Skarda R T, Muir W W
Department of Veterinary Clinical Sciences, Ohio State University, Columbus 43210.
Am J Vet Res. 1994 May;55(5):670-80.
Seven adult mares were used to determine the analgesic, CNS, and cardiopulmonary effects of detomidine hydrochloride solution after epidural or subarachnoid administration, using both regimens in random sequence. At least 1 week elapsed between experiments. A 17-gauge Huber point (Tuohy) directional needle was used to place a catheter with stylet into either the epidural space at the first coccygeal interspace or the subarachnoid space at the lumbosacral intervertebral junction. Catheters were advanced so that the tips lay at the caudal sacral (S5 to S4) epidural space or at the midsacral (S3 to S2) subarachnoid space. Position of the catheter was confirmed radiographically. A 1% solution of detomidine HCl was injected into the epidural catheter at a dosage of 60 micrograms/kg of body weight, and was expanded to a 10-ml volume with sterile water to induce selective caudal epidural analgesia (CEA). A dose of 30 micrograms of detomidine HCl/kg expanded to a 3-ml volume with spinal fluid was injected into the subarachnoid catheter to induce caudal subarachnoid analgesia (CSA). Analgesia was determined by lack of sensory perception to electrical stimulation (avoidance threshold > 40 V, 0.5-ms duration) at the perineal dermatomes and no response to superficial and deep muscular pinprick stimulation at the pelvic limb and lumbar and thoracic dermatomes. Maximal CEA and CSA extended from the coccyx to spinal cord segments T15 and T14 at 10 to 25 minutes after epidural and subarachnoid drug administrations in 2 mares. Analgesia at the perineal area lasted longer after epidural than after subarachnoid administration (142.8 +/- 28.8 minutes vs 127.1 +/- 27.7 minutes). All mares remained standing. Both CEA and CSA induced marked sedation, moderate ataxia, minimal cardiopulmonary depression, increased frequency of second-degree atrioventricular heart block, and renal diuresis. All treatments resulted in significantly (P < 0.05) decreased heart rate, respiratory rate, systemic arterial blood pressure, PCV, and plasma total solids concentration. To the contrary, arterial carbon dioxide tension, plasma bicarbonate, and standard base excess concentrations were significantly (P < 0.05) increased. Arterial oxygen tension, pH, and rectal temperature did not change significantly from baseline values. Results indicate that use of detomidine for CEA and CSA in mares probably induces local spinal and CNS effects, marked sedation, moderate ataxia, mild cardiopulmonary depression, and renal diuresis.
选用7匹成年母马,采用随机顺序进行两种给药方案,以确定盐酸地托咪定溶液硬膜外或蛛网膜下腔给药后的镇痛、中枢神经系统及心肺效应。两次实验间隔至少1周。使用17号休伯点(托伊)定向针将带芯导管置入第一尾椎间隙的硬膜外腔或腰骶椎间连接处的蛛网膜下腔。推进导管,使导管尖端位于骶尾(S5至S4)硬膜外腔或骶中(S3至S2)蛛网膜下腔。通过X线摄影确认导管位置。将1%的盐酸地托咪定溶液以60微克/千克体重的剂量注入硬膜外导管,并加无菌水至10毫升以诱导选择性尾段硬膜外镇痛(CEA)。将30微克/千克体重的盐酸地托咪定加脑脊液至3毫升注入蛛网膜下腔导管以诱导尾段蛛网膜下腔镇痛(CSA)。通过对会阴皮节电刺激无感觉(回避阈值>40伏,持续时间0.5毫秒)以及对盆腔肢体和腰、胸皮节的浅、深肌肉针刺刺激无反应来确定镇痛效果。在2匹母马中,硬膜外和蛛网膜下腔给药后10至25分钟,最大CEA和CSA从尾骨延伸至脊髓节段T15和T14。硬膜外给药后会阴区镇痛持续时间长于蛛网膜下腔给药(142.8±28.8分钟对127.1±27.7分钟)。所有母马均保持站立。CEA和CSA均引起明显镇静、中度共济失调、轻微心肺抑制、二度房室传导阻滞频率增加以及肾利尿。所有治疗均导致心率、呼吸频率、体循环动脉血压、红细胞压积和血浆总固体浓度显著(P<0.05)降低。相反,动脉血二氧化碳分压、血浆碳酸氢盐和标准碱剩余浓度显著(P<0.05)升高。动脉血氧分压、pH值和直肠温度与基线值相比无显著变化。结果表明,在母马中使用地托咪定进行CEA和CSA可能会引起局部脊髓和中枢神经系统效应、明显镇静、中度共济失调、轻度心肺抑制和肾利尿。