首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 31 毫秒
1.

Objective

To determine the effect of oral trazodone on the minimum alveolar concentration (MAC) of isoflurane in dogs.

Study design

Prospective blinded, single-observer, randomized crossover experimental study.

Animals

Six adult (age 6.8 ± 1.6 months) healthy dogs (three males and three females), weighing 24.8 ± 3.4 kg (mean ± standard deviation).

Methods

Each dog was anesthetized twice with a minimum of 7 days between anesthetic episodes. Dogs were randomly assigned to be administered two treatments in a crossover design: premedication with trazodone (8 mg kg?1; TRAZ–ISO) orally 2 hours prior to an anesthetic episode or no (ISO). Dogs were anesthetized with intravenous propofol (6 mg kg?1) and isoflurane in >95% oxygen. Isoflurane MAC was determined using an iterative bracketing technique with electrodes placed in the buccal mucosa. Hemodynamic variables were compared at the lowest end-tidal isoflurane concentration at which each dog did not respond. A paired t test was used to assess the effect of treatment on outcome variables with significance set to a value of p < 0.05.

Results

The MAC concentration (mean ± standard deviation) in dogs administered TRAZ–ISO was 0.85 ± 0.17% compared with 1.02 ± 0.11% in those administered ISO (p = 0.01, 95% confidence interval ?0.25 to ?0.05), resulting in a mean MAC reduction of 17 ± 12%. There were no differences in hemodynamic variables between treatments.

Conclusions and clinical relevance

Premedication of dogs with oral trazodone (8 mg kg?1) 2 hours prior to anesthetic induction has a significant isoflurane MAC sparing effect with no significant observed hemodynamic benefit.  相似文献   

2.

Objective

To compare the effects of intravenous (IV) medetomidine-morphine and medetomidine-methadone on preoperative sedation, isoflurane requirements and postoperative analgesia in dogs undergoing laparoscopic surgery.

Study design

Randomized, crossover trial.

Animals

Twelve adult Beagle dogs weighing 15.1 ± 4.1 kg.

Methods

Dogs were administered medetomidine (2.5 μg kg?1) IV 5 minutes before either methadone (MET) or morphine (MOR) (0.3 mg kg?1) IV. Anaesthesia was induced with propofol, maintained with isoflurane in oxygen, and depth was clinically assessed and adjusted by an anaesthetist blinded to the treatment. Animals underwent laparoscopic abdominal biopsies. Sedation and nausea scores, pulse rate (PR), respiratory rate (fR), noninvasive systolic arterial blood pressure (SAP), rectal temperature (RT) and pain scores were recorded before drug administration, 5 minutes after medetomidine injection and 10 minutes after opioid administration. Propofol dose, PR, fR, SAP, oesophageal temperature (TOES), end-tidal carbon dioxide and end-tidal isoflurane concentration (Fe′Iso) were recorded intraoperatively. Pain scores, PR, fR, SAP and RT were recorded 10 minutes after extubation, every hour for 6 hours, then at 8, 18 and 24 hours. The experiment was repeated with the other drug 1 month later.

Results

Nine dogs completed the study. After opioid administration and intraoperatively, PR, but not SAP, was significantly lower in MET. Fe′Iso was significantly lower in MET. Temperature decreased in both treatments. Pain scores were significantly higher in MOR at 3 hours after extubation, but not at other time points. Two dogs required rescue analgesia; one with both treatments and one in MOR.

Conclusion and clinical relevance

At the dose used, sedation produced by both drugs when combined with medetomidine was equivalent, while volatile anaesthetic requirements and PR perioperatively were lower with methadone. Postoperative analgesia was deemed to be adequate for laparoscopy with either protocol, although methadone provided better analgesia 3 hours after surgery.  相似文献   

3.

Objective

To compare the cardiopulmonary effects of low and high doses of fentanyl before and after the correction of bradycardia in isoflurane-anesthetized dogs.

Study design

Prospective, randomized crossover trial.

Animals

Eight healthy male Beagle dogs weighing 11.1 ± 1.3 kg [mean ± standard deviation (SD)] and aged approximately 1 year.

