Casoni Daniela, Spadavecchia Claudia, Adami Chiara
Department of Veterinary Clinical Science, School of Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
Vet Anaesth Analg. 2015 May;42(3):250-9. doi: 10.1111/vaa.12200. Epub 2014 Jul 9.
To determine the potency ratio between S-ketamine and racemic ketamine as inductive agents for achieving tracheal intubation in dogs.
Prospective, randomized, 'blinded', clinical trial conducted in two consecutive phases.
112 client-owned dogs (ASA I or II).
All animals were premedicated with intramuscular acepromazine (0.02 mg kg(-1)) and methadone (0.2 mg kg(-1)). In phase 1, midazolam (0.2 mg kg(-1)) with either 3 mg kg(-1) of racemic ketamine (group K) or 1.5 mg kg(-1) of S-ketamine (group S) was administered IV, for induction of anaesthesia and intubation. Up to two additional doses of racemic (1.5 mg kg(-1)) or S-ketamine (0.75 mg kg(-1)) were administered if required. In phase 2, midazolam (0.2 mg kg(-1)) with 1 mg kg(-1) of either racemic ketamine (group K) or S-ketamine (group S) was injected and followed by a continuous infusion (1 mg kg minute(-1)) of each respective drug. Differences between groups were statistically analyzed via t-test, Fisher exact test and ANOVA for repeated measures.
Demographics and quality and duration of premedication, induction and intubation were comparable among groups. During phase 1 it was possible to achieve tracheal intubation after a single dose in more dogs in group K (n = 25) than in group S (n = 16) (p = 0.046). A dose of 3 mg kg(-1) S-ketamine allowed tracheal intubation in the same number of dogs as 4.5 mg kg(-1) of racemic ketamine. The estimated potency ratio was 1.5:1. During phase 2, the total dose (mean ± SD) of S-ketamine (4.02 ±1.56 mg kg(-1)) and racemic ketamine (4.01 ± 1.42) required for tracheal intubation was similar.
Racemic and S-ketamine provide a similar quality of anaesthetic induction and intubation. S-ketamine is not twice as potent as racemic ketamine and, if infused, the potency ratio is 1:1.
确定S-氯胺酮与消旋氯胺酮作为犬气管插管诱导剂的效价比。
前瞻性、随机、“盲法”临床试验，分两个连续阶段进行。
112只客户拥有的犬（美国麻醉医师协会I级或II级）。
所有动物均肌肉注射乙酰丙嗪（0.02 mg·kg⁻¹）和美沙酮（0.2 mg·kg⁻¹）进行预处理。在第1阶段，静脉注射咪达唑仑（0.2 mg·kg⁻¹），同时分别联合3 mg·kg⁻¹消旋氯胺酮（K组）或1.5 mg·kg⁻¹ S-氯胺酮（S组）用于诱导麻醉和插管。如有需要，可额外追加两剂消旋氯胺酮（1.5 mg·kg⁻¹）或S-氯胺酮（0.75 mg·kg⁻¹）。在第2阶段，注射咪达唑仑（0.2 mg·kg⁻¹），同时分别联合1 mg·kg⁻¹消旋氯胺酮（K组）或S-氯胺酮（S组），随后以各自药物1 mg·kg·min⁻¹的速度持续输注。通过t检验、Fisher精确检验和重复测量方差分析对组间差异进行统计学分析。
各组间的人口统计学特征以及预处理、诱导和插管的质量及持续时间具有可比性。在第1阶段，K组（n = 25）单次给药后成功实现气管插管的犬只数量多于S组（n = 16）（p = 0.046）。3 mg·kg⁻¹ S-氯胺酮实现气管插管的犬只数量与4.5 mg·kg⁻¹消旋氯胺酮相同。估计效价比为1.5:1。在第2阶段，气管插管所需的S-氯胺酮（4.02 ± 1.56 mg·kg⁻¹）和消旋氯胺酮（4.01 ± 1.42）的总剂量相似。
消旋氯胺酮和S-氯胺酮提供相似质量的麻醉诱导和插管效果。S-氯胺酮的效力并非消旋氯胺酮的两倍，若持续输注，效价比为1:1。
