Watt Meghan, Bilof James, Ida Keila K, Jeffery Nicholas, Dickerson Vanna
Am J Vet Res. 2025 May 23;86(8). doi: 10.2460/ajvr.25.02.0057. Print 2025 Aug 1.
To determine the effect of general anesthesia on skin perfusion in healthy dogs.
Client-owned dogs (n = 22) undergoing a dental cleaning procedure were enrolled in a prospective study. All dogs were administered trazodone (4 to 6 mg/kg, PO) the evening prior to and morning of their dental procedure. After premedication (0.2 mg/kg of butorphanol and 4 μg/kg of dexmedetomidine, IM), anesthesia was induced with propofol (4 mg/kg, IV, to effect) and maintained with isoflurane in 100% oxygen. The mean speckle contrast (MSC; inversely proportional to perfusion) was recorded using laser speckle contrast imaging for the pinna, hind limb, neck, and ventral midline prior to any medication, after premedication, and every 15 minutes while under isoflurane anesthesia for 60 minutes. The percentage of change in MSC from baseline was recorded.
MSC increased after premedication versus prior to any medication for all sites, indicating a decrease in perfusion. The magnitude was greater for the ventral midline (37.2 ± 8.1%), neck (28.3 ± 9.5%), and pinna (26.8 ± 6.1%) compared to the hind limb (8.7 ± 3.1%). A mild decrease in MSC (increased perfusion) was observed over time during isoflurane anesthesia. The magnitude was greater for the pinna (-11.0 ± 3.5%) compared to the neck (-1.8 ± 1.6%), midline (8.1 ± 0.2%), and hind limb (3.5 ± 0.6%).
A decrease in skin perfusion following IM dexmedetomidine was seen. No further decrease in skin perfusion was seen over time for up to 60 minutes under isoflurane anesthesia.
Veterinarians should not hesitate to place patients under general anesthesia for short durations even when skin perfusion is a concern; however, it may be prudent to avoid dexmedetomidine.
确定全身麻醉对健康犬皮肤灌注的影响。
将接受牙齿清洁手术的客户拥有的犬（n = 22）纳入一项前瞻性研究。所有犬在牙齿手术前一晚和手术当天早晨口服曲唑酮（4至6 mg/kg）。在给予术前用药（0.2 mg/kg布托啡诺和4 μg/kg右美托咪定，肌肉注射）后，用丙泊酚（4 mg/kg，静脉注射，至起效）诱导麻醉，并用异氟醚在100%氧气中维持麻醉。在给予任何药物之前、给予术前用药后以及在异氟醚麻醉60分钟期间每15分钟，使用激光散斑对比成像记录耳廓、后肢、颈部和腹中线的平均散斑对比度（MSC；与灌注成反比）。记录MSC相对于基线的变化百分比。
与给予任何药物之前相比，所有部位在给予术前用药后MSC均增加，表明灌注减少。与后肢（8.7±3.1%）相比，腹中线（37.2±8.1%）、颈部（28.3±9.5%）和耳廓（26.8±6.1%）的增加幅度更大。在异氟醚麻醉期间，随着时间的推移观察到MSC有轻微下降（灌注增加）。与颈部（-1.8±1.6%）、中线（8.1±0.2%）和后肢（3.5±0.6%）相比，耳廓（-11.0±3.5%）的下降幅度更大。
观察到肌肉注射右美托咪定后皮肤灌注减少。在异氟醚麻醉下长达60分钟的时间内，未观察到皮肤灌注随时间进一步减少。
即使担心皮肤灌注问题，兽医也不应犹豫对患者进行短时间的全身麻醉；然而，避免使用右美托咪定可能是谨慎的做法。