Methods

The dogs were anesthetized with isoflurane [1.3 × minimum alveolar concentration (MAC)] on two occasions and fentanyl was administered intravenously; either low-dose fentanyl, loading dose (33 μg kg–1) and infusion (0.2 μg kg–1 minute–1) or a high-dose, loading dose (102 μg kg–1) and infusion (0.8 μg kg–1 minute–1). Cardiopulmonary variables were measured at three time points in equipotent isoflurane concentrations (1.3 MAC): before fentanyl administration (ISO), during fentanyl-induced bradycardia (ISO–F) and after administration of glycopyrrolate normalized heart rate (ISO–FNHR). Data are mean ± SD.

Results

Heart rate and cardiac index (CI) decreased and systemic vascular resistance index (SVRI) increased at ISO–F in both treatments. Bradycardia and vasoconstriction at ISO–F were greater in high than in low-dose fentanyl (42 ± 7 versus 57 ± 15 beats minute–1 and 3457 ± 1108 versus 2528 ± 968 dyne second cm–5 m–2), respectively. Oxygen delivery index (DO2I) decreased only during high-dose fentanyl. CI and DO2I were higher in both treatments at ISO–FNHR than at ISO–F; however, they were higher only during the high-dose fentanyl than at ISO. SVRI was higher at ISO–F than at ISO and ISO–FNHR in both treatments, and was higher at ISO–F in the high than in the low-dose treatment.

Conclusions and clinical relevance

An overall improvement in cardiovascular function of dogs anesthetized with equipotent isoflurane doses (1.3 MAC) was observed after the treatment of bradycardia only with the high-dose fentanyl.  相似文献   

4.

Objective

To investigate the efficacy of a new intravenous (IV) nanoemulsified isoflurane formulation for maintenance of general anesthesia in dogs.

Study design

Prospective, crossover, experimental study.

Animals

Seven healthy, mature, mixed-breed dogs, three male and four female, weighing 11.5 ± 1.5 kg.

Methods

Anesthesia was induced with propofol for instrumentation. Measurements were obtained before administration of either inhaled isoflurane (Iso-I) or IV 15% isoflurane-loaded lipid nanoemulsion (Iso-nano). The minimum alveolar concentration (MAC) of isoflurane was determined using the ‘up-and-down’ technique. A tail clamp was applied every 15 minutes for a total time of 90 minutes and isoflurane administration was adjusted according to the response. Data were recorded at 30, 60 and 90 minutes for end-tidal isoflurane concentration (Fe´Iso), end-tidal carbon dioxide partial pressure (Pe′CO2), inspired isoflurane concentration (FIIso), arterial hemoglobin oxygen saturation (SaO2), peripheral hemoglobin oxygen saturation (SpO2), respiratory rate (fR), heart rate (HR), arterial blood pH, PaCO2, PaO2, base excess (BE), bicarbonate (HCO3?), systemic arterial pressure (sAP), and biochemical variables of blood urea nitrogen, alanine aminotransferase, creatine kinase and creatinine.

Results

No significant differences between treatments were detected for HR, fR, SaO2 or any biochemical variables (p > 0.05). In the Iso-nano treatment, sAP was significantly decreased throughout the study. Significant decreases in pH, Pe′CO2, BE and HCO3? were measured in the Iso-nano treatment. Isoflurane MAC was significantly lower in the Iso-nano than the Iso-I treatment. The dose of isoflurane (g hour?1) required to maintain general anesthesia did not differ significantly between treatments.

Conclusions and clinical relevance

Administration of 15% isoflurane-loaded lipid nanoemulsion IV was effective in maintaining general anesthesia in dogs but did not reduce the amount of isoflurane necessary to maintain general anesthesia. Significant hypotension and nonrespiratory acidosis occurred with the injectable form.  相似文献   

5.

Objective

To compare alteration in intestinal blood flow in anaesthetized horses with changes in oral mucosa blood flow.

Study design

Prospective, randomized clinical study.

Animals

Eight warmblood horses.

Methods

After induction with guaifenesin and ketamine, anaesthesia was maintained with isoflurane at 1.5 vol% in oxygen. The tissue blood flow was measured using laser Doppler flowmetry at the jejunum, colon, rectal mucosa, oesophageal mucosa and the oral mucosa. After three baseline measurements, blood flow was first increased by dobutamine infusion and thereafter decreased by increasing isoflurane concentration and all measurements repeated twice. anova was used for comparing the measured parameters to baseline and correlation between the different measurement localizations was examined using Pearson correlation (p < 0.05).

