地西泮或咪达唑仑对猫诱导麻醉所需丙泊酚剂量的影响。
The effects of diazepam or midazolam on the dose of propofol required to induce anaesthesia in cats.
作者信息
Robinson Rebecca, Borer-Weir Kate
机构信息
Department of Veterinary Clinical Sciences, Royal Veterinary College, University of London, London, UK.
出版信息
Vet Anaesth Analg. 2015 Sep;42(5):493-501. doi: 10.1111/vaa.12244. Epub 2015 Feb 14.
OBJECTIVES
Assess effects of benzodiazepine administration on the propofol dose required to induce anaesthesia in healthy cats, investigate differences between midazolam and diazepam, and determine an optimal benzodiazepine dose for co-induction.
STUDY DESIGN
Prospective, randomised, blinded, placebo-controlled clinical trial.
ANIMALS
Ninety client-owned cats (ASA I and II) with a median (interquartile range) body mass of 4.0 (3.4-4.9) kg.
METHODS
All cats received 0.01 mg kg(-1) acepromazine and 0.2 mg kg(-1) methadone intravenously (IV). Fifteen minutes later, sedation was scored on a scale of 1-5, with 5 indicating greatest sedation. Propofol, 2 mg kg(-1) , administered IV, was followed by either midazolam or diazepam at 0.2, 0.3, 0.4 or 0.5 mg kg(-1) or saline 0.1 mL kg(-1) . Further propofol was administered until endotracheal intubation was possible. Patient signalment, sedation score, propofol dosage and adverse reactions were recorded.
RESULTS
Midazolam and diazepam (all doses) significantly reduced the propofol dose required compared with saline (p < 0.001). There was no difference between midazolam and diazepam in propofol dose reduction (p = 0.488). All individual doses of midazolam reduced propofol requirement compared with saline (0.2 mg kg(-1) , p = 0.028; 0.3 mg kg(-1) , p = 0.006; 0.4 mg kg(-1) , p < 0.001; 0.5 mg kg(-1) , p = 0.009). Diazepam 0.2 mg kg(-1) did not reduce the propofol dose compared with saline (p = 0.087), but the remaining doses did (0.3 mg kg(-1) , p = 0.001; 0.4 mg kg(-1) , p = 0.032; 0.5 mg kg(-1) , p = 0.041). Cats with sedation scores of 3 required less propofol than cats with scores of 2 (p = 0.008). There was no difference between groups in adverse events.
CONCLUSIONS AND CLINICAL RELEVANCE
Midazolam (0.2-0.5 mg kg(-1) ) and diazepam (0.3-0.5 mg kg(-1) ) administered IV after 2 mg kg(-1) propofol significantly reduced the propofol dose required for tracheal intubation.
目的
评估苯二氮䓬类药物给药对健康猫诱导麻醉所需丙泊酚剂量的影响，研究咪达唑仑和地西泮之间的差异，并确定联合诱导的最佳苯二氮䓬类药物剂量。
研究设计
前瞻性、随机、盲法、安慰剂对照临床试验。
动物
90只客户拥有的猫（美国麻醉医师协会I级和II级），中位（四分位间距）体重为4.0（3.4 - 4.9）kg。
方法
所有猫静脉注射0.01 mg kg⁻¹乙酰丙嗪和0.2 mg kg⁻¹美沙酮。15分钟后，按1 - 5分进行镇静评分，5分表示最大程度的镇静。静脉注射2 mg kg⁻¹丙泊酚后，接着给予0.2、0.3、0.4或0.5 mg kg⁻¹的咪达唑仑或地西泮，或0.1 mL kg⁻¹的生理盐水。进一步给予丙泊酚直至能够进行气管插管。记录动物的特征、镇静评分、丙泊酚剂量和不良反应。
结果
与生理盐水相比，咪达唑仑和地西泮（所有剂量）显著降低了所需的丙泊酚剂量（p < 0.001）。咪达唑仑和地西泮在丙泊酚剂量降低方面没有差异（p = 0.488）。与生理盐水相比，咪达唑仑的所有个体剂量均降低了丙泊酚需求量（0.2 mg kg⁻¹，p = 0.028；0.3 mg kg⁻¹，p = 0.006；0.4 mg kg⁻¹，p < 0.001；0.5 mg kg⁻¹，p = 0.009）。与生理盐水相比，0.2 mg kg⁻¹的地西泮未降低丙泊酚剂量（p = 0.087），但其余剂量降低了（0.3 mg kg⁻¹，p = 0.001；0.4 mg kg⁻¹，p = 0.032；0.5 mg kg⁻¹，p = 0.041）。镇静评分为3分的猫比评分为2分的猫所需丙泊酚更少（p = 0.008）。各组之间不良事件无差异。
结论及临床意义
在静脉注射2 mg kg⁻¹丙泊酚后静脉注射咪达唑仑（0.2 - 0.5 mg kg⁻¹）和地西泮（0.3 - 0.5 mg kg⁻¹）可显著降低气管插管所需的丙泊酚剂量。
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