Pypendop Bruno H, Ranasinghe M G, Pasloske Kirby
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA.
Jurox Pty Ltd, Rutherford, NSW, Australia.
Vet Anaesth Analg. 2018 Jul;45(4):459-466. doi: 10.1016/j.vaa.2018.03.003. Epub 2018 Apr 10.
To compare the performance of an alfaxalone constant rate intravenous (IV) infusion versus a 3-step IV infusion, both following a loading dose, for the maintenance of a target plasma alfaxalone concentration of 7.6 mg L (effective plasma alfaxalone concentration for immobility in 99% of the population) in cats.
Prospective randomized crossover study.
A group of six healthy, adult male neutered cats.
Catheters were placed in a jugular vein for blood sampling and in a medial saphenous vein for drug administration. An IV bolus of alfaxalone (2 mg kg) was administered, followed by either 0.2 mg kg minute for 240 minutes (single infusion; SI) or 0.4 mg kg minute for 10 minutes, then 0.3 mg kg minute for 30 minutes, and then 0.2 mg kg minute for 200 minutes (3-step infusion; 3-step). Plasma alfaxalone concentration was measured at six time points during the infusions. Measures of performance were calculated for each infusion regimen and compared using the paired Wilcoxon signed-rank test.
Median (range) absolute performance error, divergence, median prediction error and wobble were 15 (8-19)%, -8 (-12 to -6)% hour, -12 (-19 to -7)% and 10 (8-19)%, respectively, in the SI treatment, and 6 (2-16)%, 0 (-13 to 2)% hour, 1 (-16 to 4)% and 4 (3-6)% respectively, in the 3-step treatment and were significantly smaller in the 3-step treatment than in the SI treatment.
After IV administration of a bolus dose, a 3-step infusion regimen can better maintain stable plasma alfaxalone concentrations close to the target concentration than a single constant rate infusion.
比较在给予负荷剂量后,阿法沙龙持续静脉输注与三步静脉输注在维持猫血浆阿法沙龙目标浓度7.6毫克/升(99%的猫达到制动效果的有效血浆阿法沙龙浓度)方面的表现。
前瞻性随机交叉研究。
一组6只健康成年雄性去势猫。
在颈静脉放置导管用于采血,在内侧隐静脉放置导管用于给药。给予阿法沙龙静脉推注(2毫克/千克),随后要么以0.2毫克/千克·分钟的速度输注240分钟(单次输注;SI),要么以0.4毫克/千克·分钟的速度输注10分钟,然后以0.3毫克/千克·分钟的速度输注30分钟,接着以0.2毫克/千克·分钟的速度输注200分钟(三步输注;3步)。在输注过程中的六个时间点测量血浆阿法沙龙浓度。计算每种输注方案的性能指标,并使用配对Wilcoxon符号秩检验进行比较。
在单次输注治疗中,绝对性能误差、偏差、中位数预测误差和摆动的中位数(范围)分别为15(8 - 19)%、-8(-12至-6)%/小时、-12(-19至-7)%和10(8 - 19)%,而在三步输注治疗中分别为6(2 - 16)%、0(-13至2)%/小时、1(-16至4)%和4(3 - 6)%,三步输注治疗中的这些指标明显小于单次输注治疗。
静脉给予推注剂量后,三步输注方案比单一持续速率输注能更好地维持接近目标浓度的稳定血浆阿法沙龙浓度。