Results

Microperfusion at all measurement sites increased significantly during dobutamine infusion and decreased significantly during high isoflurane concentration. There was a significant correlation between flow at the oral mucosa and flow at the jejunum (r2 = 0.77, p = 0.002), colon (r2 = 0.76, p < 0.001), rectal mucosa (r2 = 0.88, p < 0.001) and oesophageal mucosa (r2 = 0.83, p <0.001).

Conclusions and clinical relevance

Oral mucosa blood flow can be used in isoflurane anaesthetized horses to reflect changes of intestinal microcirculation.  相似文献   

6.

Objective

Influence of detomidine or romifidine constant rate infusion (CRI) on plasma lactate concentration and isoflurane requirements in horses undergoing elective surgery.

Study design

Prospective, randomised, blinded, clinical trial.

Animals

A total of 24 adult healthy horses.

Methods

All horses were administered intramuscular acepromazine (0.02 mg kg?1) and either intravenous detomidine (0.02 mg kg?1) (group D), romifidine (0.08 mg kg?1) (group R) or xylazine (1.0 mg kg?1) (group C) prior to anaesthesia. Group D was administered detomidine CRI (10 μg kg?1 hour?1) in lactated Ringer's solution (LRS), group R romifidine CRI (40 μg kg?1 hour?1) in LRS and group C an equivalent amount of LRS intraoperatively. Anaesthesia was induced with ketamine and diazepam and maintained with isoflurane in oxygen. Plasma lactate samples were taken prior to anaesthesia (baseline), intraoperatively (three samples at 30 minute intervals) and in recovery (at 10 minutes, once standing and 3 hours after end of anaesthesia). End-tidal isoflurane percentage (Fe′Iso) was analysed by allocating values into three periods: Prep (15 minutes after the start anaesthesia–start surgery); Surgery 1 (start surgery–30 minutes later); and Surgery 2 (end Surgery 1–end anaesthesia). A linear mixed model was used to analyse the data. A value of p < 0.05 was considered significant.

Results

There was a difference in plasma lactate between ‘baseline’ and ‘once standing’ in all three groups (p < 0.01); values did not differ significantly between groups. In groups D and R, Fe′Iso decreased significantly by 18% (to 1.03%) and by 15% (to 1.07%), respectively, during Surgery 2 compared with group C (1.26%); p < 0.006, p < 0.02, respectively.

Conclusions and clinical relevance

Intraoperative detomidine or romifidine CRI in horses did not result in a clinically significant increase in plasma lactate compared with control group. Detomidine and romifidine infusions decreased isoflurane requirements during surgery.  相似文献   

7.

Objective

To investigate the effects of a low dose of dexmedetomidine (DEX) followed by constant rate infusion (CRI) and reversal with atipamezole on systolic and diastolic functions in isoflurane-anesthetized healthy cats.

Study design

Prospective cohort study.

Animals

A group of 11 client-owned adult cats.

Methods

Baseline transthoracic echocardiography (TTE) was performed, followed by intramuscular (IM) administration of DEX (5 μg kg?1). After 10 minutes, sedation was scored, adverse effects were recorded and another TTE performed. Approximately 40 minutes after DEX administration, anesthesia was induced by isoflurane mask and maintained with 1.2% end-tidal isoflurane and DEX CRI (1 μg kg?1 hour?1) for 80 minutes. Physiological variables were recorded every 10 minutes, and TTE was repeated 10, 30 and 60 minutes after the start of anesthesia. CRI was stopped, atipamezole (30 μg kg?1) was administered IM and a final TTE was performed after 10 minutes. Repeated measures over time were submitted to one-way analysis of variance or Kruskal–Wallis test according to data distribution; significance was assumed at p < 0.05.

Results

After DEX premedication, mild sedation and a slight but significant increase in systolic arterial pressure occurred, and vomiting was a common adverse effect. The cardiac output (CO) and heart rate decreased during anesthesia, with no changes after administration of atipamezole. Trivial valvular insufficiencies were commonly seen after DEX premedication and during CRI. Myocardial radial and longitudinal systolic functions were not affected by sedation or by anesthesia. The late phase of diastole on both right and left ventricles was affected by isoflurane–DEX CRI. Global left ventricular myocardial performance was not impaired.

Conclusions

and clinical relevance Decreased CO and late diastolic impairment were observed in healthy cats administered a low dose of DEX for premedication followed by anesthesia with isoflurane and DEX CRI.  相似文献   

8.

