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肌肉注射戊噁庚嗪(MK-467)联合美托咪定和布托啡诺对犬静脉注射氯胺酮的心肺和麻醉效果的影响。

Effects of intramuscular vatinoxan (MK-467), co-administered with medetomidine and butorphanol, on cardiopulmonary and anaesthetic effects of intravenous ketamine in dogs.

机构信息

Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland.

Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland.

出版信息

Vet Anaesth Analg. 2020 Sep;47(5):604-613. doi: 10.1016/j.vaa.2020.05.008. Epub 2020 Jun 11.

Abstract

OBJECTIVE

To investigate the impact of intramuscular (IM) co-administration of the peripheral α-adrenoceptor agonist vatinoxan (MK-467) with medetomidine and butorphanol prior to intravenous (IV) ketamine on the cardiopulmonary and anaesthetic effects in dogs, followed by atipamezole reversal.

STUDY DESIGN

Randomized, masked crossover study.

ANIMALS

A total of eight purpose-bred Beagle dogs aged 3 years.

METHODS

Each dog was instrumented and administered two treatments 2 weeks apart: medetomidine (20 μg kg) and butorphanol (100 μg kg) premedication with vatinoxan (500 μg kg; treatment MVB) or without vatinoxan (treatment MB) IM 20 minutes before IV ketamine (4 mg kg). Atipamezole (100 μg kg) was administered IM 60 minutes after ketamine. Heart rate (HR), mean arterial (MAP) and central venous (CVP) pressures and cardiac output (CO) were measured; cardiac (CI) and systemic vascular resistance (SVRI) indices were calculated before and 10 minutes after MVB or MB, and 10, 25, 40, 55, 70 and 100 minutes after ketamine. Data were analysed with repeated measures analysis of covariance models. A p-value <0.05 was considered statistically significant. Sedation, induction, intubation and recovery scores were assessed.

RESULTS

At most time points, HR and CI were significantly higher, and SVRI and CVP significantly lower with MVB than with MB. With both treatments, SVRI and MAP decreased after ketamine, whereas HR and CI increased. MAP was significantly lower with MVB than with MB; mild hypotension (57-59 mmHg) was recorded in two dogs with MVB prior to atipamezole administration. Sedation, induction, intubation and recovery scores were not different between treatments, but intolerance to the endotracheal tube was observed earlier with MVB.

CONCLUSIONS AND CLINICAL RELEVANCE

Haemodynamic performance was improved by vatinoxan co-administration with medetomidine-butorphanol, before and after ketamine administration. However, vatinoxan was associated with mild hypotension after ketamine with the dose used in this study. Vatinoxan shortened the duration of anaesthesia.

摘要

目的

研究在静脉(IV)给予氯胺酮之前,肌内(IM)给予外周α-肾上腺素受体激动剂伐替可新(MK-467)与甲磺酸右美托咪定和布托啡诺联合给药对犬心肺和麻醉效果的影响,并使用阿替美唑逆转。

研究设计

随机、双盲交叉研究。

动物

总共 8 只 3 岁的专门繁殖的比格犬。

方法

每只狗在 2 周内接受两种治疗:甲磺酸右美托咪定(20 μg/kg)和布托啡诺(100 μg/kg)预处理,然后肌内注射伐替可新(500 μg/kg;治疗 MVB)或不注射伐替可新(治疗 MB)20 分钟,然后 IV 给予氯胺酮(4mg/kg)。在氯胺酮后 60 分钟肌内注射阿替美唑(100 μg/kg)。测量心率(HR)、平均动脉(MAP)和中心静脉(CVP)压和心输出量(CO);在 MVB 或 MB 之前和 10 分钟以及氯胺酮后 10、25、40、55、70 和 100 分钟测量心脏(CI)和全身血管阻力(SVRI)指数。使用重复测量协方差分析模型分析数据。p 值<0.05 被认为具有统计学意义。评估镇静、诱导、插管和恢复评分。

结果

在大多数时间点,与 MB 相比,MVB 时 HR 和 CI 显著更高,SVRI 和 CVP 显著更低。两种治疗方法均在氯胺酮后 SVRI 和 MAP 降低,而 HR 和 CI 增加。MAP 在 MVB 时显著低于 MB;在给予阿替美唑之前,有两只狗出现 MVB 时的轻度低血压(57-59mmHg)。两种治疗方法的镇静、诱导、插管和恢复评分无差异,但 MVB 时更早出现对气管内导管的不耐受。

结论和临床相关性

伐替可新与甲磺酸右美托咪定-布托啡诺联合给药可改善氯胺酮给药前后的血液动力学性能。然而,在本研究中使用的剂量下,伐替可新与氯胺酮后出现轻度低血压有关。伐替可新缩短了麻醉持续时间。

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