Gómez Fernández Laura, Niimura Del Barrio María Chie, Loughran Claire
UCD Veterinary Hospital, University College Dublin, Belfield, Dublin 4, Eircode: D04 V1W8 Ireland.
Lumbry Park Veterinary Specialists, Alton, Hampshire United Kingdom.
Ir Vet J. 2020 Jul 2;73:13. doi: 10.1186/s13620-020-00164-0. eCollection 2020.
Hypotension is one of the most common complications observed during inhalation anaesthesia in veterinary patients. Treatment of hypotension in cattle is more challenging than in other species, owing to the limited number of drugs licensed in food producing animals. The use of adrenaline as an infusion to support blood pressure has not been described previously in bovines.
A cow and a calf presented to University College Dublin Veterinary Hospital for bilateral mandibular fracture repair and bladder rupture repair respectively, developed severe anaesthetic related hypotension unresponsive to conventional treatments. In both cases an adrenaline infusion was started and slowly increased to effect, with infusion rates ranging from 0.01 to 0.25 μg/kg/min. Blood pressure increased as the adrenaline infusion rate increased, but clinically significant improvements in blood pressure were only observed with infusion rates exceeding 0.05 μg/kg/min. The side effect observed with adrenaline infusion was an increase in plasma lactate levels in both cases. Both animals were euthanised due to non-anaesthetic related complications.
Maintenance of normotension is important during bovine anaesthesia to prevent the development of post-anaesthetic complications. In the cases described here, adrenaline was effective as an additional treatment of anaesthetic related hypotension. Further research is required to establish the recommended infusion rates, cardiovascular effects and possible side effects of adrenaline infusion administration as a treatment for hypotension in bovines.
低血压是兽医患者吸入麻醉期间最常见的并发症之一。由于食品生产动物中获批的药物数量有限，牛低血压的治疗比其他物种更具挑战性。此前尚未有关于使用肾上腺素输注来支持血压在牛身上的描述。
一头母牛和一头小牛分别因双侧下颌骨骨折修复和膀胱破裂修复就诊于都柏林大学学院兽医医院，均出现了严重的麻醉相关低血压，对传统治疗无反应。在这两个病例中，均开始输注肾上腺素并缓慢增加剂量以达到效果，输注速率范围为0.01至0.25μg/kg/min。随着肾上腺素输注速率的增加，血压升高，但仅在输注速率超过0.05μg/kg/min时才观察到临床上显著的血压改善。两个病例中输注肾上腺素均观察到的副作用是血浆乳酸水平升高。两只动物均因非麻醉相关并发症而实施安乐死。
在牛麻醉期间维持正常血压对于预防麻醉后并发症的发生很重要。在此处描述的病例中，肾上腺素作为麻醉相关低血压的辅助治疗有效。需要进一步研究以确定作为牛低血压治疗方法的肾上腺素输注的推荐输注速率、心血管效应和可能的副作用。