Objective

To determine the accuracy of high-definition oscillometry (HDO) for arterial pressure measurement during injectable or inhalation anesthesia in horses.

Study design

Prospective, clinical study.

Animals

Twenty-four horses anesthetized for procedures requiring lateral recumbency.

Methods

Horses were premedicated with xylazine, and anesthesia induced with diazepam–ketamine. Anesthesia was maintained with xylazine–ketamine–guaifenesin combination [TripleDrip (TD; n = 12) or isoflurane (ISO; n = 12)]. HDO was used to obtain systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressures, and heart rate (HR) using an 8-cm-wide cuff around the proximal tail. Invasive blood pressure (IBP), SAP, MAP, DAP and HR were recorded during HDO cycling. Bland–Altman analysis for repeated measures was used to compare HDO and IBP for all measurements. The generalized additive model was used to determine if means in the differences between HDO and IBP were similar between anesthetic protocols for all measurements.

Results

There were >110 paired samples for each variable. There was no effect of anesthetic choice on HDO performance, but more variability was present in TD compared with ISO. Skewed data required log-transformation for statistical comparison. Using raw data and standard Bland–Altman analysis, HDO overestimated SAP (TD, 3.8 ± 28.3 mmHg; ISO, 3.5 ± 13.6 mmHg), MAP (TD, 4.0 ± 23.3 mmHg; ISO, 6.3 ± 10.0 mmHg) and DAP (TD, 4.0 ± 21.2 mmHg; ISO, 7.8 ± 13.6 mmHg). In TD, 26–40% HDO measurements were within 10 mmHg of IBP, compared with 60–74% in ISO. Differences between HDO and IBP for all measurements were similar between anesthetic protocols. The numerical difference between IBP and HDO measurements for SAP, MAP and DAP significantly decreased as cuff width:tail girth ratio increased toward 40%.

Conclusion and clinical relevance

More variability in HDO occurred during TD. The cuff width:tail girth ratio is important for accuracy of HDO.  相似文献   

9.

Objective

To assess the temporal effects of a single fentanyl intravenous (IV) bolus on the minimum anesthetic concentration (MAC) of isoflurane in chickens and to evaluate the effects of this combination on heart rate (HR) and rhythm, systemic arterial pressures (sAP) and ventilation.

Study design

Prospective experimental trial.

Animals

Seventeen adult chickens weighing 1.8 ± 0.2 kg.

Methods

Individual isoflurane MAC for 17 chickens was previously determined using the bracketing method. Chickens were anesthetized with isoflurane to evaluate the effects of a single IV fentanyl bolus (10 or 30 μg kg?1) on isoflurane MAC over time using the up-and-down method. Ventilation was controlled. The isoflurane MAC reduction was estimated by logistic regression at 5 and 15 minutes after fentanyl administration. In the second phase, seven chickens were anesthetized with isoflurane, and fentanyl was administered (30 μg kg?1) IV over 1 minute during spontaneous ventilation and HR and rhythm, sAP and ventilation variables were measured.

Results

At 5 minutes after IV administration of fentanyl (10 or 30 μg kg?1), isoflurane MAC was significantly reduced by 17.6% (6.1–29.1%) [logistic regression estimate (95% Wald confidence interval)] and 42.6% (13.3–71.9%), respectively. Isoflurane MAC reduction at 15 minutes after IV administration of fentanyl (10 or 30 μg kg?1) was 6.2% (?0.6 to 12.9%) and 13.2% (?0.9 to 27.3%), respectively; however, this reduction was not significant. No clinically significant cardiopulmonary changes or arrhythmias were detected after the administration of fentanyl (30 μg kg?1).

Conclusions and clinical relevance

Administration of a single fentanyl bolus induced a dose-dependent and short-lasting reduction in isoflurane MAC. The higher dose induced no significant cardiopulmonary depression in isoflurane-anesthetized chickens during spontaneous ventilation. In chickens anesthetized with isoflurane, the clinical usefulness of a single fentanyl bolus is limited by its short duration of effect.  相似文献   

10.

Objective

To evaluate the cardiorespiratory effects of a 7° reverse Trendelenburg position (RTP) in anaesthetized horses.

Study design

Randomized, non-blinded clinical trial.

Animals

A total of 125 horses undergoing elective surgery in dorsal recumbency.

