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右美托咪定在猫行卵巢子宫切除术全静脉麻醉中对心肺功能和丙泊酚的节约作用。

Cardiopulmonary and propofol-sparing effects of dexmedetomidine in total intravenous anesthesia in cats undergoing ovariohysterectomy.

机构信息

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

Departament of Veterinary Clinics, Federal University of Pelotas, Pelotas, Brazil.

出版信息

J Feline Med Surg. 2022 Dec;24(12):e490-e497. doi: 10.1177/1098612X221130036. Epub 2022 Nov 21.

Abstract

OBJECTIVES

This study aimed to assess the effect of dexmedetomidine on the propofol-based anesthesia of cats subjected to ovariohysterectomy.

METHODS

Twenty-eight cats were randomly allocated to four groups (seven cats in each) and premedicated with either 5 µg/kg dexmedetomidine (groups Dex 1, Dex 3 and Dex 5) or 0.05 ml saline (Prop group) intramuscularly. After the induction of anesthesia with propofol, total intravenous anesthesia was initiated with 300 µg/kg/min propofol plus 3 ml/kg/h NaCl 0.9% (Prop), or 200 µg/kg/min propofol plus dexmedetomidine at the rates of 1 µg/kg/h (Dex 1), 3 µg/kg/h (Dex 3) or 5 µg/kg/h (Dex 5). Cardiorespiratory variables were assessed 5 mins after induction and every 10 mins thereafter, until the end of anesthesia. The propofol infusion rate was adjusted every 10 mins (± 50 µg/kg/min) to maintain anesthetic depth. The times to extubation, sternal recumbency, ambulation and total recovery were recorded. Pain scoring was performed 1, 2, 4, 8, 12 and 24 h after the end of anesthesia.

RESULTS

Dexmedetomidine produced a propofol-sparing effect of 72.8%, 71.1% and 74.6% in the Dex 1, Dex 3 and Dex 5 groups, respectively. Cats in the Prop group maintained higher heart rate values than the other groups, and the mean arterial pressure remained higher in the Dex 3 and Dex 5 groups. Rescue intraoperative analgesia (fentanyl bolus) was most frequent in the Prop group. There was no significant difference in the time of extubation. Cats in the Dex 1 and Dex 3 groups had a faster anesthetic recovery, with shorter times to achieving sternal recumbency, regaining ambulation and reaching full recovery. Cats in the Dex 1 and Dex 5 groups presented the best recovery quality scores, with 4 (range 4-5) and 4 (range 3-5), respectively, while the Prop group scored 1 (range 1-3), the worst anesthetic recovery score among the groups.

CONCLUSIONS AND RELEVANCE

The use of dexmedetomidine as a total intravenous anesthesia adjuvant, especially at doses of 1 and 3 µg/kg/h, reduces propofol consumption and improves cardiorespiratory stability and intraoperative analgesia, while promoting a better and quicker recovery from anesthesia.

摘要

目的

本研究旨在评估右美托咪定对接受卵巢子宫切除术的猫的依托咪酯麻醉的影响。

方法

28 只猫随机分为四组(每组 7 只),肌肉注射 5μg/kg 右美托咪定(Dex 1、Dex 3 和 Dex 5 组)或 0.05ml 生理盐水(Prop 组)进行预给药。在依托咪酯诱导麻醉后,以 300μg/kg/min 依托咪酯加 3ml/kg/h NaCl 0.9%(Prop 组)或 200μg/kg/min 依托咪酯加右美托咪定 1μg/kg/h(Dex 1 组)、3μg/kg/h(Dex 3 组)或 5μg/kg/h(Dex 5 组)开始全静脉麻醉。诱导后 5 分钟和此后每 10 分钟评估一次心肺变量,直到麻醉结束。每 10 分钟(±50μg/kg/min)调整依托咪酯输注率以维持麻醉深度。记录拔管、胸骨卧位、活动和总恢复时间。麻醉结束后 1、2、4、8、12 和 24 小时进行疼痛评分。

结果

Dex 1、Dex 3 和 Dex 5 组右美托咪定分别产生 72.8%、71.1%和 74.6%的依托咪酯节约作用。与其他组相比,Prop 组的猫心率值保持较高,Dex 3 和 Dex 5 组的平均动脉压保持较高。术中需要芬太尼(fentanyl)追加镇痛的情况在 Prop 组最为频繁。拔管时间无显著差异。Dex 1 和 Dex 3 组的猫麻醉恢复更快,胸骨卧位、恢复活动和完全恢复的时间更短。Dex 1 和 Dex 5 组的猫恢复质量评分最好,分别为 4(范围 4-5)和 4(范围 3-5),而 Prop 组评分为 1(范围 1-3),是所有组中麻醉恢复评分最差的。

结论和相关性

右美托咪定作为全静脉麻醉辅助剂使用,特别是剂量为 1 和 3μg/kg/h 时,可减少依托咪酯的消耗,改善心肺稳定性和术中镇痛效果,同时促进更快更好的麻醉恢复。

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The relationship between blood pressure and pain.血压与疼痛之间的关系。
J Clin Hypertens (Greenwich). 2013 Aug;15(8):600-5. doi: 10.1111/jch.12145. Epub 2013 Jun 10.

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