Niyatiwatchanchai Nutawan, Thengchaisri Naris
Surgery Unit, Kasetsart University Veterinary Teaching Hospital, Bangkok 10900, Thailand.
Department of Companion Animal Clinical Sciences, Kasetsart University, Bangkok 10900, Thailand.
J Vet Sci. 2020 Mar;21(2):e27. doi: 10.4142/jvs.2020.21.e27.
The efficacies of a supraglottic airway device (SGAD) and an endotracheal tube (ETT) in cats under general anesthesia with volume-controlled ventilation (VCV) were compared. Thirty healthy cats were randomly allocated for airway control using either an SGAD or an ETT. Five tidal volumes (6, 8, 10, 12, and 14 mL/kg) were randomly tested, and respiratory rates were adjusted to achieve a minute ventilation of 100 mL/kg/min. The dose of propofol necessary to insert the SGAD or ETT, the static respiratory pressure, leakage during VCV, and end tidal CO₂ (ETCO₂) were recorded. Dosages of propofol and static respiratory measurements for the SGAD and ETT groups were compared using a t-test. The distribution of leakages and hypercapnia (ETCO₂ > 45 mmHg) were compared using Fisher's exact test. A significance level of < 0.05 was established. No significant difference in dose of propofol was observed between the SGAD and ETT groups (7.1 ± 1.0, 7.3 ± 1.7 mg/kg; = 0.55). Static resistance pressure of the SGAD (22.0 ± 8.1 cmH₂O/L/sec) was significantly lower than that of the ETT (36.6 ± 12.9 cmH₂O/L/sec; < 0.01). Of the 75 trials, leakage was more frequent when using an SGAD (8 events) than when using an ETT (1 event; = 0.03). Hypercapnia occurred more frequently with SGAD (18 events) than with ETT (3 events; < 0.01). Although intubation with an ETT is the gold standard in small animal anesthesia, the use of an SGAD can reduce airway resistance and the work of breathing. Nonetheless, SGAD had more dead space and the tidal volume for VCV needs adjustment.
比较了声门上气道装置(SGAD)和气管内导管(ETT)在容量控制通气(VCV)全身麻醉下对猫的效果。30只健康猫被随机分配使用SGAD或ETT进行气道控制。随机测试了五个潮气量(6、8、10、12和14 mL/kg),并调整呼吸频率以达到100 mL/kg/min的分钟通气量。记录插入SGAD或ETT所需的丙泊酚剂量、静态呼吸压力、VCV期间的漏气情况和呼气末二氧化碳(ETCO₂)。使用t检验比较SGAD和ETT组的丙泊酚剂量和静态呼吸测量值。使用Fisher精确检验比较漏气和高碳酸血症(ETCO₂>45 mmHg)的分布情况。设定显著性水平<0.05。SGAD组和ETT组之间在丙泊酚剂量上未观察到显著差异(7.1±1.0,7.3±1.7 mg/kg;P = 0.55)。SGAD的静态阻力压力(22.0±8.水/L/秒)显著低于ETT(36.6±12.9 cmH₂O/L/秒;P<0.01)。在7次试验中,使用SGAD时漏气比使用ETT时更频繁(8次事件)(1次事件;P = 0.03)。SGAD组高碳酸血症的发生率(18次事件)高于ETT组(3次事件;P<0.01)。尽管在小动物麻醉中气管内插管是金标准,但使用SGAD可降低气道阻力和呼吸功。尽管如此,SGAD的死腔更大,VCV的潮气量需要调整。