Methods

Horses were allocated to one of three weight classes and assigned to be positioned either on a horizontal table or on a table in 7° RTP, according to a randomized block design. In all horses, anaesthesia was maintained with isoflurane in oxygen and a constant rate infusion of romifidine. All horses were mechanically ventilated throughout anaesthesia, and routine cardiovascular monitoring and arterial blood gas analysis were performed at 15-minute intervals and relevant variables calculated. Data from the first 60 minutes of anaesthesia were compared between both positions using a mixed model analysis of variance.

Results

A significant interaction was found between position and weight class for the alveolar to arterial oxygen tension gradient and F-shunt: these variables were lower in RTP than in horizontal position in the two lowest weight classes and vice versa in the highest weight class. Arterial oxygen tension and oxygenation indices were significantly worse in the horses in the higher weight classes.

Conclusions and clinical relevance

A 7° RTP did not result in clinically relevant changes in gas exchange or cardiovascular function. Horses with a higher body weight are at increased risk for hypoxaemia during anaesthesia in dorsal recumbency.  相似文献   

11.

Objective

To characterize the pharmacokinetics of dexmedetomidine when administered as a short intravenous (IV) infusion to isoflurane-anesthetized rabbits.

Study design

Experimental study.

Animals

A total of six healthy adult female New Zealand White rabbits.

Methods

Rabbits were anesthetized with isoflurane in oxygen. Following determination of isoflurane minimum alveolar concentration (MAC), the anesthetic dose was reduced to 0.7 × MAC, and dexmedetomidine hydrochloride (20 μg kg?1) was infused IV over 5 minutes. Arterial blood samples were obtained immediately before and at 1, 2, 5, 6, 7, 10, 15, 30, 60, 90, 120, 240 and 360 minutes following termination of the infusion. Samples were transferred into tubes containing ethylenediaminetetraacetic acid and centrifuged immediately. The plasma was harvested and stored at –80 °C until analyzed. Concentrations of dexmedetomidine in plasma were determined by liquid chromatography mass spectrometry. Compartment models were fitted to the time and concentration data using nonlinear regression.

Results

A three-compartment model best fit the data set. Median volume of distribution at steady state and terminal half-life were 3169 mL kg?1 (range, 2182–3859 mL kg?1) and 80 minutes (range, 72–88 minutes), respectively.

Conclusions and clinical relevance

The pharmacokinetics of dexmedetomidine in isoflurane-anesthetized, healthy, New Zealand White rabbits were characterized in this study. Data from this study can be used to determine dosing regimens for dexmedetomidine in isoflurane-anesthetized rabbits.  相似文献   

12.

Objective

To determine the median effective dose (ED50) of intravenous (IV) bupivacaine associated with a 50% probability of causing clinically relevant cardiovascular effects [defined as 30% change in heart rate (HR) or mean arterial pressure (MAP)] in chickens anesthetized with isoflurane.

Study design

Randomized up-and-down study.

Animals

A total of 14 Ross-708 broiler chickens (Gallus gallus domesticus) weighing 1.70–2.75 kg.

Methods

Anesthesia was induced and maintained with isoflurane. Monitoring included the electrocardiogram and invasive arterial pressures. Chickens were administered bupivacaine IV over 2 minutes using a dose based on the response of the previous animal. Dose was decreased when HR and/or MAP in the previous animal increased or decreased ≥30% after bupivacaine administration, or increased when HR or MAP changed <30%. The ED50 was defined as the dose resulting in ≥30% variation in HR or MAP in 50% of the population studied.

Results

The IV ED50 of bupivacaine was 1.94 mg kg?1 using Dixon’s up-and-down method and 1.96 mg kg?1 by logistic regression.

Conclusions and clinical relevance

These results suggest that 1.33 and 1.96 mg kg?1 of IV bupivacaine are associated with a respective 1 or 50% probability of a clinically significant change in MAP in isoflurane-anesthetized chickens. Identification of the cardiovascular changes associated with different doses of bupivacaine can be used as the basis for studies of therapeutic applications in the domestic chicken. Further studies are required to determine interspecies variation.  相似文献   

13.

Objective

The aim was to compare efficacy and side effects of induction with medetomidine–ketamine or medetomidine–S(+)-ketamine by intranasal (IN) instillation in rabbits and to evaluate both protocols during subsequent isoflurane anaesthesia.

Study design

Prospective, blinded, randomized experimental study in two centres.

Animals

Eighty-three healthy New Zealand White rabbits undergoing tibial or ulnar osteotomy.

