麻醉药物选择对侧卧马匹高清示波法准确性的影响。
The effect of anesthetic drug choice on accuracy of high-definition oscillometry in laterally recumbent horses.
作者信息
Duke-Novakovski Tanya, Ambros Barbara, Feng Cindy, Carr Anthony P
机构信息
Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
出版信息
Vet Anaesth Analg. 2017 May;44(3):589-593. doi: 10.1016/j.vaa.2016.08.006. Epub 2017 Jan 11.
OBJECTIVE
To determine the accuracy of high-definition oscillometry (HDO) for arterial pressure measurement during injectable or inhalation anesthesia in horses.
STUDY DESIGN
Prospective, clinical study.
ANIMALS
Twenty-four horses anesthetized for procedures requiring lateral recumbency.
METHODS
Horses were premedicated with xylazine, and anesthesia induced with diazepam-ketamine. Anesthesia was maintained with xylazine-ketamine-guaifenesin combination [TripleDrip (TD; n = 12) or isoflurane (ISO; n = 12)]. HDO was used to obtain systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressures, and heart rate (HR) using an 8-cm-wide cuff around the proximal tail. Invasive blood pressure (IBP), SAP, MAP, DAP and HR were recorded during HDO cycling. Bland-Altman analysis for repeated measures was used to compare HDO and IBP for all measurements. The generalized additive model was used to determine if means in the differences between HDO and IBP were similar between anesthetic protocols for all measurements.
RESULTS
There were >110 paired samples for each variable. There was no effect of anesthetic choice on HDO performance, but more variability was present in TD compared with ISO. Skewed data required log-transformation for statistical comparison. Using raw data and standard Bland-Altman analysis, HDO overestimated SAP (TD, 3.8 ± 28.3 mmHg; ISO, 3.5 ± 13.6 mmHg), MAP (TD, 4.0 ± 23.3 mmHg; ISO, 6.3 ± 10.0 mmHg) and DAP (TD, 4.0 ± 21.2 mmHg; ISO, 7.8 ± 13.6 mmHg). In TD, 26-40% HDO measurements were within 10 mmHg of IBP, compared with 60-74% in ISO. Differences between HDO and IBP for all measurements were similar between anesthetic protocols. The numerical difference between IBP and HDO measurements for SAP, MAP and DAP significantly decreased as cuff width:tail girth ratio increased toward 40%.
CONCLUSION AND CLINICAL RELEVANCE
More variability in HDO occurred during TD. The cuff width:tail girth ratio is important for accuracy of HDO.
目的
确定高清示波法（HDO）在马匹注射或吸入麻醉期间测量动脉压的准确性。
研究设计
前瞻性临床研究。
动物
24匹因需要侧卧的手术而接受麻醉的马。
方法
马匹用赛拉嗪进行预处理，并用地西泮-氯胺酮诱导麻醉。麻醉维持采用赛拉嗪-氯胺酮-愈创甘油醚组合[三联滴注（TD；n = 12）或异氟烷（ISO；n = 12）]。使用HDO通过在近端尾部周围使用8厘米宽的袖带获取收缩压（SAP）、平均动脉压（MAP）和舒张压（DAP）以及心率（HR）。在HDO循环期间记录有创血压（IBP）、SAP、MAP、DAP和HR。采用重复测量的Bland-Altman分析对所有测量值比较HDO和IBP。使用广义相加模型确定所有测量值在麻醉方案之间HDO和IBP差异的均值是否相似。
结果
每个变量有超过110对样本。麻醉选择对HDO性能没有影响，但与ISO相比，TD中存在更多变异性。偏态数据需要进行对数转换以进行统计比较。使用原始数据和标准Bland-Altman分析，HDO高估了SAP（TD，3.8±28.3 mmHg；ISO，3.5±13.6 mmHg）、MAP（TD，4.0±23.3 mmHg；ISO，6.3±10.0 mmHg）和DAP（TD，4.0±21.2 mmHg；ISO，7.8±13.6 mmHg）。在TD中，26%-40%的HDO测量值在IBP的10 mmHg范围内，而在ISO中为60%-74%。所有测量值在麻醉方案之间HDO和IBP的差异相似。随着袖带宽度与尾围比增加至40%，IBP与HDO测量的SAP、MAP和DAP之间的数值差异显著减小。
结论及临床意义
TD期间HDO的变异性更大。袖带宽度与尾围比对于HDO的准确性很重要。
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