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新西兰部分兽医诊所的犬猫麻醉情况调查。

A survey of dog and cat anaesthesia in a sample of veterinary practices in New Zealand.

作者信息

Sano H, Barker K, Odom T, Lewis K, Giordano P, Walsh V, Chambers J P

机构信息

a Veterinary Teaching Hospital, Institute of Veterinary, Animal and Biomedical Sciences , Massey University , Private Bag 11-222, Palmerston North , 4222 , New Zealand.

b Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine , University of Saskatchewan , 52 Campus Drive, Saskatoon , Saskatchewan , S7N 5B4 , Canada.

出版信息

N Z Vet J. 2018 Mar;66(2):85-92. doi: 10.1080/00480169.2017.1413959. Epub 2017 Dec 17.

Abstract

AIMS

To survey current anaesthesia practices for dogs and cats in small and mixed animal practices in New Zealand in order to improve anaesthesia education.

METHODS

A questionnaire was sent to 440 small and mixed animal practices, including questions regarding the type of practice, preanaesthetic examination, anaesthetic drugs and management, anaesthetic machines, monitoring and topics of interest for continuing professional development.

RESULTS

Responses were obtained from 113/440 (26%) practices, with 78 (69%) respondents from small and 35 (31%) from mixed animal practices. A preanaesthetic physical examination was carried out by >95% of respondents and premedication was usually given to dogs (112/113; 99%) and cats (95/113; 85%). Acepromazine was the preferred sedative for dogs and cats, with morphine or buprenorphine. Propofol and alfaxalone were the preferred induction agents, and isoflurane was preferred for maintenance in both dogs and cats. A venous catheter was usually placed for anaesthesia in dogs (59/113; 52%), but less so in cats (39/113; 35%). Perioperative fluid was administered at 10 mL/kg/hour by 62/110 (56%) respondents. Intubation was usually used for anaesthesia in dogs (111/112; 99%), and cats (87/112; 78%). Almost 40% of respondents usually administered supplementary oxygen if patients were not intubated. Local analgesia was used by 69/111 (88%) respondents sometimes or always if applicable. Morphine or buprenorphine, and meloxicam were common choices for post-operative analgesia after neuter surgery in dogs and cats. A semiclosed (non-rebreathing) system was used in animals weighing <10 kg, and a Mapleson E or F non-rebreathing circuit was used by 66/109 (61%) practices. Only 15/111 (14%) practices had a ventilator in their practice. A dedicated anaesthetist was usually used by 104/113 (92%) practices, and apnoea alarms, pulse oximeters, thermometers and oesophageal stethoscopes were the main monitoring devices available in practices. Loco-regional block, pain management, and anaesthetic drugs were the main topics of interest for continuing education.

CONCLUSIONS AND CLINICAL RELEVANCE

Responses by the veterinarians taking part in this survey indicated that they had a reasonably good standard of anaesthetic practice. A physical examination was carried out preanaesthesia, and premedication including analgesia was routinely administered to most patients. A dedicated anaesthetist usually monitored patients and most respondents reported they had access to basic anaesthetic monitoring equipment. Areas where changes could lead to improved anaesthetic practice were increased use of I/V catheterisation, endotracheal intubation, and supplementary oxygen, and reduced I/V fluid rates.

摘要

目的

调查新西兰小型和混合动物诊所中犬猫当前的麻醉实践情况,以改进麻醉学教育。

方法

向440家小型和混合动物诊所发送了一份问卷,内容包括诊所类型、麻醉前检查、麻醉药物及管理、麻醉机、监测以及继续职业发展感兴趣的主题等问题。

结果

共收到113/440(26%)家诊所的回复,其中78家(69%)来自小型动物诊所,35家(31%)来自混合动物诊所。超过95%的受访者会进行麻醉前体格检查,大多数犬(112/113;99%)和猫(95/113;85%)会接受术前用药。乙酰丙嗪是犬猫首选的镇静剂,常与吗啡或丁丙诺啡联用。丙泊酚和阿法沙龙是首选的诱导剂,异氟醚是犬猫维持麻醉的首选药物。犬麻醉时通常会放置静脉导管(59/113;52%),但猫放置的比例较低(39/113;35%)。62/110(56%)的受访者在围手术期以10 mL/kg/小时的速度输注液体。犬(111/112;99%)和猫(87/112;78%)麻醉时通常会进行气管插管。如果患者未插管,近40%的受访者通常会给予补充氧气。69/111(88%)的受访者在适用时有时或总是会使用局部镇痛。吗啡或丁丙诺啡以及美洛昔康是犬猫绝育手术后常用的术后镇痛药物。体重<10 kg的动物使用半封闭(非再呼吸)系统,66/109(61%)的诊所使用马普乐逊E或F非再呼吸回路。只有15/111(14%)的诊所配备有呼吸机。104/113(92%)的诊所通常会安排专门的麻醉师,诊所中主要的监测设备有呼吸暂停警报器、脉搏血氧仪、温度计和食管听诊器。局部区域阻滞、疼痛管理和麻醉药物是继续教育的主要感兴趣主题。

结论及临床意义

参与本次调查的兽医的回复表明,他们的麻醉实践标准相当不错。麻醉前会进行体格检查,大多数患者会常规接受包括镇痛在内的术前用药。通常由专门的麻醉师监测患者,大多数受访者表示他们可以使用基本的麻醉监测设备。可能改善麻醉实践的方面包括增加静脉置管、气管插管和补充氧气的使用,以及降低静脉输液速度。

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