Methods

Medetomidine (0.2 mg kg?1) with 10 mg kg?1 ketamine (MK) or 5 mg kg?1 S(+)-ketamine (MS) was administered IN to each rabbit in a randomized fashion. In Centre 1 (n = 42) rabbits were held in sternal recumbency, and in Centre 2 (n = 41) in dorsal recumbency, during drug instillation. Adverse reactions were recorded. If a rabbit swallowed during endotracheal intubation, half of the initial IN dose was repeated and intubation was re-attempted after 5 minutes. Anaesthesia was maintained with isoflurane. Heart rate, blood pressure, endtidal carbon dioxide concentration and blood gases were recorded. Data were analysed using Student's t-test, Mann–Whitney test and Fisher's exact test.

Results

In all, 39 animals were assigned to the MK group and 44 to the MS group. Two rabbits in the MS group held in dorsal recumbency died after instillation of the drug. Eight (MK) and 11 rabbits (MS) were insufficiently anaesthetized and received a second IN dose. One rabbit in MK and three in MS required an isoflurane mask induction after the second IN dose. There were no significant differences between treatments for induction, intraoperative data, blood gas values and recovery data.

Conclusion and clinical relevance

This study indicated that medetomidine–ketamine and medetomidine-S(+)-ketamine were effective shortly after IN delivery, but in dorsal recumbency IN administration of S(+)-ketamine led to two fatalities. Nasal haemorrhage was noted in both cases; however, the factors leading to death have not been fully elucidated.  相似文献   

14.

Objective

To determine the infusion rates that maintain the train-of-four (TOF) ratio within 20–70% in dogs and compare the infusion rates between diabetic and nondiabetic dogs.

Study design

Prospective clinical study.

Animals

In total, 47 dogs scheduled for phacoemulsification were included with a median (80% central range) bodyweight of 10.6 (5.7–35.5) kg and age of 7 (1–11) years. Diabetes mellitus was previously diagnosed in nine dogs.

Methods

After premedication using acepromazine and methadone, anaesthesia was induced by intravenous (IV) propofol and maintained by isoflurane and fentanyl or remifentanil. The TOF ratio was monitored by stimulating the peroneal nerve and the response quantified by accelerometry. Rocuronium 0.5 mg kg?1 was administered IV, and further infused to maintain the TOF ratio between 20% and 70%. The infusion rates of rocuronium were compared by the Mann–Whitney test between diabetic and nondiabetic dogs, and the influence of age, sex, bodyweight, body temperature, end-tidal carbon dioxide, end-tidal isoflurane concentration, mean arterial blood pressure, pulse rate and time from induction and time from rocuronium bolus to stable rocuronium infusion rate were investigated in a stepwise, forward regression model.

Results

A stable infusion rate was found in 42 dogs. A higher median (80% central range) infusion rate was found in diabetic [0.43 (0.35–0.50) mg kg?1 hour?1] compared with nondiabetic dogs [0.30 (0.20–0.50) mg kg?1 hour?1] (p = 0.013). None of the other variables investigated were found to significantly influence the infusion rate.

Conclusions and clinical relevance

There is a quite large individual variation in the infusion rates of rocuronium needed to maintain a stable neuromuscular block in a varied population of dogs. Of the variables investigated, diabetes mellitus was the only one found to significantly influence the infusion rate of rocuronium.  相似文献   

15.

Objectives

To compare the effects of a lidocaine constant rate infusion (CRI) combined with 1% isoflurane versus those of 2% isoflurane alone on cardiovascular variables in anaesthetized horses, and to estimate the sample size required to detect a difference in recovery quality.

Study design

Prospective, randomized, blinded, crossover study.

Animals

Twelve healthy experimental horses.

Methods

Horses were anaesthetized twice using an intravenous (IV) administration of acepromazine, romifidine, diazepam and ketamine. Horses were placed in dorsal recumbency and ventilated mechanically. During the first 10 minutes (P1), anaesthesia was maintained with a 2% inspired isoflurane fraction (FIIso). During the following 20 minutes (P2), horses received IV lidocaine (1.5 mg kg?1) (group IL) or saline (group I). During the last 60 minutes (P3), group IL received a lidocaine CRI (50 μg kg?1 minute?1 IV) and FIIso 1%, whereas group I received a saline CRI and FIIso 2%. Three weeks later, the horses received the alternative treatment. Painful stimuli were induced by introducing an 18 gauge needle intramuscularly. Ketamine and dobutamine requirements and physiological variables were recorded. Recoveries were assessed by two anaesthetists unaware of the treatment. Lidocaine plasma concentrations were measured during recovery. Data were analysed with anova.

