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马罗匹坦对犬术中异氟烷需求及术后恶心呕吐的影响:一项随机临床试验。

The effect of maropitant on intraoperative isoflurane requirements and postoperative nausea and vomiting in dogs: a randomized clinical trial.

作者信息

Swallow Adam, Rioja Eva, Elmer Tim, Dugdale Alex

机构信息

Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.

Department of Veterinary Science, University of Liverpool, Liverpool, UK.

出版信息

Vet Anaesth Analg. 2017 Jul;44(4):785-793. doi: 10.1016/j.vaa.2016.10.006. Epub 2017 Apr 12.

Abstract

OBJECTIVE

To establish if preoperative maropitant significantly reduced intraoperative isoflurane requirements and reduced clinical signs associated with postoperative nausea and vomiting (PONV) in dogs.

STUDY DESIGN

Randomized clinical trial.

ANIMALS

Twenty-four healthy, client-owned dogs undergoing routine ovariohysterectomy.

METHODS

Premedication involved acepromazine (0.03 mg kg) combined with methadone (0.3 mg kg) intramuscularly 45 minutes before anaesthetic induction with intravenous (IV) propofol, dosed to effect. Meloxicam (0.2 mg kg) was administered intravenously. Dogs were randomly assigned to administration of saline (group S; 0.1 mL kg, n=12) or maropitant (group M; 1 mg kg, n=12) subcutaneously at time of premedication. Methadone (0.1 mg kg IV) was repeated 4 hours later. Anaesthesia was maintained with isoflurane in oxygen, dosed to effect by an observer unaware of group allocation. The dogs were assessed hourly, starting 1 hour postoperatively, using the short form of the Glasgow Composite Pain Score (GCPS), and for ptyalism and signs attributable to PONV [score from 0 (none) to 3 (severe)] by blinded observers. Owners completed a questionnaire at the postoperative recheck.

RESULTS

Overall mean±standard deviation end-tidal isoflurane percentage was lower in group M (1.19±0.26%) than group S (1.44±0.23%) (p=0.022), but was not significantly different between groups at specific noxious events (skin incision, ovarian pedicle clamp application, cervical clamp application, wound closure). Cardiorespiratory variables and postoperative GCPS were not significantly different between groups. Overall, 50% of dogs displayed signs attributable to PONV, with no difference in PONV scores between groups (p=0.198). No difference in anaesthetic recovery was noted by owners between groups.

CONCLUSIONS

Maropitant reduced overall intraoperative isoflurane requirements but did not affect the incidence of PONV.

CLINICAL RELEVANCE

Maropitant provided no significant benefits to dogs undergoing ovariohysterectomy with this anaesthetic and analgesic protocol, although clinically significant reductions in isoflurane requirements were noted.

摘要

目的

确定术前使用马罗匹坦是否能显著降低犬类术中异氟烷的需求量,并减少与术后恶心和呕吐(PONV)相关的临床症状。

研究设计

随机临床试验。

动物

24只接受常规卵巢子宫切除术的健康、客户拥有的犬。

方法

麻醉诱导前45分钟,使用乙酰丙嗪(0.03毫克/千克)与美沙酮(0.3毫克/千克)肌肉注射进行术前用药,随后静脉注射丙泊酚,剂量根据效果调整。静脉注射美洛昔康(0.2毫克/千克)。犬在术前用药时被随机分为皮下注射生理盐水组(S组;0.1毫升/千克,n = 12)或马罗匹坦组(M组;1毫克/千克,n = 12)。4小时后重复静脉注射美沙酮(0.1毫克/千克)。使用异氟烷和氧气维持麻醉,由不了解分组情况的观察者根据效果调整剂量。术后1小时开始,每小时对犬进行评估,使用格拉斯哥综合疼痛评分(GCPS)简表,由不知情的观察者评估流涎情况以及与PONV相关的症状[评分从0(无)到3(严重)]。主人在术后复查时填写问卷。

结果

M组的呼气末异氟烷总体平均±标准差百分比(1.19±0.26%)低于S组(1.44±0.23%)(p = 0.022),但在特定有害事件(皮肤切口、卵巢蒂钳夹、宫颈钳夹、伤口缝合)时两组间无显著差异。两组间心肺变量和术后GCPS无显著差异。总体而言,50%的犬表现出与PONV相关的症状,两组间PONV评分无差异(p = 0.198)。主人在两组间未观察到麻醉恢复有差异。

结论

马罗匹坦降低了术中异氟烷的总体需求量,但不影响PONV的发生率。

临床相关性

尽管观察到异氟烷需求量有临床显著降低,但在采用这种麻醉和镇痛方案进行卵巢子宫切除术的犬中,马罗匹坦未提供显著益处。

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