Muñoz Kirk A, Robertson Sheilah A, Wilson Deborah V
Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA.
Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA.
Vet Anaesth Analg. 2017 Jul;44(4):766-774. doi: 10.1016/j.vaa.2017.01.004. Epub 2017 Mar 6.
To determine the intubation dose and select physiologic effects of alfaxalone alone or in combination with midazolam or ketamine in dogs.
Prospective, clinical study.
Fifty-three healthy client-owned dogs [mean±standard deviation (SD)] 5.1±1.8 years, 27±15.4 kg, scheduled for elective orthopedic surgery.
After premedication with acepromazine (0.02 mg kg) and hydromorphone (0.1 mg kg) intramuscularly, alfaxalone (0.25 mg kg) was administered intravenously over 15 seconds followed immediately by 0.9% saline (AS), midazolam (0.3 mg kg; AM), ketamine (1 mg kg; AK1), or ketamine (2 mg kg; AK2). Additional alfaxalone (0.25 mg kg increments) was administered as required to permit endotracheal intubation. The incidence of apnea and the time from intubation until spontaneous movement were recorded. Heart rate (HR) and blood pressure were recorded 15 minutes after premedication, after intubation and 2, 5, 10 and 15 minutes thereafter. Blood was collected for measurement of serum glucose and insulin concentrations before induction, after intubation and at 2, 5, 10 and 50 minutes. Data were analyzed by split-plot anova with Bonferroni adjustment for the number of group comparisons.
Mean±SD alfaxalone mg kg doses required for endotracheal intubation were AS (1.0±0.4), AM (0.4±0.2), AK1 (0.5±0.3) and AK2 (0.5±0.4) (p=0.0005). Differences in cardiopulmonary variables among groups were minor; HR decreased in AS, while in other groups, HR increased transiently postintubation. Incidence of apnea in AS was 54% with no significant difference among groups. Midazolam significantly prolonged time from intubation until spontaneous movement (p<0.002).
Midazolam and ketamine reduced the alfaxalone dose required for endotracheal intubation. Serum glucose and insulin concentrations were not influenced by administration of alfaxalone alone or when administered with midazolam or ketamine.
确定阿法沙龙单独使用或与咪达唑仑或氯胺酮联合使用时在犬中的插管剂量，并选择其生理效应。
前瞻性临床研究。
53只健康的客户拥有的犬[平均±标准差（SD）]，年龄5.1±1.8岁，体重27±15.4千克，计划进行择期骨科手术。
肌肉注射乙酰丙嗪（0.02毫克/千克）和氢吗啡酮（0.1毫克/千克）进行预处理后，在15秒内静脉注射阿法沙龙（0.25毫克/千克），随后立即注射0.9%生理盐水（AS组）、咪达唑仑（0.3毫克/千克；AM组）、氯胺酮（1毫克/千克；AK1组）或氯胺酮（2毫克/千克；AK2组）。根据需要追加阿法沙龙（每次增加0.25毫克/千克）以允许进行气管插管。记录呼吸暂停的发生率以及从插管到自主运动的时间。在预处理后15分钟、插管后以及此后2、5、10和15分钟记录心率（HR）和血压。在诱导前、插管后以及2、5、10和50分钟采集血液以测量血清葡萄糖和胰岛素浓度。数据采用裂区方差分析，并使用Bonferroni校正进行组间比较次数的调整。
气管插管所需的平均±SD阿法沙龙毫克/千克剂量分别为：AS组（1.0±0.4）、AM组（0.4±0.2）、AK1组（0.5±0.3）和AK2组（0.5±0.4）（p = 0.0005）。各组之间心肺变量的差异较小；AS组HR下降，而在其他组中，插管后HR短暂升高。AS组呼吸暂停的发生率为54%，各组之间无显著差异。咪达唑仑显著延长了从插管到自主运动的时间（p < 0.002）。
咪达唑仑和氯胺酮降低了气管插管所需的阿法沙龙剂量。单独使用阿法沙龙或与咪达唑仑或氯胺酮联合使用时，血清葡萄糖和胰岛素浓度均不受影响。