Results

During P3, group IL had a lower heart rate (p = 0.002), higher mean arterial pressure (p < 0.001) and lower dobutamine requirement (p < 0.001) than group I. One horse had lidocaine plasma concentrations above toxic levels. Recoveries did not differ significantly between groups. Sample sizes of 208 horses in each group would be necessary to detect a statistically significant difference (85% statistical power) in recovery quality.

Conclusions and clinical relevance

A lidocaine CRI combined with FIIso 1% rather than FIIso 2% alone may improve cardiovascular variables in healthy anaesthetized horses.  相似文献   

16.

Objective

To evaluate the pharmacokinetics of two doses of tramadol during isoflurane anaesthesia in sheep and their ability to prevent the cardiovascular response induced by surgical stimulation.

Study design

Prospective randomized controlled study.

Animals

A total of 12 healthy sheep (mean weight, 47.5 ± 7.9 kg) undergoing lumbar transpedicular intervertebral disk nucleotomy.

Methods

Sheep were sedated with medetomidine, anaesthesia was induced with propofol and maintained with isoflurane at 1.5 vol.%. Baseline heart rate and blood pressure were measured and sheep were randomly assigned an intravenous injection of tramadol (4 or 6 mg kg?1). Fentanyl was injected as rescue analgesic if cardiovascular parameters were increased more than 20% compared to baseline. If those variables were below 20% of baseline, the concentration of isoflurane was gradually decreased until parameters returned to the original value. Blood collections were performed at pre-assigned times, and concentrations of tramadol and O-desmethyltramadol (M1) assessed by high-performance liquid chromatography.

Results

Time from premedication to anaesthesia induction, anaesthesia time, propofol dose and intraoperative body temperature were similar between doses. Cardiovascular variables remained between ±20% of baseline value, and no statistical difference was observed between treatments. Regardless of the dose of tramadol administered, arterial blood pressure was statistically higher than baseline 10 minutes after tramadol administration, but it gradually returned to previous values. A two-compartment model and a non-compartment model described the pharmacokinetics of tramadol and M1, respectively. Plasma concentrations of tramadol rapidly decreased in the first 2 hours for both doses with an elimination half-life of more than 40 minutes. The M1 maximum concentration was similar for both doses, and it was detected in plasma after 35 minutes.

Conclusions and clinical relevance

Both doses of tramadol provided adequate cardiovascular stability during spinal surgery in sheep. The pharmacokinetic variables may be used to plan the dosage regime during general anaesthesia.  相似文献   

17.

Objective

The aim of this study was to evaluate the effect of continuous positive airway pressure (CPAP) on regional distribution of ventilation and dead space in anaesthetized horses.

Study design

Randomized, experimental, crossover study.

Animals

A total of eight healthy adult horses.

Methods

Horses were anaesthetized twice with isoflurane in 50% oxygen and medetomidine as continuous infusion in dorsal recumbency, and administered in random order either CPAP (8 cmH2O) or NO CPAP for 3 hours. Electrical impedance tomography (and volumetric capnography (VCap) measurements were performed every 30 minutes. Lung regions with little ventilation [dependent silent spaces (DSSs) and nondependent silent spaces (NSSs)], centre of ventilation (CoV) and dead space variables, as well as venous admixture were calculated. Statistical analysis was performed using multivariate analysis of variance and Pearson correlation.

Results

Data from six horses were statistically analysed. In CPAP, the CoV shifted to dependent parts of the lungs (p < 0.001) and DSSs were significantly smaller (p < 0.001), while no difference was seen in NSSs. Venous admixture was significantly correlated with DSS with the treatment time taken as covariate (p < 0.0001; r = 0.65). No differences were found for any VCap parameters.

Conclusions and clinical relevance

In dorsally recumbent anaesthetized horses, CPAP of 8 cmH2O results in redistribution of ventilation towards the dependent lung regions, thereby improving ventilation-perfusion matching. This improvement was not associated with an increase in dead space indicative for a lack in distension of the airways or impairment of alveolar perfusion.  相似文献   

18.

