Plunkett Amanda H, Schoonover Mike J, Young Jenna M, Taylor Jared D, Holbrook Todd C
Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, Oklahoma.
Department of Veterinary Pathobiology, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, Oklahoma.
Vet Surg. 2019 Apr;48(3):417-423. doi: 10.1111/vsu.13181. Epub 2019 Feb 17.
To determine the influence of location and movement on subtourniquet pressure (STP) generated by application of a wide-rubber tourniquet (WRT) on equine limbs.
Randomized experimental cross-over design.
Six standing, sedated horses.
Horses were sedated with detomidine hydrochloride (0.2 μg/kg IV), and 4 investigators applied WRTs to the antebrachium (AB), gaskin (GK), and midmetacarpus (MC) of each horse in a predetermined, randomized order. Subtourniquet pressure was consequently measured at 10-minute intervals (T0, T10, T20, T30) for 30 minutes. Indirect systolic blood pressure (SBP) was measured presedation, postsedation, and throughout the tourniquet application period. Target STP was established as SBP + 100 mm Hg. Limb movements at each location were classified as none, low, moderate, or high, on the basis of counts and magnitude.
Mean STP did not change with time (P = .93) and exceeded SBP by 163 mm Hg (95% CI 122-205), 185 mm Hg (95% CI 156-214), and 402 mm Hg (95% CI 351-454) at the AB, GK, and MC, respectively. Mean STP at each location exceeded the target STP in 59 of 70 (81%) of the trials. Limb movements affected STP generated by tourniquets at the AB (P = .04) and MC (P < .0001) but not at the GK (P = .67).
Wide-rubber tourniquets applied at the AB, GK, and MC generated STP >100 mm Hg above SBP for 30 minutes in standing, sedated horses.
Wide-rubber tourniquets as applied in this study can achieve and maintain the current recommended STP (SBP + 100 mm Hg) for equine IV regional limb perfusion. Number and magnitude of limb movement can decrease STP over time, potentially reducing the efficacy of a WRT.
确定在马的肢体上应用宽橡胶止血带(WRT)时,位置和运动对止血带下压力(STP)的影响。
随机实验交叉设计。
6匹站立的镇静马匹。
用盐酸右美托咪定(0.2μg/kg静脉注射)对马匹进行镇静,4名研究人员按照预定的随机顺序,在每匹马的前臂(AB)、小腿(GK)和掌骨中部(MC)应用WRT。随后每隔10分钟(T0、T10、T20、T30)测量30分钟的止血带下压力。在镇静前、镇静后以及整个止血带应用期间测量间接收缩压(SBP)。目标STP设定为SBP + 100 mmHg。根据计数和幅度,将每个位置的肢体运动分为无、低、中或高。
平均STP不随时间变化(P = 0.93),在AB、GK和MC处分别比SBP高163 mmHg(95%CI 122 - 205)、185 mmHg(95%CI 156 - 214)和402 mmHg(95%CI 351 - 454)。在70次试验中的59次(81%),每个位置的平均STP超过了目标STP。肢体运动影响AB处(P = 0.04)和MC处(P < 0.0001)止血带产生的STP,但不影响GK处(P = 0.67)。
在站立的镇静马匹中,在AB、GK和MC处应用宽橡胶止血带30分钟,产生的STP比SBP高>100 mmHg。
本研究中应用的宽橡胶止血带可达到并维持当前推荐的马静脉区域肢体灌注的STP(SBP + 100 mmHg)。肢体运动的次数和幅度会随时间降低STP,可能降低WRT的效果。