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通过静脉恒速输注法,在山羊体内以三种不同剂量联合使用阿法沙龙和芬太尼时,测定阿法沙龙的最低输注速率。

Determination of the minimum infusion rate of alfaxalone during its co-administration with fentanyl at three different doses by constant rate infusion intravenously in goats.

作者信息

Dzikiti Brighton T, Ndawana Patience S, Zeiler Gareth, Ferreira Jacques P, Dzikiti Loveness N

机构信息

Department of Companion Animal Clinical Studies, University of Pretoria, Pretoria, South Africa.

Department of Clinical Veterinary Studies, University of Zimbabwe, Harare, Zimbabwe.

出版信息

Vet Anaesth Analg. 2016 May;43(3):316-25. doi: 10.1111/vaa.12300. Epub 2015 Sep 9.

Abstract

OBJECTIVE

To determine the minimum infusion rate (MIR) of alfaxalone required to prevent purposeful movement of the extremities in response to standardized noxious stimulation during its co-administration with fentanyl at three different doses by constant rate infusion (CRI) intravenously (IV) in goats.

STUDY DESIGN

Prospective, blinded, randomized crossover, experimental.

ANIMALS

Eight healthy goats; four does and four wethers.

METHODS

For induction of anaesthesia, a bolus of fentanyl was administered at 0.005 mg kg(-1) (LFent), 0.015 mg kg(-1) (MFent) or 0.03 mg kg(-1) (HFent) followed by alfaxalone at 2.0 mg kg(-1) . For maintenance, the goats received alfaxalone at an initial infusion rate of 9.6 mg kg(-1)  hour(-1) and one of three fentanyl treatments: 0.005 mg kg(-1)  hour(-1) (LFent), 0.015 mg kg(-1)  hour(-1) (MFent) or 0.03 mg kg(-1) hour(-1) (HFent). The MIR of alfaxalone was determined during fentanyl CRI by testing for responses to stimulation (clamping on a digit with Vulsellum forceps) every 30 minutes. Some cardiopulmonary parameters were measured.

RESULTS

The alfaxalone MIR median (range) was 6.7 (6.7-8.6), 2.9 (1.0-6.7) and 1.0 (1.0-4.8) mg kg(-1)  hour(-1) during LFent, MFent and HFent, respectively. Alfaxalone MIR was significantly lower during MFENT and HFENT compared to LFENT. Significantly low oxygen haemoglobin saturation (SaO2 ) and arterial oxygen partial pressure (PaO2 ), observed 2 minutes into anaesthesia after all fentanyl treatments, were the most remarkable adverse cardiopulmonary effects observed. Recovery from anaesthesia was severely affected by high doses of fentanyl with excitatory behavioural signs predominant for up to 2 hours post-administration after MFent and HFent.

CONCLUSIONS AND CLINICAL RELEVANCE

Fentanyl reduces alfaxalone MIR in goats in a dose-dependent manner. Immediate oxygen supplementation after induction of general anaesthesia is recommended to prevent hypoxaemia. Doses of fentanyl equal to or greater than 0.015 mg kg(-1)  hour(-1) tend to be associated with severe excitatory behaviour and should be avoided when fentanyl is administered to goats.

摘要

目的

通过静脉恒速输注(CRI),确定在山羊体内与三种不同剂量的芬太尼联合使用时,预防肢体对标准化有害刺激产生有意识运动所需的阿法沙龙最低输注速率(MIR)。

研究设计

前瞻性、盲法、随机交叉实验。

动物

八只健康山羊,四只母羊和四只公羊。

方法

诱导麻醉时,静脉注射负荷剂量的芬太尼,剂量分别为0.005 mg kg⁻¹(低剂量芬太尼,LFent)、0.015 mg kg⁻¹(中剂量芬太尼,MFent)或0.03 mg kg⁻¹(高剂量芬太尼,HFent),随后静脉注射2.0 mg kg⁻¹阿法沙龙。维持麻醉时,山羊初始以9.6 mg kg⁻¹小时⁻¹的速率输注阿法沙龙,并接受三种芬太尼处理之一:0.005 mg kg⁻¹小时⁻¹(LFent)、0.015 mg kg⁻¹小时⁻¹(MFent)或0.03 mg kg⁻¹小时⁻¹(HFent)。在芬太尼CRI期间,每30分钟通过测试对刺激的反应(用卵圆钳夹住手指)来确定阿法沙龙的MIR。测量了一些心肺参数。

结果

在低剂量芬太尼、中剂量芬太尼和高剂量芬太尼期间,阿法沙龙MIR中位数(范围)分别为6.7(6.7 - 8.6)、2.9(1.0 - 6.7)和1.0(1.0 - 4.8)mg kg⁻¹小时⁻¹。与低剂量芬太尼相比,中剂量芬太尼和高剂量芬太尼期间阿法沙龙MIR显著更低。在所有芬太尼处理后麻醉2分钟时观察到的显著低氧血红蛋白饱和度(SaO₂)和动脉血氧分压(PaO₂)是观察到的最显著的不良心肺效应。高剂量芬太尼严重影响麻醉恢复,中剂量芬太尼和高剂量芬太尼给药后长达2小时内主要表现为兴奋性行为体征。

结论及临床意义

芬太尼以剂量依赖方式降低山羊体内阿法沙龙的MIR。建议全身麻醉诱导后立即补充氧气以预防低氧血症。当给山羊使用芬太尼时,等于或大于0.015 mg kg⁻¹小时⁻¹的芬太尼剂量往往与严重的兴奋性行为相关,应避免使用。

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