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在接受卵巢子宫切除术的猫中,用乙酰丙嗪或美托咪定镇静后,用于全静脉麻醉的阿法沙龙的最低输注速率。

Minimum infusion rate of alfaxalone for total intravenous anaesthesia after sedation with acepromazine or medetomidine in cats undergoing ovariohysterectomy.

作者信息

Schwarz Andrea, Kalchofner Karin, Palm Julia, Picek Stephanie, Hartnack Sonja, Bettschart-Wolfensberger Regula

机构信息

Equine Department, Vetsuisse Faculty, Section Anaesthesiology, University of Zurich, Zurich, Switzerland.

出版信息

Vet Anaesth Analg. 2014 Sep;41(5):480-90. doi: 10.1111/vaa.12144. Epub 2014 Feb 27.

Abstract

OBJECTIVE

To determine the induction doses, then minimum infusion rates of alfaxalone for total intravenous anaesthesia (TIVA), and subsequent, cardiopulmonary effects, recovery characteristics and alfaxalone plasma concentrations in cats undergoing ovariohysterectomy after premedication with butorphanol-acepromazine or butorphanol-medetomidine.

STUDY DESIGN

Prospective randomized blinded clinical study.

ANIMALS

Twenty-eight healthy cats.

METHODS

Cats undergoing ovariohysterectomy were assigned into two groups: together with butorphanol [0.2 mg kg(-1) intramuscularly (IM)], group AA (n = 14) received acepromazine (0.1 mg kg(-1) IM) and group MA (n = 14) medetomidine (20 μg kg(-1) IM). Anaesthesia was induced with alfaxalone to effect [0.2 mg kg(-1) intravenously (IV) every 20 seconds], initially maintained with 8 mg kg(-1)  hour(-1) alfaxalone IV and infusion adjusted (±0.5 mg kg(-1)  hour(-1) ) every five  minutes according to alterations in heart rate (HR), respiratory rate (fR ), Doppler blood pressure (DBP) and presence of palpebral reflex. Additional alfaxalone boli were administered IV if cats moved/swallowed (0.5 mg kg(-1) ) or if fR >40 breaths minute(-1) (0.25 mg kg(-1) ). Venous blood samples were obtained to determine plasma alfaxalone concentrations. Meloxicam (0.2 mg kg(-1) IV) was administered postoperatively. Data were analysed using linear mixed models, Chi-squared, Fishers exact and t-tests.

RESULTS

Alfaxalone anaesthesia induction dose (mean ± SD), was lower in group MA (1.87 ± 0.5; group AA: 2.57 ± 0.41 mg kg(-1) ). No cats became apnoeic. Intraoperative bolus requirements and TIVA rates (group AA: 11.62 ± 1.37, group MA: 10.76 ± 0.96 mg kg(-1)  hour(-1) ) did not differ significantly between groups. Plasma concentrations ranged between 0.69 and 10.76 μg mL(-1) . In group MA, fR , end-tidal carbon dioxide, temperature and DBP were significantly higher and HR lower.

CONCLUSION AND CLINICAL RELEVANCE

Alfaxalone TIVA in cats after medetomidine or acepromazine sedation provided suitable anaesthesia with no need for ventilatory support. After these premedications, the authors recommend initial alfaxalone TIVA rates of 10 mg kg(-1)  hour(-1) .

摘要

目的

确定在使用布托啡诺 - 乙酰丙嗪或布托啡诺 - 美托咪定进行预处理后,接受卵巢子宫切除术的猫在全静脉麻醉(TIVA)中阿法沙龙的诱导剂量、最低输注速率,以及随后的心肺效应、恢复特征和阿法沙龙血浆浓度。

研究设计

前瞻性随机双盲临床研究。

动物

28只健康猫。

方法

接受卵巢子宫切除术的猫被分为两组:AA组(n = 14)在使用布托啡诺[0.2 mg kg⁻¹肌肉注射(IM)]的同时,接受乙酰丙嗪(0.1 mg kg⁻¹ IM);MA组(n = 14)接受美托咪定(20 μg kg⁻¹ IM)。用阿法沙龙诱导麻醉至起效[每20秒静脉注射(IV)0.2 mg kg⁻¹],最初以8 mg kg⁻¹ 小时⁻¹的阿法沙龙IV维持,并根据心率(HR)、呼吸频率(fR)、多普勒血压(DBP)和睑反射的变化每5分钟调整输注速率(±0.5 mg kg⁻¹ 小时⁻¹)。如果猫移动/吞咽(0.5 mg kg⁻¹)或fR > 40次/分钟(0.25 mg kg⁻¹),则静脉注射额外的阿法沙龙推注剂量。采集静脉血样以测定血浆阿法沙龙浓度。术后给予美洛昔康(0.2 mg kg⁻¹ IV)。使用线性混合模型、卡方检验、费舍尔精确检验和t检验分析数据。

结果

MA组阿法沙龙麻醉诱导剂量(平均值±标准差)较低(1.87 ± 0.5;AA组:2.57 ± 0.41 mg kg⁻¹)。没有猫出现呼吸暂停。术中推注需求量和TIVA速率(AA组:11.62 ± 1.37,MA组:10.76 ± 0.96 mg kg⁻¹ 小时⁻¹)在两组之间无显著差异。血浆浓度范围在0.69至10.76 μg mL⁻¹之间。在MA组中,fR、呼气末二氧化碳、体温和DBP显著更高,HR更低。

结论及临床意义

美托咪定或乙酰丙嗪镇静后,阿法沙龙TIVA可为猫提供合适的麻醉,无需通气支持。在这些预处理后,作者建议阿法沙龙TIVA的初始速率为10 mg kg⁻¹ 小时⁻¹。

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