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持续输注利多卡因对用赛拉嗪、咪达唑仑、氯胺酮和异氟醚麻醉的犊牛的心血管影响。

Cardiovascular effects of a continuous rate infusion of lidocaine in calves anesthetized with xylazine, midazolam, ketamine and isoflurane.

作者信息

Araújo Marcelo A, Dias Bianca P, Bovino Fernanda, Deschk Maurício, Abimussi Caio Jx, Oliva Valéria Nls, Rodrigues Celso A, Santos Paulo Sp

机构信息

Department of Veterinary Medicine, Faculty Integrated, Campo Mourão, PR, Brazil.

出版信息

Vet Anaesth Analg. 2014 Mar;41(2):145-52. doi: 10.1111/vaa.12102. Epub 2013 Dec 18.

Abstract

OBJECTIVE

To assess the cardiovascular changes of a continuous rate infusion of lidocaine in calves anesthetized with xylazine, midazolam, ketamine and isoflurane during mechanical ventilation.

STUDY DESIGN

Prospective, randomized, cross-over, experimental trial.

ANIMALS

A total of eight, healthy, male Holstein calves, aged 10 ± 1 months and weighing 114 ± 11 kg were included in the study.

METHODS

Calves were administered xylazine followed by ketamine and midazolam, orotracheal intubation and maintenance on isoflurane (1.3%) using mechanical ventilation. Forty minutes after induction, lidocaine (2 mg kg⁻¹ bolus) or an equivalent volume of saline (0.9%) was administered IV followed by a continuous rate infusion (100 μg kg⁻¹ minute⁻¹) of lidocaine (treatment L) or saline (treatment C). Heart rate (HR), systolic, diastolic and mean arterial pressures (SAP, DAP and MAP), central venous pressure (CVP), mean pulmonary arterial pressure (mPAP), pulmonary arterial occlusion pressure (PAOP), cardiac output, end-tidal carbon dioxide (Pe'CO2 ) and core temperature (CT) were recorded before lidocaine or saline administration (Baseline) and at 20-minute intervals (T20-T80). Plasma concentrations of lidocaine were measured in treatment L.

RESULTS

The HR was significantly lower in treatment L compared with treatment C. There was no difference between the treatments with regards to SAP, DAP, MAP and SVRI. CI was significantly lower at T60 in treatment L when compared with treatment C. PAOP and CVP increased significantly at all times compared with Baseline in treatment L. There was no significant difference between times within each treatment and between treatments with regards to other measured variables. Plasma concentrations of lidocaine ranged from 1.85 to 2.06 μg mL⁻¹ during the CRI.

CONCLUSION AND CLINICAL RELEVANCE

At the studied rate, lidocaine causes a decrease in heart rate which is unlikely to be of clinical significance in healthy animals, but could be a concern in compromised animals.

摘要

目的

评估在机械通气期间,对用赛拉嗪、咪达唑仑、氯胺酮和异氟烷麻醉的犊牛持续输注利多卡因时的心血管变化。

研究设计

前瞻性、随机、交叉、实验性试验。

动物

总共8头健康的雄性荷斯坦犊牛,年龄10±1个月,体重114±11千克,纳入本研究。

方法

给犊牛注射赛拉嗪,随后注射氯胺酮和咪达唑仑,进行气管插管,并使用机械通气维持异氟烷(1.3%)麻醉。诱导40分钟后,静脉注射利多卡因(2毫克/千克推注剂量)或等量的生理盐水(0.9%),随后持续输注利多卡因(治疗组L)或生理盐水(治疗组C)(100微克/千克/分钟)。在注射利多卡因或生理盐水之前(基线)以及每隔20分钟(T20 - T80)记录心率(HR)、收缩压、舒张压和平均动脉压(SAP、DAP和MAP)、中心静脉压(CVP)、平均肺动脉压(mPAP)、肺动脉闭塞压(PAOP)、心输出量、呼气末二氧化碳(Pe'CO2)和核心体温(CT)。在治疗组L中测量利多卡因的血浆浓度。

结果

与治疗组C相比,治疗组L的HR显著降低。治疗组在SAP、DAP、MAP和SVRI方面无差异。与治疗组C相比,治疗组L在T60时CI显著降低。与基线相比,治疗组L中PAOP和CVP在所有时间均显著升高。在各治疗组内不同时间以及各治疗组之间,其他测量变量无显著差异。持续输注期间利多卡因的血浆浓度范围为1.85至2.06微克/毫升。

结论及临床意义

在所研究的输注速率下,利多卡因会使心率降低,这在健康动物中可能不具有临床意义,但在身体状况不佳的动物中可能是一个问题。

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