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芬太尼诱导的犬在急诊腹部手术后机械通气撤机过程中发生肌肉僵硬:病例报告。

Fentanyl-induced muscle rigidity in a dog during weaning from mechanical ventilation after emergency abdominal surgery: A case report.

机构信息

Small Animal Emergency and Critical Care Service, Sendai Animal Care and Research Center, Sendai, Japan.

Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan.

出版信息

Vet Med Sci. 2023 Jan;9(1):37-42. doi: 10.1002/vms3.1001. Epub 2022 Nov 21.

Abstract

A 22.5-kg, 8.4-year-old female mixed breed dog was presented for an emergency ovariohysterectomy for pyometra. No neurological abnormalities were observed on preoperative physical examination. Surgery was completed uneventfully under fentanyl- and sevoflurane-based anaesthesia. Cardiorespiratory indices remained stable under mechanical ventilation throughout the procedure. Approximately 23 min after the discontinuation of fentanyl infusion, the investigator noticed jaw closure and stiffness and thoraco-abdominal muscle rigidity. To rule out fentanyl-induced muscle rigidity, naloxone was administered. Following administration of naloxone, there was a return of spontaneous respiratory effort, indicated by capnogram and visible chest wall excursion. Based on the clinical signs and response to naloxone administration, the dog was diagnosed with suspected fentanyl-induced muscle rigidity. Six minutes after the return of spontaneous respiration, the dog was extubated uneventfully without additional naloxone administration. During 4 days of postoperative hospitalization, no recurrent muscle rigidity was observed, and the patient was discharged safely. The total dose of fentanyl administered was 0.61 mg (27 μg kg ).

摘要

一只 22.5 公斤、8.4 岁的雌性混种犬因子宫蓄脓紧急进行卵巢子宫切除术。术前体格检查未观察到神经异常。在芬太尼和七氟醚为基础的麻醉下顺利完成手术。在整个手术过程中,机械通气下的心肺指数保持稳定。芬太尼输注停止后约 23 分钟,研究者注意到下颌闭合和僵硬以及胸腹肌僵硬。为排除芬太尼引起的肌肉僵硬,给予纳洛酮。给予纳洛酮后,呼吸努力恢复自主,呼气末二氧化碳描记图和可见的胸壁运动表明这一点。根据临床症状和纳洛酮给药后的反应,诊断该犬疑似芬太尼引起的肌肉僵硬。自主呼吸恢复 6 分钟后,该犬在未追加纳洛酮的情况下顺利拔管。术后住院 4 天内,未观察到复发性肌肉僵硬,患者安全出院。芬太尼的总剂量为 0.61 毫克(27 微克公斤)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ad5/9857132/689cd31150f3/VMS3-9-37-g002.jpg

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