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盐酸瑞芬太尼持续输注对丙泊酚麻醉犬左心室收缩和舒张功能的影响。

Effect of a constant rate infusion of remifentanil hydrochloride on left ventricular systolic and diastolic function in propofol-anesthetized dogs.

作者信息

Marques Marcel G, Cancelli Carlos H B, Fernandes Carollina M S, Games Bruna M M, Floriano Beatriz P, Perri Silvia H V, Sousa Marlos G, Ferreira Wagner L, Santos Paulo S P

出版信息

Am J Vet Res. 2018 Dec;79(12):1261-1267. doi: 10.2460/ajvr.79.12.1261.

DOI:10.2460/ajvr.79.12.1261
PMID:30457904
Abstract

OBJECTIVE To assess the effects of a constant rate infusion (CRI) of remifentanil hydrochloride on left ventricular systolic and diastolic function in healthy propofol-anesthetized dogs. ANIMALS 6 healthy Beagles. PROCEDURES Each dog underwent 2 experimental treatments separated by a 7-day interval. In 1 treatment, anesthesia was induced with propofol and maintained with a CRI of propofol (0.6 mg/kg/min); dogs also received a CRI of saline (0.9% NaCl) solution. In the other treatment, anesthesia was similarly induced and maintained with propofol; dogs also received a CRI of remifentanil (0.3 μg/kg/min). Doppler echocardiographic and hemodynamic variables of interest were determined at baseline (before anesthesia) and at 20, 40, and 60 minutes following the simultaneous start of the 2 CRIs of each treatment; all CRIs were administrated for 60 minutes. RESULTS For the 2 treatments, end-diastolic and end-systolic volume indices did not differ from baseline or at any time point. Peak tissue Doppler-derived mitral annulus systolic velocity decreased from baseline with both treatments; however, no differences were found between treatments at any time point. Mean arterial blood pressure decreased similarly with both treatments. Heart rate and Doppler-determined cardiac index decreased significantly with the propofol-remifentanil treatment, compared with findings for the propofol-saline solution treatment. For the propofol-remifentanil treatment, the ratio of peak velocity flow in early diastole to that in late diastole remained > 1.80, whereas the ratio of early to late Doppler-derived mitral annulus velocity had a normal relaxation pattern. CONCLUSIONS AND CLINICAL RELEVANCE Results of this study indicated that a CRI of remifentanil administered along with a CRI of propofol does not impair left ventricular systolic and diastolic function in healthy dogs.

摘要

目的 评估盐酸瑞芬太尼持续输注(CRI)对健康的丙泊酚麻醉犬左心室收缩和舒张功能的影响。

动物 6只健康的比格犬。

方法 每只犬接受2次实验性处理,间隔7天。在1次处理中,用丙泊酚诱导麻醉并用丙泊酚CRI(0.6 mg/kg/min)维持;犬还接受生理盐水(0.9% NaCl)溶液CRI。在另一次处理中,用丙泊酚同样诱导和维持麻醉;犬还接受瑞芬太尼CRI(0.3 μg/kg/min)。在基线(麻醉前)以及每种处理的2次CRI同时开始后的20、40和60分钟测定感兴趣的多普勒超声心动图和血流动力学变量;所有CRI均持续输注60分钟。

结果 对于这2种处理,舒张末期和收缩末期容积指数与基线或任何时间点相比均无差异。两种处理的组织多普勒衍生的二尖瓣环收缩期峰值速度均较基线降低;然而,在任何时间点两种处理之间均未发现差异。两种处理的平均动脉血压均有类似下降。与丙泊酚-生理盐水溶液处理相比,丙泊酚-瑞芬太尼处理使心率和多普勒测定的心脏指数显著降低。对于丙泊酚-瑞芬太尼处理,舒张早期峰值流速与舒张晚期峰值流速之比保持>1.80,而多普勒衍生的二尖瓣环早期与晚期速度之比具有正常的舒张模式。

结论及临床意义 本研究结果表明,丙泊酚CRI联合瑞芬太尼CRI给药不会损害健康犬的左心室收缩和舒张功能。

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Remifentanil improves left ventricular diastolic parameters in patients with impaired diastolic function: a prospective clinical study.瑞芬太尼改善舒张功能障碍患者的左心室舒张功能参数:一项前瞻性临床研究。
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