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比较甲啡烷和丁丙诺啡联合安定在犬胃镜检查中的效果。

Comparison of the effects of methadone and butorphanol combined with acepromazine for canine gastroduodenoscopy.

机构信息

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

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

出版信息

Vet Anaesth Analg. 2020 Nov;47(6):748-756. doi: 10.1016/j.vaa.2020.03.008. Epub 2020 Jul 27.

Abstract

OBJECTIVE

To evaluate the feasibility of gastroduodenoscopy in dogs premedicated with acepromazine in combination with butorphanol or methadone.

STUDY DESIGN

Prospective, randomized, double-blinded clinical trial.

ANIMALS

A group of 40 client-owned dogs.

METHODS

Dogs were randomly allocated to one of two groups and give intramuscular acepromazine 0.02 mg kg combined with either butorphanol 0.3 mg kg (group ACEBUT) or methadone 0.2 mg kg (group ACEMET). General anaesthesia was induced with propofol and ketamine and maintained with sevoflurane (2.3%) in oxygen. Cardiopulmonary variables were recorded at 5 minute intervals during anaesthesia. Feasibility of the entire gastroduodenoscopy was evaluated with a visual analogue scale (VAS) from 0 (best) to 100 (worst) (primary outcome of the study). Lower oesophageal sphincter dilatation and duodenal intubation were scored. Pylorus diameter was measured with standard endoscopic inflatable balloons. Overall cardiovascular stability was assessed during anaesthesia, using a VAS (0-100), as was the presence of fluid in the oesophagus, regurgitation, need for mechanical ventilation, and intraoperative and postoperative rescue analgesia (secondary outcomes of the study). Differences between treatments were analysed with Mann-Whitney U, Student t test, Fisher exact test or mixed model analysis of variance as appropriate. Subsequently, feasibility VAS of the gastroduodenoscopy was assessed for noninferiority between groups. The noninferiority margin was set as -10.

RESULTS

All gastroduodenoscopies were successfully completed in both groups using an endoscope tip diameter of 12.8 mm in all but one dog. Feasibility of gastroduodenoscopy was evaluated as 2.9 ± 5.6 in group ACEBUT and 5.1 ± 5.8 in group ACEMET. No significant differences between groups were detected in any measured or assessed variables, and noninferiority was confirmed.

CONCLUSION AND CLINICAL RELEVANCE

In our study population, the effects of methadone and butorphanol when combined with acepromazine were comparable.

摘要

目的

评估在咪达唑仑联合丁丙诺啡或美沙酮预处理的犬中进行胃镜检查的可行性。

研究设计

前瞻性、随机、双盲临床试验。

动物

一组 40 只宠物犬。

方法

犬被随机分配到两组之一,并接受肌肉注射咪达唑仑 0.02mg/kg 与丁丙诺啡 0.3mg/kg(ACEBUT 组)或美沙酮 0.2mg/kg(ACEMET 组)联合使用。全身麻醉采用异丙酚和氯胺酮诱导,并用 2.3%氧气中的七氟醚维持。麻醉期间每 5 分钟记录心肺变量。使用视觉模拟量表(VAS)从 0(最佳)到 100(最差)(研究的主要结果)评估整个胃镜检查的可行性。评估下食管括约肌扩张和十二指肠插管情况。使用标准内镜可充气球囊测量幽门直径。使用 VAS(0-100)评估麻醉期间的整体心血管稳定性,以及食管内液体、反流、需要机械通气以及术中和术后急救镇痛的存在情况(研究的次要结果)。使用 Mann-Whitney U、Student t 检验、Fisher 确切检验或混合模型方差分析(视情况而定)分析处理之间的差异。随后,对两组之间的胃镜检查可行性 VAS 进行非劣效性评估。非劣效性边界设定为-10。

结果

两组中所有犬均使用 12.8mm 内镜尖端成功完成胃镜检查,除一只犬外均成功完成。ACEBUT 组胃镜检查的可行性评分为 2.9±5.6,ACEMET 组评分为 5.1±5.8。两组在任何测量或评估的变量中均无显著差异,且确认了非劣效性。

结论和临床相关性

在我们的研究人群中,美沙酮和丁丙诺啡与咪达唑仑联合使用的效果相当。

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