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猫去势术时,使用或不使用咪达唑仑或阿替美唑的无阿片类药物分离麻醉方案联合局部麻醉对术后的影响。

Effects of dissociative anesthesia opioid-free protocols combined with local anesthesia, with or without flumazenil or atipamezole postoperatively, for orchiectomy in cats.

机构信息

Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil.

Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, UFRRJ, Seropédica, RJ, Brazil.

出版信息

Vet Anaesth Analg. 2022 Jan;49(1):45-53. doi: 10.1016/j.vaa.2021.09.003. Epub 2021 Sep 21.

Abstract

OBJECTIVE

To evaluate the anesthetic effects of two drug combinations with local anesthesia, with or without postoperative antagonists, for orchiectomy in cats.

STUDY DESIGN

Prospective, randomized blinded clinical study.

ANIMALS

A total of 64 healthy cats.

METHODS

Cats were assigned to four equal groups: ketamine (5 mg kg) and dexmedetomidine (10 μg kg) were administered intramuscularly (IM), followed postoperatively with intravenous (IV) saline (5 mL; group KDS) or atipamezole (50 μg kg; group KDA); and ketamine (14 mg kg) with midazolam (0.5 mg kg) and acepromazine (0.1 mg kg) IM, with postoperative IV saline (5 mL; group KMAS) or flumazenil (0.1 mg kg; group KMAF). Lidocaine (2 mg kg) was divided between subcutaneous and intratesticular injection. Physiologic variables were recorded at time points during anesthesia. Ketamine rescue dose was recorded. The degree of sedation and the quality of recovery were evaluated postoperatively.

RESULTS

Time to loss of pedal reflex was longer in groups KMAS and KMAF than in groups KDS and KDA (p = 0.010). Total rescue dose of ketamine was higher in KMAS and KMAF than in KDS and KDA (p = 0.003). Heart rate (HR) during anesthesia was higher in KMAS and KMAF than in KDS and KDA (p = 0.001). Times to head up (p = 0.0005) and to sternal recumbency (p = 0.0003) were shorter in KDA than in KDS, KMAS and KMAF. Lower sedation scores were assigned sooner to KDA than KDS, KMAS and KMAF (p < 0.001). Recovery quality scores were good in all groups.

CONCLUSIONS AND CLINICAL RELEVANCE

Both anesthetic protocols allowed the performance of orchiectomy. Groups KMAS and KMAF required higher rescue doses of ketamine before injecting lidocaine. HR and oscillometric systolic pressure were minimally changed in groups KD and tachycardia was recorded in groups KMA. Only atipamezole shortened the anesthetic recovery.

摘要

目的

评估两种局部麻醉药物组合在猫去势手术中的麻醉效果,这些组合分别与或不与术后拮抗剂联合使用。

研究设计

前瞻性、随机、双盲临床研究。

动物

共 64 只健康猫。

方法

将猫分为四组,每组 16 只:肌肉注射(IM)给予氯胺酮(5mg/kg)和右美托咪定(10μg/kg),然后静脉注射(IV)生理盐水(5mL;组 KDS)或阿替美唑(50μg/kg;组 KDA);IM 给予氯胺酮(14mg/kg)、咪达唑仑(0.5mg/kg)和乙酰丙嗪(0.1mg/kg),然后 IV 给予生理盐水(5mL;组 KMAS)或氟马西尼(0.1mg/kg;组 KMAF)。利多卡因(2mg/kg)分为皮下和睾丸内注射。在麻醉期间的各个时间点记录生理变量。记录氯胺酮解救剂量。术后评估镇静程度和恢复质量。

结果

与 KDS 和 KDA 组相比,KMAS 和 KMAF 组的足垫反射消失时间更长(p=0.010)。KMAS 和 KMAF 组的氯胺酮总解救剂量高于 KDS 和 KDA 组(p=0.003)。麻醉期间的心率(HR)在 KMAS 和 KMAF 组高于 KDS 和 KDA 组(p=0.001)。与 KDS、KMAS 和 KMAF 组相比,KDA 组抬头(p=0.0005)和胸骨卧倒(p=0.0003)时间更短。与 KDS、KMAS 和 KMAF 组相比,KDA 组更早出现较低的镇静评分(p<0.001)。所有组的恢复质量评分均良好。

结论和临床相关性

两种麻醉方案均允许进行去势手术。在注射利多卡因之前,KMAS 和 KMAF 组需要更高剂量的氯胺酮解救。KD 组的 HR 和示波法收缩压有轻微变化,KMA 组记录到心动过速。只有阿替美唑缩短了麻醉恢复时间。

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