Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada.
Vet Anaesth Analg. 2020 Jul;47(4):472-480. doi: 10.1016/j.vaa.2020.03.006. Epub 2020 Apr 11.
To determine the dose and cardiopulmonary effects of propofol alone or with midazolam for induction of anesthesia in American Society of Anesthesiologists status ≥III dogs requiring emergency abdominal surgery.
Prospective, randomized, blinded, clinical trial.
A total of 19 client-owned dogs.
Dogs were sedated with fentanyl (2 μg kg) intravenously (IV) for instrumentation for measurement of heart rate, arterial blood pressure, cardiac index, systemic vascular resistance index, arterial blood gases, respiratory rate and rectal temperature. After additional IV fentanyl (3 μg kg), the quality of sedation was scored and cardiopulmonary variables recorded. Induction of anesthesia was with IV propofol (1 mg kg) and saline (0.06 mL kg; group PS; nine dogs) or midazolam (0.3 mg kg; group PM; 10 dogs), with additional propofol (0.25 mg kg) IV every 6 seconds until endotracheal intubation. Induction/intubation quality was scored, and anesthesia was maintained with isoflurane. Variables were recorded for 5 minutes with the dog in lateral recumbency, breathing spontaneously, and then in dorsal recumbency with mechanical ventilation for the next 15 minutes. A general linear mixed model was used with post hoc analysis for multiple comparisons between groups (p < 0.05).
There were no differences in group demographics, temperature and cardiopulmonary variables between groups or within groups before or after induction. The propofol doses for induction of anesthesia were significantly different between groups, 1.9 ± 0.5 and 1.1 ± 0.5 mg kg for groups PS and PM, respectively, and the induction/intubation score was significantly better for group PM.
Midazolam co-induction reduced the propofol induction dose and improved the quality of induction in critically ill dogs without an improvement in cardiopulmonary variables, when compared with a higher dose of propofol alone.
确定单独使用或联合咪达唑仑的丙泊酚用于需要急诊腹部手术的美国麻醉医师协会（ASA）分级≥III 的犬麻醉诱导的剂量和心肺效应。
前瞻性、随机、盲法、临床试验。
共 19 只患犬。
对犬静脉（IV）注射芬太尼（2 μg/kg）镇静，用于测量心率、动脉血压、心指数、全身血管阻力指数、动脉血气、呼吸频率和直肠温度。在额外 IV 注射芬太尼（3 μg/kg）后，对镇静质量进行评分并记录心肺变量。麻醉诱导使用 IV 丙泊酚（1 mg/kg）和生理盐水（0.06 mL/kg；PS 组，9 只犬）或咪达唑仑（0.3 mg/kg；PM 组，10 只犬），每 6 秒静脉注射额外的丙泊酚（0.25 mg/kg），直到气管插管。对诱导/插管质量进行评分，并用异氟醚维持麻醉。在犬侧卧、自主呼吸 5 分钟后，记录变量，然后在俯卧位机械通气 15 分钟。使用一般线性混合模型进行组间（p < 0.05）的事后分析。
两组在人口统计学、体温和心肺变量方面无差异，无论是在诱导前还是诱导后。两组丙泊酚诱导麻醉的剂量差异有统计学意义，PS 组和 PM 组分别为 1.9 ± 0.5 和 1.1 ± 0.5 mg/kg，PM 组的诱导/插管评分显著更好。
与单独使用较高剂量的丙泊酚相比，咪达唑仑辅助诱导可降低丙泊酚诱导剂量并改善危重犬的诱导质量，而不改善心肺变量。
