静脉硫酸镁输注对成年犬丙泊酚全静脉麻醉的影响：一项随机、盲法试验。

The effect of intravenous magnesium sulphate infusion on total intravenous anesthesia with propofol in adult dogs: A randomized, blinded trial.

机构信息

Department of Veterinary Medicine, Federal University of Paraná, Curitiba, Brazil, PR, Brazil.

Department of Veterinary Medicine, Center for Agro-Veterinary Sciences (CAV), Santa Catarina State University (UDESC), Lages, Santa Catarina, Brazil.

出版信息

Vet Anaesth Analg. 2024 Nov-Dec;51(6):603-612. doi: 10.1016/j.vaa.2024.07.007. Epub 2024 Jul 26.

DOI:10.1016/j.vaa.2024.07.007

PMID:39181818

Abstract

OBJECTIVE

To evaluate cardiopulmonary, arterial blood gas and propofol-sparing effects of magnesium sulfate (MgSO) constant rate infusion (CRI) in mechanically ventilated dogs maintained under total intravenous anesthesia with propofol.

STUDY DESIGN

Blinded, randomized, clinical trial.

ANIMALS

A total of 24 healthy adult dogs.

METHODS

Dogs were premedicated with intramuscular acepromazine (0.05 mg kg) and morphine (0.5 mg kg), followed by an intravenous (IV) bolus of saline or MgSO (50 mg kg over 15 minutes) and propofol (given to effect to induce anesthesia). Anesthesia was maintained with an IV propofol infusion (beginning at 0.3 mg kg minute, adjusted as necessary). Concurrently, one of three IV infusions were administered: GS (0.9% NaCl), GM30 (MgSO, 30 mg kg hour) or GM80 (MgSO, 80 mg kg hour). Propofol induction and maintenance doses were recorded. The following variables were recorded at baseline (T0), after bolus treatment (T1), after beginning mechanical ventilation (T5) and every 15 minutes until the end of the procedure (T15-T120): mean arterial pressure, heart rate, peripheral oxygen saturation, end-tidal partial pressure of CO, temperature, blood gas variables, indirect calorimetry and extubation time. Values of p < 0.05 were considered significant.

RESULTS

Propofol induction bolus dose was lower in GM30 (31.2%, p = 0.04) and GM80 (38.9%, p = 0.003) than in GS. The maintenance propofol infusion rate in GM80 was 16.9% lower (p = 0.03), resulting in fewer propofol CRI rescues during the perioperative period. GM30 and GM80 exhibited faster extubation times than GS (46.2%, p = 0.002 and 48.9%, p = 0.001, respectively).

CONCLUSIONS AND CLINICAL RELEVANCE

Infusion of a 50 mg kg bolus, followed by CRI of MgSO (30 and 80 mg kg hour), reduces the propofol induction and maintenance (CRI) requirement, maintaining cardiorespiratory stability and reducing the time required to extubation.

摘要

目的

评价硫酸镁（MgSO）恒速输注（CRI）对机械通气犬心肺、动脉血气和丙泊酚节约作用，这些犬在丙泊酚全静脉麻醉下维持。

研究设计

盲法、随机、临床试验。

动物

共 24 只健康成年犬。

方法

犬肌肉注射咪达唑仑（0.05 mg/kg）和吗啡（0.5 mg/kg）进行预给药，然后静脉（IV）推注生理盐水或 MgSO（15 分钟内 50 mg/kg）和丙泊酚（给予效应诱导麻醉）。用 IV 丙泊酚输注（起始剂量 0.3 mg/kg/min，必要时进行调整）维持麻醉。同时，给予三种 IV 输注中的一种：GS（0.9%NaCl）、GM30（MgSO，30 mg/kg/h）或 GM80（MgSO，80 mg/kg/h）。记录丙泊酚诱导和维持剂量。在基线（T0）、推注治疗后（T1）、开始机械通气后（T5）以及程序结束前每 15 分钟（T15-T120）记录以下变量：平均动脉压、心率、外周血氧饱和度、呼气末二氧化碳分压、温度、血气变量、间接热量测定和拔管时间。p 值<0.05 被认为具有统计学意义。

结果

GM30（31.2%，p=0.04）和 GM80（38.9%，p=0.003）的丙泊酚诱导推注剂量低于 GS。GM80 的丙泊酚维持输注率降低 16.9%（p=0.03），导致围手术期丙泊酚 CRI 抢救次数减少。GM30 和 GM80 的拔管时间均快于 GS（分别为 46.2%，p=0.002 和 48.9%，p=0.001）。