Coleman Amanda E, Shepard Molly K, Schmiedt Chad W, Hofmeister Erik H, Brown Scott A
Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, GA, USA.
MedVet Medical & Cancer Center for Pets of Chicago, Chicago, IL, USA.
Vet Anaesth Analg. 2016 Sep;43(5):482-94. doi: 10.1111/vaa.12338. Epub 2016 Feb 5.
To examine whether preanesthetic administration of enalapril, compared with placebo, results in a greater decline in blood pressure (BP) or decreased responsiveness of BP to isotonic fluids or vasopressors in healthy dogs during isoflurane anesthesia.
Randomized, experimental, placebo-controlled, blinded, crossover study.
Twelve healthy, female, purpose-bred beagles.
Dogs underwent the following week-long treatment protocols, each preceded by a 1 week washout period: oral placebo twice daily (PLA); oral enalapril, 0.5 mg kg(-1) twice daily, with the 15th dose withheld on the day of anesthesia (ENA-W), and oral enalapril, 0.5 mg kg(-1) twice daily, with the 15th dose administered 90 minutes prior to anesthetic induction (ENA). On day 8 of each treatment period, dogs were anesthetized in random order utilizing a standard protocol. Following stabilization at an end-tidal isoflurane concentration (Fe'Iso) of 1.3%, invasively measured systolic (SAP), diastolic (DAP) and mean (MAP) arterial blood pressure were continuously recorded via telemetry. Hypotension (SAP < 85 mmHg) was treated with the following sequential interventions: lactated Ringer's solution (LRS) bolus (10 mL kg(-1) ); repeated LRS bolus; dopamine (7 μg kg(-1) min(-1) ); and dopamine (10 μg kg(-1) min(-1) ) first without and then with vasopressin (1 mU kg(-1) hour(-1) ).
Compared with the PLA but not the ENA-W group, the ENA group had significantly lower average SAP, DAP and MAP at an Fe'Iso of 1.3%, spent more minutes in hypotension, and required a greater number of interventions to correct moderate-to-severe mean arterial hypotension.
In healthy dogs, enalapril administered 90 minutes prior to isoflurane anesthesia increases the degree of intra-anesthetic hypotension and the number of interventions required to correct moderate-to-severe hypotension.
Dogs receiving angiotensin-converting enzyme inhibitors on the day of anesthesia may exhibit clinically significant intra-anesthetic hypotension.
研究在异氟烷麻醉期间，与安慰剂相比，麻醉前给予依那普利是否会使健康犬的血压（BP）下降幅度更大，或使BP对等渗液体或血管升压药的反应性降低。
随机、实验、安慰剂对照、盲法、交叉研究。
12只健康的雌性专用繁殖比格犬。
犬接受以下为期一周的治疗方案，每个方案前有1周的洗脱期：每日口服两次安慰剂（PLA）；每日口服依那普利0.5 mg·kg⁻¹，每日两次，麻醉当天不给予第15剂（ENA-W），以及每日口服依那普利0.5 mg·kg⁻¹，每日两次，在麻醉诱导前90分钟给予第15剂（ENA）。在每个治疗期的第8天，按照标准方案对犬进行随机麻醉。在呼气末异氟烷浓度（Fe'Iso）稳定在1.3%后，通过遥测连续记录有创测量的收缩压（SAP）、舒张压（DAP）和平均动脉压（MAP）。低血压（SAP < 85 mmHg）采用以下序贯干预措施治疗：乳酸林格氏液（LRS）推注（10 mL·kg⁻¹）；重复LRS推注；多巴胺（7 μg·kg⁻¹·min⁻¹）；以及先给予多巴胺（10 μg·kg⁻¹·min⁻¹），然后给予血管加压素（1 mU·kg⁻¹·小时⁻¹）。
与PLA组相比，但与ENA-W组不同，在Fe'Iso为1.3%时，ENA组的平均SAP、DAP和MAP显著更低，低血压持续时间更长，纠正中度至重度平均动脉低血压所需的干预措施更多。
在健康犬中，异氟烷麻醉前90分钟给予依那普利会增加麻醉期间低血压的程度以及纠正中度至重度低血压所需的干预措施数量。
麻醉当天接受血管紧张素转换酶抑制剂的犬可能会出现具有临床意义的麻醉期间低血压。
