Anesthésiologie et Réanimation Vétérinaires, Département Clinique des Animaux de Compagnie et des Équidés, Faculté de Médecine Vétérinaire, Université de Liège, Belgium.
Chirurgie et Clinique Chirurgicale des Petits Animaux, Département Clinique des Animaux de Compagnie et des Équidés, Faculté de Médecine Vétérinaire, Université de Liège, Liège, Belgium.
Vet Anaesth Analg. 2020 Sep;47(5):595-603. doi: 10.1016/j.vaa.2020.04.009. Epub 2020 May 12.
To compare the isoflurane-sparing effects of sufentanil-lidocaine-ketamine (SLK) and fentanyl-lidocaine-ketamine (FLK) infusions in dogs undergoing total ear canal ablation and lateral bulla osteotomy (TECA-LBO).
Randomized blinded clinical study.
A group of 20 client-owned dogs undergoing TECA-LBO.
Intravenous (IV) administration of lidocaine (3 mg kg) and ketamine (0.6 mg kg) with fentanyl (5.4 μg kg; n = 10; FLK group) or sufentanil (0.72 μg kg; n = 10; SLK group) was immediately followed by the corresponding constant rate infusion (CRI) (lidocaine 3 mg kg hour; ketamine 0.6 mg kg hour; either fentanyl 5.4 μg kg hour or sufentanil 0.72 μg kg hour). Anaesthesia was induced with propofol 3-5 mg kg IV and was maintained with isoflurane. End-tidal isoflurane concentration (Fe'Iso) was decreased in 0.2% steps every 15 minutes until spontaneous movements were observed (treated with propofol 1 mg kg IV) or an increase of > 30% in heart rate or mean arterial pressure from baseline occurred (treated with rescue fentanyl or sufentanil). Quality of recovery and pain were assessed at extubation using the short-form Glasgow Composite Pain Scale (SF-GCPS), Colorado State University Canine Acute Pain scale (CSU-CAP), and visual analogue scale (VAS). Data were analysed with analysis of variance, t tests, Fisher test and Spearman coefficient (p < 0.05).
Fe'Iso decreased significantly in SLK group (45%; p = 0.0006) but not in FLK (15%; p = 0.1135) (p = 0.0136). SLK group had lower scores for recovery quality (p = 0.0204), SF-GCPS (p = 0.0071) and CSU-CAP (p = 0.0273) than FLK at extubation. Intraoperative rescue analgesia and VAS were not significantly different between groups.
Compared with FLK infusion, CRI of SLK at these doses decreased isoflurane requirements, decreased pain scores and improved recovery quality at extubation in dogs undergoing TECA-LBO.
比较舒芬太尼-利多卡因-氯胺酮（SLK）和芬太尼-利多卡因-氯胺酮（FLK）输注在接受全耳道切除和外侧鼓室切开术（TECA-LBO）的犬中的异氟醚节省效应。
随机盲法临床研究。
一组 20 只接受 TECA-LBO 的患犬。
静脉内（IV）给予利多卡因（3 mg/kg）和氯胺酮（0.6 mg/kg），同时给予芬太尼（5.4 μg/kg；n=10；FLK 组）或舒芬太尼（0.72 μg/kg；n=10；SLK 组），随后立即给予相应的持续输注（CRI）（利多卡因 3 mg/kg/h；氯胺酮 0.6 mg/kg/h；芬太尼 5.4 μg/kg/h 或舒芬太尼 0.72 μg/kg/h）。用异丙酚 3-5 mg/kg IV 诱导麻醉，用异氟醚维持。每隔 15 分钟以 0.2%的步长降低呼气末异氟醚浓度（Fe'Iso），直到观察到自主运动（用 1 mg/kg IV 异丙酚处理）或心率或平均动脉压从基线增加>30%（用救援芬太尼或舒芬太尼处理）。使用短形式格拉斯哥复合疼痛量表（SF-GCPS）、科罗拉多州立大学犬急性疼痛量表（CSU-CAP）和视觉模拟量表（VAS）在拔管时评估恢复质量和疼痛。采用方差分析、t 检验、Fisher 检验和斯皮尔曼系数进行数据分析（p<0.05）。
SLK 组 Fe'Iso 显著降低（45%；p=0.0006），但 FLK 组无显著降低（15%；p=0.1135）（p=0.0136）。与 FLK 组相比，SLK 组在拔管时的恢复质量评分（p=0.0204）、SF-GCPS 评分（p=0.0071）和 CSU-CAP 评分（p=0.0273）较低。两组术中解救镇痛和 VAS 无显著差异。
与 FLK 输注相比，这些剂量的 SLK 的 CRI 降低了 TECA-LBO 犬的异氟醚需求，降低了疼痛评分，并改善了拔管时的恢复质量。
