比较顺式阿曲库铵在异氟烷或丙泊酚麻醉犬中的神经肌肉阻滞作用。

Comparison of the neuromuscular blocking effects of cisatracurium during isoflurane or propofol anesthesia in dogs.

机构信息

Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan.

Veterinary Medicine Teaching Hospital, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan.

出版信息

Vet Anaesth Analg. 2020 Jul;47(4):454-462. doi: 10.1016/j.vaa.2020.03.002. Epub 2020 Mar 29.

DOI:10.1016/j.vaa.2020.03.002

PMID:32409258

Abstract

OBJECTIVE

To compare the neuromuscular blocking effects of cisatracurium during isoflurane versus propofol anesthesia in dogs.

STUDY DESIGN

Prospective, randomized study.

ANIMALS

A total of 20 healthy, client-owned dogs (16 females, four males) weighing 12.5-22 kg and aged 1-8 years.

METHODS

Dogs undergoing elective surgery were randomized in equal numbers to an isoflurane (ISO) or propofol (PPF) group. Other drugs used during anesthesia were equal between groups. Single-twitch (ST) stimulation was used to monitor neuromuscular response. After recording the baseline ST (T0), cumulative doses of cisatracurium (0.05 mg kg) were administered intravenously until ST/T0 ≤5%. Effective doses 50 (ED) and 95 (ED) of cisatracurium in each group were calculated from group dose-response curves. Recovery of ST (TR) was defined as spontaneous recovery of ST to 80-120% of T0 remaining stable for 2 minutes. The ST after each dose of cisatracurium, duration 25% (time after the last dose until 25% recovery of TR), recovery index (time to recovery from 25% to 75% of TR) and duration to TR (time after the last dose until recovery of TR) were recorded.

RESULTS

Incremental doses of cisatracurium, median (range), were 2 (1-3) in ISO and 4 (2-5) in PPF to achieve ≥95% depression of ST/T0 (p < 0.01). ED and ED were 20 μg kg and 117 μg kg in ISO and 128 μg kg and 167 μg kg in PPF, respectively. The duration 25%, recovery index and duration to TR, median (range), were longer in ISO [22.6 (10.3-24.3), 5.3 (3.0-7.8) and 36.1 (20.1-49.7) minutes, respectively] than in PPF [10.2 (6.8-16.5), 3.0 (2.0-3.8) and 17.7 (14.2-28.7) minutes, respectively] (p < 0.01).

CONCLUSIONS AND CLINICAL RELEVANCE

Cisatracurium-induced neuromuscular blockade was significantly enhanced and prolonged by isoflurane compared with propofol.

摘要

目的

比较异氟烷和丙泊酚麻醉犬时顺式阿曲库铵的神经肌肉阻滞作用。

研究设计

前瞻性、随机研究。

动物

共 20 只健康的、有主人的狗（16 只雌性，4 只雄性），体重 12.5-22 公斤，年龄 1-8 岁。

方法

接受择期手术的狗被随机等分为异氟烷（ISO）或丙泊酚（PPF）组。麻醉过程中使用的其他药物在两组之间相等。单刺激（ST）刺激用于监测神经肌肉反应。记录基线 ST（T0）后，静脉给予顺式阿曲库铵（0.05mg/kg）累积剂量，直至 ST/T0≤5%。从组剂量反应曲线计算每组顺式阿曲库铵的有效剂量 50（ED）和 95（ED）。记录每剂顺式阿曲库铵后的 ST（TR），定义为 ST 自发恢复至 T0 的 80-120%，并稳定 2 分钟。记录 ST 后的时间（从最后一次给药到 TR 恢复 25%的时间）、恢复指数（从 25%恢复到 75%TR 的时间）和 TR 后的时间（从最后一次给药到 TR 恢复的时间）。

结果

ISO 组中，顺式阿曲库铵的递增剂量中位数（范围）为 2（1-3），PPF 组为 4（2-5），以达到≥95%的 ST/T0 抑制（p<0.01）。ISO 组的 ED 和 ED 分别为 20μg/kg 和 117μg/kg，PPF 组分别为 128μg/kg 和 167μg/kg。ISO 组的 25%时间、恢复指数和 TR 时间中位数（范围）分别为 22.6（10.3-24.3）、5.3（3.0-7.8）和 36.1（20.1-49.7）分钟，明显长于 PPF 组的 10.2（6.8-16.5）、3.0（2.0-3.8）和 17.7（14.2-28.7）分钟（p<0.01）。