Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA.
Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA.
J Feline Med Surg. 2021 Jun;23(6):563-567. doi: 10.1177/1098612X20967886. Epub 2020 Oct 28.
The objective of this study was to evaluate the time to decreased reactivity of the arytenoid cartilages in cats after application of topical lidocaine.
One hundred and ten mixed-breed cats were randomly assigned to one of five groups based on the time between application of lidocaine and stimulation of the larynx: 5 (T5), 15 (T15), 30 (T30), 45 (T45) or 60 (T60) s. Cats were premedicated with dexmedetomidine, ketamine and buprenorphine. Anesthesia was induced with propofol to effect. Lidocaine 2% (2 mg/kg) was applied topically to the vocal cords using a catheter attached to a syringe under direct laryngoscopy. After lidocaine application, the designated time elapsed and the vocal cords were stimulated with the patient end of an endotracheal tube. Severity of reaction was reported as none, mild, moderate or severe. All cats were intubated after the reactivity score was recorded. Anesthesia was maintained with isoflurane and 100% oxygen while cats were spayed or castrated. Cats were monitored in recovery for signs of respiratory complications and pain.
There was a significant difference in overall reactivity score between T5 and T45 ( = 0.0038). Also, there was a significant difference in the number of cats with no reaction compared with cats with any reaction between T5 and T30 ( = 0.03), as well as between T5 and T45 ( = 0.0028). No cat had a severe reactivity score at T45 or T60. All cats were successfully intubated. There were no complications during intubation, maintenance of anesthesia or recovery.
As the lowest overall reactivity score occurred at T45, it is recommended to wait at least 45 s after application of topical lidocaine before attempting tracheal intubation.
本研究旨在评估猫在局部应用利多卡因后杓状软骨反应性降低的时间。
110 只混种猫随机分为 5 组,根据利多卡因应用与喉刺激之间的时间间隔:5(T5)、15(T15)、30(T30)、45(T45)或 60(T60)秒。猫用右美托咪定、氯胺酮和丁丙诺啡进行预处理。用异丙酚诱导麻醉至效果。在直接喉镜下,用连接注射器的导管将 2%利多卡因(2mg/kg)局部应用于声带。利多卡因应用后,经过指定的时间间隔,用患者端的气管内导管刺激声带。反应严重程度报告为无、轻度、中度或重度。所有猫在记录反应评分后均进行插管。在进行卵巢切除术或去势术时,猫用异氟醚和 100%氧气维持麻醉。在恢复期间监测猫有无呼吸并发症和疼痛迹象。
在总体反应评分方面,T5 与 T45 之间存在显著差异(=0.0038)。此外,T5 与 T30(=0.03)以及 T5 与 T45(=0.0028)之间,无反应的猫与有任何反应的猫数量存在显著差异。在 T45 或 T60 时,没有猫出现严重反应评分。所有猫均成功插管。在插管、麻醉维持或恢复期间均无并发症。
由于总体反应评分最低发生在 T45,因此建议在尝试气管内插管前至少等待 45 秒,局部应用利多卡因后。