Gruenheid Michaela, Aarnes Turi K, McLoughlin Mary A, Simpson Elaine M, Mathys Dimitria A, Mollenkopf Dixie F, Wittum Thomas E
J Am Vet Med Assoc. 2018 Aug 1;253(3):301-306. doi: 10.2460/javma.253.3.301.
OBJECTIVE To determine whether brachycephalic dogs were at greater risk of anesthesia-related complications than nonbrachycephalic dogs and identify other risk factors for such complications. DESIGN Retrospective cohort study. ANIMALS 223 client-owned brachycephalic dogs undergoing general anesthesia for routine surgery or diagnostic imaging during 2012 and 223 nonbrachycephalic client-owned dogs matched by surgical procedure and other characteristics. PROCEDURES Data were obtained from the medical records regarding dog signalment, clinical signs, anesthetic variables, surgery characteristics, and complications noted during or following anesthesia (prior to discharge from the hospital). Risk of complications was compared between brachycephalic and nonbrachycephalic dogs, controlling for other factors. RESULTS Perianesthetic (intra-anesthetic and postanesthetic) complications were recorded for 49.1% (n = 219) of all 446 dogs (49.8% [111/223] of brachycephalic and 48.4% [108/223] of nonbrachycephalic dogs), and postanesthetic complications were recorded for 8.7% (39/446; 13.9% [31/223] of brachycephalic and 3.6% [8/223] of nonbrachycephalic dogs). Factors associated with a higher perianesthetic complication rate included brachycephalic status and longer (vs shorter) duration of anesthesia; the risk of perianesthetic complications decreased with increasing body weight and with orthopedic or radiologic procedures (vs soft tissue procedures). Factors associated with a higher postanesthetic complication rate included brachycephalic status, increasing American Society of Anesthesiologists status, use of ketamine plus a benzodiazepine (vs propofol with or without lidocaine) for anesthetic induction, and invasive (vs noninvasive) procedures. CONCLUSIONS AND CLINICAL RELEVANCE Controlling for other factors, brachycephalic dogs undergoing routine surgery or imaging were at higher risk of peri- and postanesthetic complications than nonbrachycephalic dogs. Careful monitoring is recommended for brachycephalic dogs in the perianesthetic period.
目的 确定短头犬与非短头犬相比是否有更高的麻醉相关并发症风险，并识别此类并发症的其他风险因素。 设计 回顾性队列研究。 动物 2012 年接受常规手术或诊断性成像全身麻醉的 223 只客户拥有的短头犬和 223 只按手术程序和其他特征匹配的非短头客户拥有犬。 程序 从病历中获取有关犬的信号、临床体征、麻醉变量、手术特征以及麻醉期间或之后（出院前）记录的并发症的数据。 在控制其他因素的情况下，比较短头犬和非短头犬的并发症风险。 结果 在所有 446 只犬中，49.1%（n = 219）记录了围麻醉期（麻醉期内和麻醉后）并发症（短头犬为 49.8% [111/223]，非短头犬为 48.4% [108/223]），麻醉后并发症记录为 8.7%（39/446；短头犬为 13.9% [31/223]，非短头犬为 3.6% [8/223]）。 围麻醉期并发症发生率较高的相关因素包括短头犬状态和较长（相对于较短）的麻醉持续时间；围麻醉期并发症风险随着体重增加以及骨科或放射学手术（相对于软组织手术）而降低。 麻醉后并发症发生率较高的相关因素包括短头犬状态、美国麻醉医师协会状态增加、麻醉诱导使用氯胺酮加苯二氮䓬（相对于使用或不使用利多卡因的丙泊酚）以及侵入性（相对于非侵入性）手术。 结论及临床意义 在控制其他因素的情况下，接受常规手术或成像的短头犬比非短头犬有更高的围麻醉期和麻醉后并发症风险。 建议在围麻醉期对短头犬进行仔细监测。
