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硬膜外注射芬太尼-赛拉嗪对绵羊的抗伤害感受及心肺效应

The anti-nociceptive and cardiopulmonary effects of extradural fentanyl-xylazine in sheep.

作者信息

Aminkov Bogdan Y, Dinev Dinko, Pascalev Michail

机构信息

Department of Surgery and Radiology, Faculty of Veterinary Medicine, 6000 Stara Zagora, Bulgaria.

出版信息

Vet Anaesth Analg. 2002 Jul;29(3):126-132. doi: 10.1046/j.1467-2995.2002.00080.x. Epub 2016 Nov 15.

Abstract

OBJECTIVE

To compare the anti-nociceptive effects of extradural xylazine, fentanyl and a xylazine-fentanyl combination in sheep, and to measure the cardiopulmonary effects of the xylazine-fentanyl combination.

STUDY DESIGN

Prospective, randomized study.

ANIMALS

Twenty-five half-merino ewes 2-4 years of age and body mass 54.2 ± 1.1 kg.

METHODS

Six sheep in group 1 received 0.2 mg kg xylazine by extradural injection, six in group 2 received fentanyl 1.5 μg kg and 13 in group 3 received the combination of both treatments. In all groups, drugs were mixed with saline (0.15 mL kg before injection). Pulmonary and carotid arterial catheters were placed in seven sheep of group 3 which were used to evaluate cardiopulmonary effects. Anti-nociception was determined by the response to electrical stimulation (40 V for 1.5 milliseconds) of the left flank and by superficial and deep muscular 'pinpricking' stimulation of the pelvic and thoracic limbs and thoracolumbar region.

RESULTS

Lack of response to electrical stimulation at the left flank was present in 10 ± 1.1 minutes (mean ± SEM) (group 1) and in 4.5 ± 0.5 minutes in group 3. The duration of lack of response to electrical stimulation at the left flank was 96 ± 6 minutes in group 1 and 315 ± 6 minutes in group 3. Responses persisted in group 3. Significant decreases (p < 0.05) in cardiac output 30, 45, 60 and 90 minutes after injection, and in cardiac work at 30 and 45 minutes were observed in the seven animals of group 3. Arterial blood pH was lowest at 90 minutes, arterial bicarbonate was lowest at 60 minutes and values for both arterial and mixed venous base excess increased significantly at 60 and 90 minutes. There was no significant change from baseline values in heart rate, mean arterial blood pressure, respiratory rate, body temperature, systemic vascular resistance, arterial and mixed venous PO, PCO, oxygen saturation, blood oxygen content, haemoglobin concentration, mixed venous blood bicarbonate and pH.

CONCLUSIONS

Fentanyl decreases the onset time and prolongs the duration of anti-nociception produced by xylazine. The combination decreases cardiac output but is without significant respiratory effects.

CLINICAL RELEVANCE

Further studies are required to show that surgery is possible in sheep after extradural xylazine-fentanyl injection.

摘要

目的

比较硬膜外注射赛拉嗪、芬太尼及赛拉嗪 - 芬太尼联合用药对绵羊的抗伤害感受作用,并测定赛拉嗪 - 芬太尼联合用药对心肺的影响。

研究设计

前瞻性随机研究。

动物

25只2 - 4岁的半美利奴母羊,体重54.2±1.1千克。

方法

第1组6只绵羊接受硬膜外注射0.2毫克/千克赛拉嗪,第2组6只接受1.5微克/千克芬太尼,第3组13只接受两种药物联合治疗。所有组中,药物均与生理盐水混合(注射前0.15毫升/千克)。对第3组的7只绵羊放置肺动脉和颈动脉导管,用于评估心肺影响。通过对左侧胁腹的电刺激(40伏,持续1.5毫秒)反应以及对盆腔和胸肢及胸腰段区域的浅部和深部肌肉“针刺”刺激来确定抗伤害感受。

结果

第1组在10±1.1分钟(均值±标准误)出现对左侧胁腹电刺激无反应,第3组为4.5±0.5分钟。第1组对左侧胁腹电刺激无反应的持续时间为96±6分钟,第3组为315±6分钟。第3组仍有反应。第3组的7只动物在注射后30、45、60和90分钟心输出量显著降低(p<0.05),在30和45分钟心脏做功显著降低。动脉血pH在90分钟时最低,动脉碳酸氢盐在60分钟时最低,动脉和混合静脉碱剩余值在60和90分钟时显著升高。心率、平均动脉血压、呼吸频率、体温、全身血管阻力、动脉和混合静脉血氧分压、二氧化碳分压、血氧饱和度、血氧含量、血红蛋白浓度、混合静脉血碳酸氢盐和pH与基线值相比无显著变化。

结论

芬太尼可缩短赛拉嗪产生抗伤害感受的起效时间并延长其持续时间。联合用药可降低心输出量,但对呼吸无显著影响。

临床意义

需要进一步研究以表明硬膜外注射赛拉嗪 - 芬太尼后绵羊能否进行手术。

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