Bustamante R, Aguado D, Cediel R, Gómez de Segura I A, Canfrán S
Anaesthesiology Service, Department of Animal Medicine and Surgery, Veterinary Teaching Hospital, Veterinary Faculty, Complutense University of Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain.
Anaesthesiology Service, Department of Animal Medicine and Surgery, Veterinary Teaching Hospital, Veterinary Faculty, Complutense University of Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain.
Vet J. 2018 Mar;233:49-54. doi: 10.1016/j.tvjl.2018.01.002. Epub 2018 Jan 11.
The aim of this study was to compare the effects on mean arterial pressure (MAP) and ventilation of propofol total IV anaesthesia (TIVA) and isoflurane as anaesthetic maintenance in healthy dogs undergoing orthopaedic surgery, with epidural anaesthesia. Dogs were premedicated IM with dexmedetomidine (4μg/kg) and methadone (0.3mg/kg), induced with IV propofol (0.65-5mg/kg) and randomly assigned to be maintained with isoflurane (group I) or propofol (group P). Isoflurane end-tidal concentration (EtISO) and propofol infusion rate were adjusted during the surgery to maintain a suitable anaesthetic depth. All dogs received bupivacaine (1mg/kg) and morphine (0.1mg/kg) in the lumbosacral epidural space (total volume 0.2mL/kg). MAP was recorded every 5min during the procedure. Statistical analysis was performed using parametric (Student's t test) and nonparametric (Mann-Whitney U-test, chi-square) tests, as appropriate. Anaesthetic maintenance in groups I and P was accomplished by providing a mean EtISO of 1.12±0.15% and a mean propofol infusion rate of 15.0±4.7mg/kg/h, respectively. MAP was significantly higher in group P than in group I (92±17mmHg versus 78±10mmHg; P=0.021). Eleven dogs in group P and two dogs in group I reached an EtCO>7.3kPa, requiring mechanical ventilation (P=0.001). In combination with epidural anaesthesia, propofol TIVA improved MAP and is a suitable alternative to isoflurane in orthopaedic surgery of the hind limb in healthy dogs. Nevertheless, since it was associated with increased respiratory depression, mechanical ventilation should be available.
本研究旨在比较在接受骨科手术的健康犬中,丙泊酚全凭静脉麻醉(TIVA)和异氟烷作为麻醉维持药物,并联合硬膜外麻醉时,对平均动脉压(MAP)和通气的影响。犬经肌肉注射右美托咪定(4μg/kg)和美沙酮(0.3mg/kg)进行术前用药,静脉注射丙泊酚(0.65 - 5mg/kg)诱导麻醉,然后随机分为异氟烷维持组(I组)和丙泊酚维持组(P组)。手术过程中调整异氟烷呼气末浓度(EtISO)和丙泊酚输注速率以维持合适的麻醉深度。所有犬在腰骶部硬膜外间隙注射布比卡因(1mg/kg)和吗啡(0.1mg/kg)(总体积0.2mL/kg)。手术过程中每5分钟记录一次MAP。根据情况使用参数检验(学生t检验)和非参数检验(曼 - 惠特尼U检验、卡方检验)进行统计分析。I组和P组的麻醉维持分别通过提供平均EtISO为1.12±0.15%和平均丙泊酚输注速率为15.0±4.7mg/kg/h来完成。P组的MAP显著高于I组(92±17mmHg对78±10mmHg;P = 0.021)。P组11只犬和I组2只犬的EtCO>7.3kPa,需要机械通气(P = 0.001)。与硬膜外麻醉联合使用时,丙泊酚TIVA可改善MAP,是健康犬后肢骨科手术中异氟烷的合适替代药物。然而,由于其与呼吸抑制增加有关,应备有机械通气设备。