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异氟烷气体与瓜氟醚、氯胺酮和咪达唑仑恒速输注用于维持美洲黑熊()麻醉的比较。

COMPARISON OF ISOFLURANE GAS VERSUS A GUAIFENESIN, KETAMINE, AND MEDETOMIDINE CONSTANT-RATE INFUSION FOR MAINTENANCE ANESTHESIA IN AMERICAN BLACK BEARS ().

机构信息

Smithsonian Institution's National Zoological Park, Smithsonian Conservation Biology Institute, Wildlife Health Sciences, Washington, DC 20008, USA,

Smithsonian Institution's National Zoological Park, Smithsonian Conservation Biology Institute, Wildlife Health Sciences, Washington, DC 20008, USA.

出版信息

J Zoo Wildl Med. 2019 Sep;50(3):570-578. doi: 10.1638/2018-0124.

Abstract

Published anesthetic protocols for captive and free-ranging bears are limited to injectable inductions with maintenance via inhalants or additional injectable boluses. Though common in other species, intravenous (IV) continuous-rate infusions (CRI) using guaifenesin combinations have not been evaluated in ursids. This study evaluated the use of a CRI compared to an inhalant for maintenance anesthesia. Seven healthy American black bears () were anesthetized in a crossover design with two different anesthetic maintenance protocols. Bears were immobilized with ketamine (2.02 ± 0.14 mg/kg) and medetomidine (0.04 ± 0.003 mg/kg) for both protocols. The anesthetic maintenance control protocol consisted of isoflurane gas (ISO) started at 2% delivered by endotracheal tube; the experimental protocol consisted of guaifenesin, medetomidine, ketamine (GMK) IV CRI started at 50 mg/kg/hr guaifenesin, 0.01 mg/kg/hr medetomidine, and 1 mg/kg/hr ketamine. Induction and recovery parameters including time to first effect, recumbency, and hands on; duration of maintenance protocol; and time from reversals administered to head up, standing on all four feet, no ataxia, and to fully recovered were recorded and compared between protocols. Heart rate, respiratory rate, rectal temperature, blood pressure, end tidal carbon dioxide, and hemoglobin oxygen saturation were recorded at 5-min intervals and compared between protocols. Venous blood gases were obtained at the start, middle, and end of the maintenance anesthesia and compared between protocols. All bears exhibited hypertension with mild respiratory acidosis throughout procedures. Measured physiologic parameters did not differ significantly between the isoflurane and the GMK CRI maintenance protocols, with the exception of higher endpoint (ISO) pCO2 measurements. No adverse events were recorded with either protocol, and adequate depth of anesthesia was maintained with both protocols. GMK CRI provides a safe, effective, and more portable alternative to inhalant anesthetics for maintenance anesthesia in bears in captivity or in the field.

摘要

已发表的圈养和自由放养熊类的麻醉方案仅限于使用吸入剂或额外的注射推注来维持经注射诱导的麻醉。尽管在其他物种中很常见,但熊类尚未评估使用含有愈创甘油醚的静脉 (IV) 持续率输注 (CRI)。本研究评估了 CRI 与吸入剂维持麻醉的效果。在一项交叉设计中,使用两种不同的麻醉维持方案对 7 只健康的美洲黑熊进行麻醉。两种方案均使用氯胺酮(2.02±0.14mg/kg)和甲磺酸右美托咪定(0.04±0.003mg/kg)进行麻醉诱导。麻醉维持对照方案包括通过气管内管给予 2%的异氟烷(ISO);实验方案包括持续输注愈创甘油醚、甲磺酸右美托咪定、氯胺酮(GMK)IV CRI,起始剂量为 50mg/kg/hr 愈创甘油醚、0.01mg/kg/hr 甲磺酸右美托咪定和 1mg/kg/hr 氯胺酮。记录并比较了两种方案的诱导和恢复参数,包括首次起效时间、卧倒时间和上手时间;维持方案的持续时间;以及从逆转药物给药到抬头、四肢站立、无共济失调和完全恢复的时间。在 5 分钟的间隔内记录心率、呼吸频率、直肠温度、血压、呼气末二氧化碳和血红蛋白氧饱和度,并比较两种方案之间的差异。在维持麻醉的开始、中间和结束时获取静脉血气,并比较两种方案之间的差异。所有熊在整个过程中均表现出高血压和轻度呼吸性酸中毒。除了较高的终点(ISO)pCO2 测量值外,两种方案的测量生理参数均无显著差异。两种方案均未记录到不良事件,两种方案均能维持足够的麻醉深度。GMK CRI 为圈养或野外环境中的熊提供了一种安全、有效且更便携的吸入麻醉替代方案,可用于维持麻醉。

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