Minghella Enzo, Auckburally Adam, Pawson Patricia, Scott Marian E, Flaherty Derek
Institute of Biodiversity, Animal Health and Comparative Medicine, School of Veterinary Medicine, University of Glasgow, Glasgow, UK.
School of Mathematics and Statistics, University of Glasgow, Glasgow, UK.
Vet Anaesth Analg. 2016 Sep;43(5):472-81. doi: 10.1111/vaa.12336. Epub 2016 Feb 2.
To evaluate the propofol requirement, cardiovascular and respiratory variables using midazolam or lidocaine with a propofol target-controlled infusion (PTCI) for induction of anaesthesia in healthy dogs.
Prospective, randomized, controlled blinded clinical trial.
Sixty client-owned dogs [American Society of Anesthesiologists (ASA) I-II] undergoing surgical procedures.
Thirty minutes after premedication with acepromazine (0.03 mg kg(-1) ) and morphine (0.2 mg kg(-1) ), PTCI was started and maintained at a plasma target concentration of 1 μg mL(-1) . Three minutes later, dogs (n = 20 per group) received either 5 mL 0.9% sodium chloride (SG), 2 mg kg(-1) of lidocaine (LG) or 0.2 mg kg(-1) of midazolam (MG) intravenously (IV) as a co-induction agent. Two minutes later, suitability for endotracheal intubation was assessed. If intubation was not possible, the propofol target was increased by 0.5 μg mL(-1) every 60 seconds until it was successfully achieved. Heart rate (HR), respiratory rate (fR ), and oscillometric systolic arterial pressure (SAP), mean arterial pressure (MAP) and diastolic arterial pressure (DAP) were recorded immediately prior to commencing PTCI (B0), prior to intubation (BI), immediately after (T0), and at 3 (T3) and 5 (T5) minutes post-intubation. End-tidal partial pressures of carbon dioxide (PE(') CO2 ) were recorded at T0, T3 and T5. The occurrence of excitement at any time point was noted.
The median (range) propofol target concentration for endotracheal intubation was significantly lower in MG, 1.5 (1.0-4.0) μg mL(-1) compared with LG, 2.5 (1.5-4.5) μg mL(-1) or SG, 3.0 (2.0-5.0) μg mL(-1) . Heart rate, MAP, fR and PE(') CO2 were similar in the three groups at all time points. No excitement was reported in any dog.
Midazolam, but not lidocaine, provided a significant reduction in PTCI requirement for induction of anaesthesia thereby allowing successful intubation. However, cardiovascular and respiratory effects were not different between the groups.
使用咪达唑仑或利多卡因联合丙泊酚靶控输注（PTCI），评估健康犬麻醉诱导时的丙泊酚需求量、心血管和呼吸变量。
前瞻性、随机、对照双盲临床试验。
60只接受手术的客户拥有的犬[美国麻醉医师协会（ASA）I-II级]。
用乙酰丙嗪（0.03 mg kg⁻¹）和吗啡（0.2 mg kg⁻¹）进行术前用药30分钟后，开始PTCI并维持血浆靶浓度为1 μg mL⁻¹。三分钟后，犬（每组n = 20）静脉注射（IV）5 mL 0.9%氯化钠（SG）、2 mg kg⁻¹利多卡因（LG）或0.2 mg kg⁻¹咪达唑仑（MG）作为联合诱导剂。两分钟后，评估气管插管的适宜性。如果无法插管，丙泊酚靶浓度每60秒增加0.5 μg mL⁻¹，直至成功插管。在开始PTCI前（B0）、插管前（BI）、插管后立即（T0）以及插管后3分钟（T3）和5分钟（T5）记录心率（HR）、呼吸频率（fR）以及示波法测量的收缩动脉压（SAP）、平均动脉压（MAP）和舒张动脉压（DAP）。在T0、T3和T5记录呼气末二氧化碳分压（PEʹCO₂）。记录任何时间点的兴奋情况。
咪达唑仑组气管插管时丙泊酚靶浓度中位数（范围）显著低于利多卡因组，分别为1.5（1.0 - 4.0）μg mL⁻¹、利多卡因组为2.5（1.5 - 4.5）μg mL⁻¹、生理盐水组为3.0（2.0 - 5.0）μg mL⁻¹。三组在所有时间点的心率、MAP、fR和PEʹCO₂相似。所有犬均未报告有兴奋情况。
咪达唑仑而非利多卡因可显著降低麻醉诱导时的丙泊酚需求量，从而实现成功插管。然而，各组之间的心血管和呼吸效应并无差异。
