hopster, Klinik für Pferde, Stiftung Tierärztliche Hochschule Hannover, Bünteweg 9, 30559 Hannover, E-Mail:
Tierarztl Prax Ausg G Grosstiere Nutztiere. 2013;41(6):371-7.
In most ocular procedures, a central position of the eye is necessary. This can be achieved using a deep plane of anaesthesia, locoregional blocks or with neuromuscular blocking agents. The aim of this study was to evaluate the influence of atracurium on cardiovascular parameters, and on recovery quality and duration in horses.
Thirty-four warmblood horses undergoing in total 50 vitrectomies were divided into two groups. Premedication, induction and maintenance were identical in all patients. After 20 minutes, horses of group A received atracurium (0.1 mg/kg) while in the control group (group K) the depth of anaesthesia was adapted to keep the bulbus in a central position. Dobutamine and fluids were administered to maintain the mean arterial blood pressure (MAP) above 70 mmHg. Cardiac output (CO), heart rate (HR), MAP, respiratory rate, end-expiratory isoflurane concentration (ETIso) and dobutamine requirements were determined. Position and movement of the globe during the surgical procedure were scored. Time and quality of the recovery period was scored.
Horses of group K required significantly higher concentrations of isoflurane (group A: 1.08 ± 0.1%; group K: 1.34 ± 0.2%) and had an overall lower MAP (group A: 88.4 ± 10.3 mmHg; group K: 76.6 ± 11.6 mmHg) and CO (group A: 36.9 ± 11.7 l/min; group K: 28.5 ± 7.2 l/min) but needed significantly more dobutamine (group A: 0.37 ± 0.17 μg/kg/min; group K: 0.99 ± 0.46 μg/kg/min) compared to group A. Complete relaxation occurred 9.5 ± 2.5 minutes after atracurium bolus and lasted for 25 ± 7.1 minutes. The score of the bulbus position and movement was significantly lower in group A, resulting in a better quality for the surgical procedure. In group A, the recovery time to standing was significantly shorter (group A: 18.1 ± 5.4 min; group K: 31.5 ± 7.1 min), with no difference in quality.
The use of atracurium resulted in a better cardiovascular condition, probably because of the isoflurane-sparing effect. The recovery time was shorter in these horses without negative effects on recovery quality. No signs of residual atracurium effects were detected.
在大多数眼科手术中，眼睛保持居中位置很有必要。这可以通过采用深度麻醉平面、局部阻滞或使用神经肌肉阻滞剂来实现。本研究的目的是评估阿曲库铵对马的心血管参数、恢复质量和恢复持续时间的影响。
34匹接受了50次玻璃体切除术的温血马被分为两组。所有患者的术前用药、诱导和维持用药均相同。20分钟后，A组马接受阿曲库铵（0.1mg/kg），而对照组（K组）则调整麻醉深度以保持眼球处于居中位置。给予多巴酚丁胺和液体以维持平均动脉血压（MAP）高于70mmHg。测定心输出量（CO）、心率（HR）、MAP、呼吸频率、呼气末异氟烷浓度（ETIso）和多巴酚丁胺需求量。对手术过程中眼球的位置和运动进行评分。对恢复期的时间和质量进行评分。
K组马需要显著更高浓度的异氟烷（A组：1.08±0.1%；K组：1.34±0.2%），总体MAP较低（A组：88.4±10.3mmHg；K组：76.6±11.6mmHg），CO也较低（A组：36.9±11.7l/min；K组：28.5±7.2l/min），但与A组相比，需要显著更多的多巴酚丁胺（A组：0.37±0.17μg/kg/min；K组：0.99±0.46μg/kg/min）。推注阿曲库铵后9.5±2.5分钟出现完全松弛，并持续25±7.1分钟。A组眼球位置和运动的评分显著更低，从而使手术质量更好。在A组，站立恢复时间显著更短（A组：18.1±5.4分钟；K组：31.5±7.1分钟），恢复质量无差异。
使用阿曲库铵导致更好的心血管状况，可能是由于其节省异氟烷的作用。这些马的恢复时间更短，且对恢复质量无负面影响。未检测到阿曲库铵残留效应的迹象。
