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实验猪模型中泮库溴铵和维库溴铵的血流动力学差异

Haemodynamic differences between pancuronium and vecuronium in an experimental pig model.

作者信息

Grong Kristoffer, Salminen Pirjo-Riitta, Stangeland Lodve, Dahle Geir O

机构信息

Department of Clinical Science, University of Bergen, Bergen, Norway.

出版信息

Vet Anaesth Analg. 2015 May;42(3):242-9. doi: 10.1111/vaa.12198. Epub 2014 Jul 2.

Abstract

OBJECTIVE

To compare baseline cardiovascular function in anesthetised pigs using either pancuronium or vecuronium as a neuromuscular blocker.

STUDY DESIGN

Retrospective, non-randomized comparison.

ANIMALS

Norwegian Land Race pigs (Sus scrofa domesticus) weighing mean 42 ± SD 3 kg.

METHODS

One hundred and sixteen animals from four different research protocols premedicated with identical doses of ketamine, diazepam, atropine and isoflurane, and anaesthetised with pentobarbital, fentanyl, midazolam and N(2)O were arranged into three uniform groups with respect to neuromuscular blocking agent: pancuronium bolus of 0.063 mg kg(-1) followed by 0.14 mg kg(-1) hour(-1) (n = 54), low-dose vecuronium 0.4 mg kg(-1) /0.2 mg kg(-1) hour(-1) (n = 29) and high-dose vecuronium 0.6 mg kg(-1) /0.3 mg kg(-1) hour(-1) (n = 33).

RESULTS

The majority of cardiovascular parameters demonstrated no significant differences between groups. For heart rate, there was an overall group difference, p = 0.036. Dromotropy was low in the pancuronium group, with an increased normalised PR-interval compared to the high-dose vecuronium group, median 0.200 interquartile range (0.190, 0.215) versus 0.182 (0.166, 0.199), p < 0.05. Left ventricular compliance was increased in pancuronium-treated animals, demonstrated as a reduction in the nonlinear end-diastolic pressure volume relationship β compared to both vecuronium groups, 0.021 (0.016, 0.025) versus 0.031 (0.025, 0.046) and 0.031 (0.022, 0.048), p < 0.05. The linear end-diastolic pressure volume relationship EDPVR(lin) was reduced as well in the pancuronium group, compared to the low-dose vecuronium group, 0.131 (0.116, 0.169) versus 0.181 (0.148, 0.247), p < 0.05.

CONCLUSIONS

There are only minor haemodynamic differences when using pancuronium compared to vecuronium in the fentanyl-pentobarbital-midazolam-N(2)O anesthetised domestic pigs. Furthermore, increasing doses of vecuronium have minimal haemodynamic effects.

CLINICAL RELEVANCE

Experimental studies in pigs using either pancuronium or vecuronium as a neuromuscular blocking agent are comparable with regard to cardiac and haemodynamic performance.

摘要

目的

比较使用泮库溴铵或维库溴铵作为神经肌肉阻滞剂时,麻醉猪的基线心血管功能。

研究设计

回顾性、非随机比较。

动物

挪威长白猪(家猪),平均体重42±标准差3千克。

方法

来自四个不同研究方案的116只动物,预先使用相同剂量的氯胺酮、地西泮、阿托品和异氟烷进行预处理,并用戊巴比妥、芬太尼、咪达唑仑和N₂O麻醉,根据神经肌肉阻滞剂分为三个均匀组:泮库溴铵推注剂量为0.063毫克/千克,随后以0.14毫克/千克·小时⁻¹给药(n = 54),低剂量维库溴铵0.4毫克/千克/0.2毫克/千克·小时⁻¹(n = 29)和高剂量维库溴铵0.6毫克/千克/0.3毫克/千克·小时⁻¹(n = 33)。

结果

大多数心血管参数在各组之间无显著差异。心率方面,总体组间存在差异,p = 0.036。泮库溴铵组的变时性较低,与高剂量维库溴铵组相比,标准化PR间期增加,中位数分别为0.200四分位间距(0.190,0.215)和0.182(0.166,0.199),p < 0.05。泮库溴铵处理的动物左心室顺应性增加,表现为与两个维库溴铵组相比,非线性舒张末期压力容积关系β降低,分别为0.021(0.016,0.025)、0.031(0.025,0.046)和0.031(0.022,0.048),p < 0.05。与低剂量维库溴铵组相比,泮库溴铵组的线性舒张末期压力容积关系EDPVR(lin)也降低,分别为0.131(0.116,0.169)和0.181(0.148,0.247),p < 0.05。

结论

在芬太尼 - 戊巴比妥 - 咪达唑仑 - N₂O麻醉的家猪中,使用泮库溴铵与维库溴铵相比,血流动力学差异较小。此外,增加维库溴铵剂量对血流动力学影响最小。

临床意义

在猪中使用泮库溴铵或维库溴铵作为神经肌肉阻滞剂的实验研究在心脏和血流动力学性能方面具有可比性。

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