Umar Mohammed Ahmed, Fukui Sho, Kawase Kodai, Itami Takaharu, Yamashita Kazuto
Department of Veterinary Surgery and Theriogenology, Faculty of Veterinary Medicine, University of Maiduguri, Maiduguri, Borno State, Nigeria.
J Vet Med Sci. 2015 Mar;77(3):281-8. doi: 10.1292/jvms.14-0370. Epub 2014 Nov 19.
Cardiovascular effects of total intravenous anesthesia using ketamine-medetomidine-propofol drug combination (KMP-TIVA) were determined in 5 Thoroughbred horses undergoing surgery. The horses were anesthetized with intravenous administration (IV) of ketamine (2.5 mg/kg) and midazolam (0.04 mg/kg) following premedication with medetomidne (5 µg/kg, IV) and artificially ventilated. Surgical anesthesia was maintained by controlling propofol infusion rate (initially 0.20 mg/kg/min following an IV loading dose of 0.5 mg/kg) and constant rate infusions of ketamine (1 mg/kg/hr) and medetomidine (1.25 µg/kg/hr). The horses were anesthetized for 175 ± 14 min (range from 160 to 197 min). Propofol infusion rates ranged from 0.13 to 0.17 mg/kg/min, and plasma concentration (Cpl) of propofol ranged from 11.4 to 13.3 µg/ml during surgery. Cardiovascular measurements during surgery remained within clinically acceptable ranges in the horses (heart rate: 33 to 37 beats/min, mean arterial blood pressure: 111 to 119 mmHg, cardiac index: 48 to 53 ml/kg/min, stroke volume: 650 to 800 ml/beat and systemic vascular resistance: 311 to 398 dynes/sec/cm(5)). The propofol Cpl declined rapidly after the cessation of propofol infusion and was significantly lower at 10 min (4.5 ± 1.5 µg/ml), extubation (4.0 ± 1.2 µg/ml) and standing (2.4 ± 0.9 µg/ml) compared with the Cpl at the end of propofol administration (11.4 ± 2.7 µg/ml). All the horses recovered uneventfully and stood at 74 ± 28 min after the cessation of anesthesia. KMP-TIVA provided satisfactory quality and control of anesthesia with minimum cardiovascular depression in horses undergoing surgery.
在5匹接受手术的纯种马中测定了使用氯胺酮-美托咪定-丙泊酚药物组合（KMP-TIVA）进行全静脉麻醉的心血管效应。在给予美托咪定（5μg/kg，静脉注射）进行术前用药后，马匹通过静脉注射氯胺酮（2.5mg/kg）和咪达唑仑（0.04mg/kg）进行麻醉，并进行人工通气。通过控制丙泊酚输注速率（在静脉注射负荷剂量0.5mg/kg后初始为0.20mg/kg/min）以及氯胺酮（1mg/kg/小时）和美托咪定（1.25μg/kg/小时）的恒速输注来维持手术麻醉。马匹麻醉时间为175±14分钟（范围为160至197分钟）。丙泊酚输注速率范围为0.13至0.17mg/kg/min，手术期间丙泊酚的血浆浓度（Cpl）范围为11.4至13.3μg/ml。手术期间马匹的心血管测量值保持在临床可接受范围内（心率：33至37次/分钟，平均动脉血压：111至119mmHg，心脏指数：48至53ml/kg/min，每搏量：650至800ml/次，全身血管阻力：311至398达因/秒/厘米(5)）。丙泊酚输注停止后，丙泊酚Cpl迅速下降，与丙泊酚给药结束时的Cpl（11.4±2.7μg/ml）相比，在10分钟时（4.5±1.5μg/ml）、拔管时（4.0±1.2μg/ml）和站立时（2.4±0.9μg/ml）显著降低。所有马匹均顺利恢复，麻醉停止后74±28分钟站立。KMP-TIVA为接受手术的马匹提供了令人满意的麻醉质量和控制，且心血管抑制最小。
