Suppr超能文献

右美托咪定-吗啡与右美托咪定-美沙酮用于腹腔镜手术犬镇静、异氟烷需求及术后镇痛的比较

Comparison of medetomidine-morphine and medetomidine-methadone for sedation, isoflurane requirement and postoperative analgesia in dogs undergoing laparoscopy.

作者信息

Raillard Mathieu, Michaut-Castrillo Julien, Spreux Damien, Gauthier Olivier, Touzot-Jourde Gwenola, Holopherne-Doran Delphine

机构信息

Faculty of Vetsuisse, University of Bern, Bern, Switzerland.

Nantes-Atlantic National College of Veterinary Medicine, Food Science and Engineering-ONIRIS, Nantes, France.

出版信息

Vet Anaesth Analg. 2017 Jan;44(1):17-27. doi: 10.1111/vaa.12394. Epub 2017 Feb 23.

Abstract

OBJECTIVE

To compare the effects of intravenous (IV) medetomidine-morphine and medetomidine-methadone on preoperative sedation, isoflurane requirements and postoperative analgesia in dogs undergoing laparoscopic surgery.

STUDY DESIGN

Randomized, crossover trial.

ANIMALS

Twelve adult Beagle dogs weighing 15.1 ± 4.1 kg.

METHODS

Dogs were administered medetomidine (2.5 μg kg) IV 5 minutes before either methadone (MET) or morphine (MOR) (0.3 mg kg) IV. Anaesthesia was induced with propofol, maintained with isoflurane in oxygen, and depth was clinically assessed and adjusted by an anaesthetist blinded to the treatment. Animals underwent laparoscopic abdominal biopsies. Sedation and nausea scores, pulse rate (PR), respiratory rate (f), noninvasive systolic arterial blood pressure (SAP), rectal temperature (RT) and pain scores were recorded before drug administration, 5 minutes after medetomidine injection and 10 minutes after opioid administration. Propofol dose, PR, f, SAP, oesophageal temperature (T), end-tidal carbon dioxide and end-tidal isoflurane concentration (Fe'Iso) were recorded intraoperatively. Pain scores, PR, f, SAP and RT were recorded 10 minutes after extubation, every hour for 6 hours, then at 8, 18 and 24 hours. The experiment was repeated with the other drug 1 month later.

RESULTS

Nine dogs completed the study. After opioid administration and intraoperatively, PR, but not SAP, was significantly lower in MET. Fe'Iso was significantly lower in MET. Temperature decreased in both treatments. Pain scores were significantly higher in MOR at 3 hours after extubation, but not at other time points. Two dogs required rescue analgesia; one with both treatments and one in MOR.

CONCLUSION AND CLINICAL RELEVANCE

At the dose used, sedation produced by both drugs when combined with medetomidine was equivalent, while volatile anaesthetic requirements and PR perioperatively were lower with methadone. Postoperative analgesia was deemed to be adequate for laparoscopy with either protocol, although methadone provided better analgesia 3 hours after surgery.

摘要

目的

比较静脉注射美托咪定-吗啡和美托咪定-美沙酮对接受腹腔镜手术犬的术前镇静、异氟烷需求及术后镇痛的效果。

研究设计

随机交叉试验。

动物

12只体重为15.1±4.1千克的成年比格犬。

方法

在静脉注射美沙酮(MET)或吗啡(MOR)(0.3毫克/千克)前5分钟,给犬静脉注射美托咪定(2.5微克/千克)。用丙泊酚诱导麻醉,用氧气中的异氟烷维持麻醉,由对治疗不知情的麻醉师临床评估并调整麻醉深度。动物接受腹腔镜腹部活检。在给药前、美托咪定注射后5分钟和阿片类药物给药后10分钟记录镇静和恶心评分、脉搏率(PR)、呼吸频率(f)、无创收缩期动脉血压(SAP)、直肠温度(RT)和疼痛评分。术中记录丙泊酚剂量、PR、f、SAP、食管温度(T)、呼气末二氧化碳和呼气末异氟烷浓度(Fe'Iso)。拔管后10分钟、每小时记录6小时,然后在8、18和24小时记录疼痛评分、PR、f、SAP和RT。1个月后用另一种药物重复该实验。

结果

9只犬完成了研究。给药后及术中,MET组的PR显著降低,但SAP未降低。MET组的Fe'Iso显著降低。两种治疗方法体温均下降。拔管后3小时,MOR组的疼痛评分显著更高,但在其他时间点无差异。2只犬需要补救镇痛;一只在两种治疗中均需要,一只在MOR组中需要。

结论及临床意义

在所用剂量下,两种药物与美托咪定联合使用时产生的镇静效果相当,而美沙酮组围手术期挥发性麻醉剂需求和PR较低。两种方案用于腹腔镜手术时术后镇痛均被认为足够,尽管美沙酮在术后3小时提供了更好的镇痛效果。

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验