Lehnus Kristina S, Brearley Jacqueline
Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
Vet Anaesth Analg. 2019 Nov;46(6):729-735. doi: 10.1016/j.vaa.2019.06.004. Epub 2019 Jun 28.
To describe alfentanil-propofol admixture for induction of anaesthesia for canine radiotherapy and compare it to alfentanil-atropine followed by propofol induction in terms of heart rate (HR), mean arterial pressure (MAP), recovery duration and quality.
Prospective, masked, randomized clinical crossover trial.
A group of 40 client-owned dogs anaesthetized from October 2017 to June 2018.
Dogs were randomly assigned to be administered one of two protocols. For both protocols, IV preanaesthetic medication was given 30 seconds before rapid IV administration of a set volume of induction agent, with further induction agent administered as needed to permit intubation. For protocol ADMIX, the preanaesthetic medication was 0.04 mL kg 0.9% sodium chloride and the induction agent was 0.2 mL kg propofol-alfentanil admixture. For protocol ATRO, the preanaesthetic medication was 10 μg kg alfentanil with 12 μg kg atropine (0.04 mL kg total volume) and the induction agent was 0.2 mL kg propofol. Anaesthesia was maintained with sevoflurane. Cardiorespiratory variables, agitation, hypotension, or inadequate depth of anaesthesia requiring supplemental boluses of propofol or increased vaporizer settings were recorded. Time to extubation, sternal recumbency and walking was noted. Videos were recorded for recovery quality scoring. Owner questionnaires gave feedback about recoveries at home. The other protocol was administered for the next radiotherapy session.
The only significantly different variable between protocols was mean HR during anaesthesia, which was lower in ADMIX (p < 0.001). Hypotension was recorded in seven (17.5%) dogs in ATRO and three (7.5%) in ADMIX, with an association (p < 0.005) between ATRO and hypotension. Owners reported animals recovered 'normal' behaviour and appetite by the next morning.
Both protocols were acceptable for dogs undergoing radiotherapy, with minimal differences in anaesthetic quality, recovery duration and quality. Although MAP did not differ overall, the incidence of hypotension was higher in ATRO.
描述用于犬放疗麻醉诱导的阿芬太尼 - 丙泊酚混合剂,并在心率(HR)、平均动脉压(MAP)、恢复持续时间和质量方面,将其与先使用阿芬太尼 - 阿托品再使用丙泊酚诱导进行比较。
前瞻性、盲法、随机临床交叉试验。
2017年10月至2018年6月期间接受麻醉的40只客户拥有的犬。
将犬随机分配接受两种方案之一。对于两种方案,在快速静脉注射一定体积的诱导剂前30秒给予静脉麻醉前用药,根据需要给予更多诱导剂以利于插管。对于混合剂(ADMIX)方案,麻醉前用药为0.04 mL/kg 0.9%氯化钠,诱导剂为0.2 mL/kg丙泊酚 - 阿芬太尼混合剂。对于阿托品(ATRO)方案,麻醉前用药为10 μg/kg阿芬太尼加12 μg/kg阿托品(总体积0.04 mL/kg),诱导剂为0.2 mL/kg丙泊酚。用七氟醚维持麻醉。记录心肺变量、躁动、低血压或因麻醉深度不足需要补充丙泊酚推注或增加蒸发器设置的情况。记录拔管时间、胸骨卧位和行走时间。录制恢复质量评分的视频。主人问卷提供在家恢复情况的反馈。在下一次放疗时给予另一种方案。
两种方案之间唯一显著不同的变量是麻醉期间的平均心率,混合剂(ADMIX)方案较低(p < 0.001)。阿托品(ATRO)方案中有7只(17.5%)犬出现低血压,混合剂(ADMIX)方案中有3只(7.5%),且阿托品(ATRO)方案与低血压之间存在关联(p < 0.005)。主人报告动物在第二天早上恢复了“正常”行为和食欲。
两种方案对接受放疗的犬均适用,麻醉质量、恢复持续时间和质量差异最小。虽然总体MAP无差异,但阿托品(ATRO)方案中低血压的发生率较高。