Mikkelsen Mai Louise Grandsgaard, Ambrus Rikard, Miles James Edward, Poulsen Helle Harding, Moltke Finn Borgbjerg, Eriksen Thomas
Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, 16 Dyrlægevej, 1870, Frederiksberg C, Denmark.
Department of Surgical Gastroenterology C, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, 2100, Copenhagen Ø, Denmark.
Acta Vet Scand. 2016 Jun 22;58(1):42. doi: 10.1186/s13028-016-0223-6.
The objective of this review is to evaluate the existing literature with regard to the influence of propofol and remifentanil total intravenous anaesthesia (TIVA) on cerebral perfusion and oxygenation in healthy pigs. Anaesthesia has influence on cerebral haemodynamics and it is important not only in human but also in veterinary anaesthesia to preserve optimal regulation of cerebral haemodynamics. Propofol and remifentanil are widely used in neuroanaesthesia and are increasingly used in experimental animal studies. In translational models, the pig has advantages compared to small laboratory animals because of brain anatomy, metabolism, neurophysiological maturation, and cerebral haemodynamics. However, reported effects of propofol and remifentanil on cerebral perfusion and oxygenation in pigs have not been reviewed. An electronic search identified 99 articles in English. Title and abstract screening selected 29 articles for full-text evaluation of which 19 were excluded with reasons. Of the 10 peer-reviewed articles included for review, only three had propofol or remifentanil anaesthesia as the primary study objective and only two directly investigated the effect of anaesthesia on cerebral perfusion and oxygenation (CPO). The evidence evaluated in this systematic review is limited, not focused on propofol and remifentanil and possibly influenced by factors of potential importance for CPO assessment. In one study of healthy pigs, CPO measures were within normal ranges following propofol-remifentanil anaesthesia, and addition of a single remifentanil bolus did not affect regional cerebral oxygen saturation (rSO2). Even though the pool of evidence suggests that propofol and remifentanil alone or in combination have limited effects on CPO in healthy pigs, confirmative evidence is lacking.
本综述的目的是评估现有文献中丙泊酚和瑞芬太尼全凭静脉麻醉（TIVA）对健康猪脑灌注和氧合的影响。麻醉会影响脑血流动力学，在人类麻醉和兽医麻醉中，维持脑血流动力学的最佳调节都很重要。丙泊酚和瑞芬太尼广泛应用于神经麻醉，并且在实验动物研究中的使用也越来越多。在转化模型中，猪由于脑解剖结构、代谢、神经生理成熟度和脑血流动力学等因素，相比于小型实验动物具有优势。然而，关于丙泊酚和瑞芬太尼对猪脑灌注和氧合的影响的报道尚未得到综述。电子检索共找到99篇英文文章。通过标题和摘要筛选，选择了29篇文章进行全文评估，其中19篇因各种原因被排除。在纳入综述的10篇经过同行评审的文章中，只有3篇以丙泊酚或瑞芬太尼麻醉作为主要研究目标，只有2篇直接研究了麻醉对脑灌注和氧合（CPO）的影响。本系统综述所评估的证据有限，并非聚焦于丙泊酚和瑞芬太尼，并且可能受到对CPO评估具有潜在重要性的因素的影响。在一项对健康猪的研究中，丙泊酚 - 瑞芬太尼麻醉后CPO指标在正常范围内，单次推注瑞芬太尼并未影响局部脑氧饱和度（rSO2）。尽管现有证据表明丙泊酚和瑞芬太尼单独或联合使用对健康猪的CPO影响有限，但仍缺乏确凿证据。
