Department of Animal Medicine and Surgery, Veterinary Teaching Hospital, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain.
Department of Animal Medicine and Surgery, Veterinary Teaching Hospital, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain.
Vet Anaesth Analg. 2020 Jul;47(4):437-446. doi: 10.1016/j.vaa.2019.10.010. Epub 2020 Mar 24.
To determine the alfaxalone dose reduction during total intravenous anaesthesia (TIVA) when combined with ketamine or midazolam constant rate infusions and to assess recovery quality in healthy dogs.
Prospective, blinded clinical study.
A group of 33 healthy, client-owned dogs subjected to dental procedures.
After premedication with intramuscular acepromazine 0.05 mg kg and methadone 0.3 mg kg, anaesthetic induction started with intravenous alfaxalone 0.5 mg kg followed by either lactated Ringer's solution (0.04 mL kg, group A), ketamine (2 mg kg, group AK) or midazolam (0.2 mg kg, group AM) and completed with alfaxalone until endotracheal intubation was achieved. Anaesthesia was maintained with alfaxalone (6 mg kg hour), adjusted (±20%) every 5 minutes to maintain a suitable level of anaesthesia. Ketamine (0.6 mg kg hour) or midazolam (0.4 mg kg hour) were employed for anaesthetic maintenance in groups AK and AM, respectively. Physiological variables were monitored during anaesthesia. Times from alfaxalone discontinuation to extubation, sternal recumbency and standing position were calculated. Recovery quality and incidence of adverse events were recorded. Groups were compared using parametric analysis of variance and nonparametric (Kruskal-Wallis, Chi-square, Fisher's exact) tests as appropriate, p < 0.05.
Midazolam significantly reduced alfaxalone induction and maintenance doses (46%; p = 0.034 and 32%, p = 0.012, respectively), whereas ketamine only reduced the alfaxalone induction dose (30%; p = 0.010). Recovery quality was unacceptable in nine dogs in group A, three dogs in group AK and three dogs in group AM.
Midazolam, but not ketamine, reduced the alfaxalone infusion rate, and both co-adjuvant drugs reduced the alfaxalone induction dose. Alfaxalone TIVA allowed anaesthetic maintenance for dental procedures in dogs, but the quality of anaesthetic recovery remained unacceptable irrespective of its combination with ketamine or midazolam.
确定氟烷和氯胺酮或咪达唑仑持续输注联合应用于全静脉麻醉（TIVA）时氟烷的剂量减少，并评估健康犬的恢复质量。
前瞻性、盲法临床研究。
一组 33 只接受牙科手术的健康、有主人的狗。
术前肌肉注射乙酰丙嗪 0.05mg/kg 和美沙酮 0.3mg/kg，然后静脉注射氟烷 0.5mg/kg 进行麻醉诱导，随后输注乳酸林格氏液（0.04ml/kg，A 组）、氯胺酮（2mg/kg，AK 组）或咪达唑仑（0.2mg/kg，AM 组），直至气管插管完成。用氟烷（6mg/kg/h）维持麻醉，每 5 分钟调整一次（±20%），以维持适当的麻醉水平。在 AK 组和 AM 组中分别使用氯胺酮（0.6mg/kg/h）和咪达唑仑（0.4mg/kg/h）维持麻醉。在麻醉过程中监测生理变量。计算从氟烷停药到拔管、胸骨卧位和站立位的时间。记录恢复质量和不良事件的发生率。使用参数方差分析和非参数（Kruskal-Wallis、卡方、Fisher 精确检验）检验比较各组，p<0.05。
咪达唑仑显著降低氟烷诱导和维持剂量（46%，p=0.034 和 32%，p=0.012），而氯胺酮仅降低氟烷诱导剂量（30%，p=0.010）。A 组 9 只狗、AK 组 3 只狗和 AM 组 3 只狗的恢复质量不可接受。
咪达唑仑而非氯胺酮降低了氟烷输注率，两种辅助药物均降低了氟烷诱导剂量。氟烷 TIVA 可用于犬的牙科手术麻醉维持，但无论与氯胺酮还是咪达唑仑联合应用，麻醉恢复质量仍不理想。
