Höglund Odd Viking, Lövebrant Johanna, Olsson Ulf, Höglund Katja
Department of Clinical Sciences, Box 7054, 750 07, Uppsala, Sweden.
Alingsås Veterinärstuga AB, Björkekärrsvägen 26, 441 91, Alingsås, Sweden.
Acta Vet Scand. 2016 Nov 17;58(1):80. doi: 10.1186/s13028-016-0263-y.
Surgery causes a stress response, a physiologic response to trauma. The intraoperative surgical stress response in dogs diagnosed with pyometra has not previously been described. The aim of this study was to investigate the intraoperative surgical stress response, assessed by blood pressure and heart rate measurements, in dogs diagnosed with pyometra and healthy controls. All dogs were premedicated with acepromazine and methadone, anaesthesia was induced with propofol and maintained with isoflurane, where after the dogs were subjected to ovariohysterectomy.
Eight dogs diagnosed with pyometra and eight healthy controls were used. Systolic blood pressure and heart rate were measured to assess the surgical stress response. Additionally propofol dosage at induction of anaesthesia and the end-tidal isoflurane concentration were investigated. The surgery was split into four phases. Phase 0 was the period 10 min before the skin incision, phase 1 was skin incision and opening of abdomen, phase 2 was manipulation of uterine horns, lifting of the ovary with stretching of the mesovarium, ligation and transection of mesovarium and phase 3 was ligation and transection of cervix, removal of organs and closing of the abdomen. Dosage of propofol at induction of anaesthesia was 3.6 ± 1 mg/kg in dogs with pyometra and 4.1 ± 1 in healthy controls (P = 0.37). In both groups, systolic blood pressure increased between phase 1 and 2, from 87 ± 15 to 114 ± 19 mmHg in dogs with pyometra, and from 88 ± 18 to 106 ± 20 mmHg in healthy controls, (both P < 0.0001). Systolic blood pressure did not differ significantly between groups in any of the phases. Heart rate and end-tidal concentration of isoflurane did not differ significantly between phases or between groups.
The increased blood pressure at removal of ovaries during ovariohysterectomy suggests a pronounced noxious stimulus at this part of the procedure. In principle, the study parameters and response to surgery did not differ significantly between dogs with pyometra and healthy controls.
手术会引发应激反应,这是机体对创伤的一种生理反应。此前尚未有关于患有子宫蓄脓症的犬只术中手术应激反应的描述。本研究的目的是通过测量血压和心率,调查患有子宫蓄脓症的犬只及健康对照犬只的术中手术应激反应。所有犬只均预先使用乙酰丙嗪和美沙酮进行预处理,用丙泊酚诱导麻醉并使用异氟烷维持麻醉,随后对犬只进行卵巢子宫切除术。
使用了8只被诊断为子宫蓄脓症的犬只和8只健康对照犬只。测量收缩压和心率以评估手术应激反应。此外,还研究了麻醉诱导时丙泊酚的剂量以及呼气末异氟烷浓度。手术分为四个阶段。阶段0为皮肤切开前10分钟,阶段1为皮肤切开和打开腹腔,阶段2为操作子宫角、提起卵巢并拉伸卵巢系膜、结扎和切断卵巢系膜,阶段3为结扎和切断子宫颈、取出器官并关闭腹腔。患有子宫蓄脓症的犬只麻醉诱导时丙泊酚剂量为3.6±1mg/kg,健康对照犬只为4.1±1mg/kg(P = 0.37)。在两组中,收缩压在阶段1和阶段2之间均升高,患有子宫蓄脓症的犬只从87±15mmHg升至114±19mmHg,健康对照犬只从88±18mmHg升至106±20mmHg(均P < 0.0001)。在任何阶段,两组之间的收缩压均无显著差异。心率和呼气末异氟烷浓度在各阶段之间或组间均无显著差异。
卵巢子宫切除术中切除卵巢时血压升高表明该手术步骤的这一部分存在明显的有害刺激。原则上,患有子宫蓄脓症的犬只和健康对照犬只在研究参数和对手术的反应方面无显著差异。