Ilkiw J E, Pascoe P J, Fisher L D
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis 95616, USA.
Am J Vet Res. 1997 Nov;58(11):1274-9.
To evaluate effect of incremental doses of alfentanil on isoflurane minimum alveolar concentration (MAC) in cats to determine whether alfentanil reduces isoflurane MAC and, if so, maximal isoflurane MAC reduction.
6 healthy spayed female cats.
Cats were anesthetized with isoflurane and instrumented to allow collection of arterial blood for measurement of gas tensions, pH, and plasma alfentanil concentration and to measure arterial blood pressure. Isoflurane MAC was determined in triplicate, and alfentanil was administered i.v., using a computer-driven syringe pump to achieve estimated plasma alfentanil concentrations of 50, 100, 250, 500, 750, and 1,000 ng/ml; isoflurane MAC was determined at each alfentanil concentration. Cats were allowed to recover, and the process was graded as poor, good, or excellent.
Alfentanil had a significant dose effect on isoflurane MAC reduction. Significant regression was found for normalized isoflurane MAC versus estimated plasma alfentanil concentration. A quadratic term was necessary to fit the model and, using this curve, MAC reduction (35.0 +/- 6.6%) was estimated to be maximal at a plasma alfentanil concentration of 500 ng/ml. Significant differences were evident in rectal temperature, bicarbonate concentration, base deficit, arterial carbon dioxide and oxygen tensions, and arterial pH between isoflurane alone and some plasma alfentanil concentration and the corresponding reduction in isoflurane concentration.
Infusion of alfentanil resulted in maximal MAC reduction midway between that reported for horses and dogs. At such plasma alfentanil concentration, adverse effects were minimal, but included increase in rectal temperature, metabolic acidosis, and decrease in PaO2. Provided cats were not handled during the recovery period, recovery was smooth and quiet.
Infusion of alfentanil decreases the need for potent inhalant anesthetics in cats and could potentially be a clinically useful anesthetic regimen in sick cats.
评估递增剂量的阿芬太尼对猫异氟烷最低肺泡有效浓度(MAC)的影响,以确定阿芬太尼是否会降低异氟烷MAC,若会降低,确定异氟烷MAC的最大降低幅度。
6只健康的绝育雌性猫。
猫用异氟烷麻醉,并安装仪器以便采集动脉血用于测量气体张力、pH值和血浆阿芬太尼浓度,以及测量动脉血压。异氟烷MAC测定三次,通过计算机驱动的注射泵静脉注射阿芬太尼,以达到估计血浆阿芬太尼浓度为50、100、250、500、750和1000 ng/ml;在每个阿芬太尼浓度下测定异氟烷MAC。让猫恢复,并将恢复过程分为差、好或优三个等级。
阿芬太尼对异氟烷MAC降低有显著的剂量效应。发现标准化异氟烷MAC与估计血浆阿芬太尼浓度之间存在显著回归关系。需要一个二次项来拟合模型,使用该曲线,估计在血浆阿芬太尼浓度为500 ng/ml时MAC降低幅度最大(35.0±6.6%)。单独使用异氟烷与某些血浆阿芬太尼浓度及相应异氟烷浓度降低之间,直肠温度、碳酸氢盐浓度、碱缺失、动脉二氧化碳和氧张力以及动脉pH值存在明显差异。
输注阿芬太尼导致MAC最大降低幅度处于马和狗报道的中间值。在这种血浆阿芬太尼浓度下,不良反应最小,但包括直肠温度升高、代谢性酸中毒和动脉血氧分压降低。如果在恢复期不处理猫,恢复过程顺利且安静。
输注阿芬太尼可减少猫强效吸入麻醉剂的需求,可能成为病猫临床上有用的麻醉方案。