Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA.
Department of Clinical Sciences, Faculty of Veterinary Medicine, Universite de Montreal, Saint-Hyacinthe, Canada.
J Feline Med Surg. 2020 Nov;22(11):1029-1045. doi: 10.1177/1098612X20965830.
Procedural sedation and analgesia (PSA) describes the process of depressing a patient's conscious state to perform unpleasant, minimally invasive procedures, and is part of the daily routine in feline medicine. Maintaining cardiopulmonary stability is critical while peforming PSA.
Decision-making with respect to drug choice and dosage regimen, taking into consideration the cat's health status, behavior, any concomitant diseases and the need for analgesia, represents an everyday challenge in feline practice. While PSA is commonly perceived to be an uneventful procedure, complications may arise, especially when cats that were meant to be sedated are actually anesthetized.
This clinical article reviews key aspects of PSA in cats while exploring the literature and discussing complications and risk factors. Recommendations are given for patient assessment and preparation, clinical monitoring and fasting protocols, and there is discussion of how PSA protocols may change blood results and diagnostic tests. An overview of, and rationale for, building a PSA protocol, and the advantages and disadvantages of different classes of sedatives and anesthetics, is presented in a clinical context. Finally, injectable drug protocols are reported, supported by an evidence-based approach and clinical experience.
程序镇静和镇痛 (PSA) 描述了抑制患者意识状态以进行不愉快的、微创性程序的过程，是猫医学日常工作的一部分。在进行 PSA 时，维持心肺稳定性至关重要。
考虑到猫的健康状况、行为、任何伴随疾病以及对镇痛的需求，在药物选择和剂量方案方面做出决策，是猫科实践中的日常挑战。虽然 PSA 通常被认为是一个无事件的程序，但可能会出现并发症，尤其是当原本应该镇静的猫实际上被麻醉时。
本文回顾了猫 PSA 的关键方面，同时探讨了文献、并发症和危险因素。针对患者评估和准备、临床监测和禁食方案提出了建议，并讨论了 PSA 方案如何改变血液结果和诊断测试。在临床背景下介绍了 PSA 方案的构建，以及不同类别的镇静剂和麻醉剂的优缺点的概述和原理。最后，报告了注射药物方案，并提供了循证方法和临床经验的支持。
