Miller Chris, Hughes Ellen, Gurney Matt
Northwest Veterinary Specialists, Sutton Weaver, Cheshire, United Kingdom.
College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.
Vet Anaesth Analg. 2019 Sep;46(5):613-619. doi: 10.1016/j.vaa.2019.03.009. Epub 2019 Jun 8.
To qualitatively assess the co-induction of anaesthesia with midazolam and alfaxalone and to determine cardiovascular or respiratory alterations compared with alfaxalone alone.
A randomized, blinded, clinical trial.
A total of 29 American Society of Anesthesiologists grade I or II, client-owned dogs undergoing elective orthopaedic or soft tissue surgery.
All dogs received 0.02 mg kg acepromazine and 0.3 mg kg methadone intramuscularly 30 minutes prior to anaesthesia. Measurements of heart rate (HR), respiratory frequency and blood pressure (BP) were assessed pre-induction and at 0, 2 and 5 minutes post-induction. Anaesthesia was induced with 0.5 mg kg alfaxalone followed by either 0.4 mg kg midazolam intravenously (group M) or an equal volume of saline (group S). Conditions were assessed for intubation and further boluses of 0.25 mg kg alfaxalone were given as required. Response to co-induction, ease of intubation and quality of induction were scored, and total dose of alfaxalone required for intubation was recorded. Repeated measures one-way analysis of variance with post hoc Tukey's test was used to assess within group changes over time and Student t tests were used to compare between groups. Incidence of apnoea was assessed using a Fisher's exact test. Data are shown as mean ± standard deviation.
Group M included 14 dogs and group S 15 dogs. There was a significant difference in the total dose of alfaxalone required for intubation, 0.65 ± 0.20 mg kg group M and 0.94 ± 0.26 mg kg group S (p = 0.002). Apnoea occurred significantly more frequently in group M (p = 0.007). There were no clinically significant differences in HR or BP at the measured time points between groups.
Co-induction with midazolam had significant alfaxalone-sparing effects with no clinically detectable cardiovascular changes. Apnoea is common after co-induction.
定性评估咪达唑仑与阿法沙龙联合诱导麻醉的效果，并确定与单独使用阿法沙龙相比的心血管或呼吸变化。
一项随机、双盲临床试验。
共有29只美国麻醉医师协会I级或II级、由客户拥有的犬，接受择期骨科或软组织手术。
所有犬在麻醉前30分钟肌肉注射0.02 mg/kg乙酰丙嗪和0.3 mg/kg美沙酮。在诱导前以及诱导后0、2和5分钟评估心率（HR）、呼吸频率和血压（BP）。用0.5 mg/kg阿法沙龙诱导麻醉，随后静脉注射0.4 mg/kg咪达唑仑（M组）或等体积生理盐水（S组）。评估插管条件，并根据需要给予0.25 mg/kg阿法沙龙的追加剂量。对联合诱导的反应、插管的难易程度和诱导质量进行评分，并记录插管所需阿法沙龙的总剂量。采用重复测量单因素方差分析及事后Tukey检验评估组内随时间的变化，采用Student t检验比较组间差异。使用Fisher精确检验评估呼吸暂停的发生率。数据以平均值±标准差表示。
M组有14只犬，S组有15只犬。插管所需阿法沙龙的总剂量存在显著差异，M组为0.65±0.20 mg/kg，S组为0.94±0.26 mg/kg（p = 0.002）。M组呼吸暂停的发生率显著更高（p = 0.007）。两组在测量时间点的HR或BP无临床显著差异。
与咪达唑仑联合诱导具有显著的阿法沙龙节省效应，且无临床可检测到的心血管变化。联合诱导后呼吸暂停很常见。
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