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马异氟烷麻醉维持和苏醒期间使用盐酸右美托咪定或罗哌卡因的效果。

Effects of detomidine or romifidine during maintenance and recovery from isoflurane anaesthesia in horses.

机构信息

Faculty of Veterinary Medicine, Department of Large Animals Surgery, Anaesthesia and Orthopaedics, University of Ghent, Merelbeke, Belgium.

School of Animal Science and Food Engineering, Department of Veterinary Medicine, University of São Paulo, Pirassununga, São Paulo, Brazil.

出版信息

Vet Anaesth Analg. 2022 Nov;49(6):624-633. doi: 10.1016/j.vaa.2022.07.004. Epub 2022 Jul 19.

Abstract

OBJECTIVE

To evaluate the effects of detomidine or romifidine on cardiovascular function, isoflurane requirements and recovery quality in horses undergoing isoflurane anaesthesia.

STUDY DESIGN

Prospective, randomized, blinded, clinical study.

ANIMALS

A total of 63 healthy horses undergoing elective surgery during general anaesthesia.

METHODS

Horses were randomly allocated to three groups of 21 animals each. In group R, horses were given romifidine intravenously (IV) for premedication (80 μg kg), maintenance (40 μg kg hour) and before recovery (20 μg kg). In group D2.5, horses were given detomidine IV for premedication (15 μg kg), maintenance (5 μg kg hour) and before recovery (2.5 μg kg). In group D5, horses were given the same doses of detomidine IV for premedication and maintenance but 5 μg kg prior to recovery. Premedication was combined with morphine IV (0.1 mg kg) in all groups. Cardiovascular and blood gas variables, expired fraction of isoflurane (Fe'Iso), dobutamine or ketamine requirements, recovery times, recovery events scores (from sternal to standing position) and visual analogue scale (VAS) were compared between groups using either anova followed by Tukey, Kruskal-Wallis followed by Bonferroni or chi-square tests, as appropriate (p < 0.05).

RESULTS

No significant differences were observed between groups for Fe'Iso, dobutamine or ketamine requirements and recovery times. Cardiovascular and blood gas measurements remained within physiological ranges for all groups. Group D5 horses had significantly worse scores for balance and coordination (p = 0.002), overall impression (p = 0.021) and final score (p = 0.008) than group R horses and significantly worse mean scores for VAS than the other groups (p = 0.002).

CONCLUSIONS AND CLINICAL RELEVANCE

Detomidine or romifidine constant rate infusion provided similar conditions for maintenance of anaesthesia. Higher doses of detomidine at the end of anaesthesia might decrease the recovery quality.

摘要

目的

评估在马进行异氟烷麻醉时,使用盐酸右美托咪定或盐酸罗哌卡因对心血管功能、异氟烷需求和恢复质量的影响。

研究设计

前瞻性、随机、盲法、临床研究。

动物

共 63 匹接受全身麻醉下择期手术的健康马。

方法

马被随机分为三组,每组 21 匹马。在 R 组中,马接受罗哌卡因静脉注射(IV)进行预处理(80μg/kg)、维持(40μg/kg/小时)和恢复前(20μg/kg)。在 D2.5 组中,马接受盐酸右美托咪定 IV 预处理(15μg/kg)、维持(5μg/kg/小时)和恢复前(2.5μg/kg)。在 D5 组中,马接受相同剂量的盐酸右美托咪定 IV 预处理和维持,但在恢复前给予 5μg/kg。所有组均在预处理时联合使用吗啡 IV(0.1mg/kg)。比较各组间心血管和血气变量、呼出异氟烷分数(Fe'Iso)、多巴酚丁胺或氯胺酮需求、恢复时间、恢复事件评分(从胸骨到站立位置)和视觉模拟评分(VAS),采用方差分析加 Tukey 检验、Kruskal-Wallis 检验加 Bonferroni 检验或卡方检验,根据需要(p<0.05)。

结果

各组间 Fe'Iso、多巴酚丁胺或氯胺酮需求和恢复时间无显著差异。心血管和血气测量值在所有组均保持在生理范围内。D5 组马的平衡和协调评分(p=0.002)、总体印象评分(p=0.021)和最终评分(p=0.008)明显差于 R 组马,VAS 的平均评分明显差于其他组(p=0.002)。

结论和临床相关性

盐酸右美托咪定或盐酸罗哌卡因恒速输注为维持麻醉提供了相似的条件。麻醉结束时给予更高剂量的盐酸右美托咪定可能会降低恢复质量。

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