Objective

To compare the effects of MK-467 during isoflurane anaesthesia combined with xylazine or dexmedetomidine on global and gastrointestinal perfusion parameters.

Study design

Prospective, randomized experimental trial.

Animals

A total of 15 warmblood horses.

Methods

Horses were divided into two groups for administration of either dexmedetomidine (D) or xylazine (X) for premedication (D: 3.5 μg kg?1; X: 0.5 mg kg?1) and as constant rate infusion during isoflurane anaesthesia (D: 7 μg kg?1 hour?1; X: 1 mg kg?1 hour?1). During anaesthesia, heart rate, mean arterial blood pressure (MAP), systemic vascular resistance index (SVRI) and cardiac index (CI) were measured. Microperfusion of the colon, jejunum and stomach was measured using laser Doppler flowmetry. After 2 hours of stabilization, MK-467 (250 μg kg?1) was administered, and measurements were continued for another 90 minutes. For statistical analysis, the permutation test and Wilcoxon rank-sum test were used (p < 0.05).

Results

There were no differences in baseline measurements between groups. The MK-467 bolus resulted in a significant decrease in MAP (D: –58%; X: –48%) and SVRI (D: –68%; X: –65%) lasting longer in group D (90 minutes) compared to group X (60 minutes). While CI increased (D: +31%; X: +35%), microperfusion was reduced in the colon (D: –44%; X: –34%), jejunum (D: –26%; X: –33%) and stomach (D: –37%; X: –35%).

Conclusions and clinical relevance

Alpha-2-agonist induced vasoconstriction was reversed by the MK-467 dose used, resulting in hypotension and rise in CI. Gastrointestinal microperfusion decreased, probably as a result of insufficient perfusion pressure. An infusion rate for MK-467 as well as an ideal agonist/antagonist ratio should be determined.  相似文献   

19.

Objective

To evaluate the ability of pulse wave transit time (PWTT) to detect changes in stroke volume (SV) and to estimate cardiac output (CO) compared with the thermodilution technique in isoflurane-anaesthetized dogs.

Study design

Prospective, experimental study.

Animals

Eight adult laboratory dogs.

Methods

The dogs were anaesthetized with isoflurane and mechanically ventilated. Reference CO (TDCO) was measured via a pulmonary artery catheter using the thermodilution technique and reference SV (TDSV) was calculated. PWTT was calculated as the time from the electrocardiogram R-wave peak to the rise point of the pulse oximeter wave. Estimated CO (esCO) was derived from PWTT after calibration with arterial pulse pressure (both non-invasive and invasive methods) and TDCO. Haemodynamic changes were induced by administration of phenylephrine (vasoconstriction), high isoflurane (vasodilatation and negative inotropy) and dobutamine (vasodilatation and positive inotropy). Trending between percentage change in PWTT and TDSV was assessed using concordance analysis and receiver operator characteristic (ROC) curve. The agreement between esCO and TDCO was evaluated using the Bland–Altman method.

Results

The direction of percentage change between consecutive PWTT and the corresponding TDSV showed a concordance rate of 95%, with correlation coefficients of ?0.86 (p < 0.001). Area under the ROC curve for the change in PWTT to detect 15% change in TDSV was 0.91 (p < 0.001). TDCO compared with esCO calibrated with invasive and non-invasive blood pressure showed a bias (precision of agreement) of 0.58 (1.54) and 0.57 (1.59) L minute?1 with a percentage error of ±61% and ±63%, respectively.

Conclusions and clinical relevance

In isoflurane-anaesthetized dogs, PWTT showed a good trending ability to detect 15% changes in SV. This technique is easy to use, inexpensive, non-invasive and could become routine anaesthetic monitoring. However, the agreement between absolute esCO and TDCO was unacceptable.  相似文献   

20.

Objective

To compare the effects of controlled mechanical ventilation (CMV) and constant positive end-expiratory pressure (PEEP) and interposed recruitment manoeuvres (RMs) with those of CMV without PEEP on gas exchange during general anaesthesia and the early recovery period.

Study design

Prospective, randomized clinical trial.

Animals

A total of 48 Warmblood horses undergoing elective surgery in lateral (Lat) (n = 24) or dorsal (Dors) (n = 24) recumbency.

Methods

Premedication (romifidine), induction (diazepam and ketamine) and maintenance (isoflurane in oxygen) were identical in all horses. Groups Lat- CMV and Dors-CMV (each n = 12) were ventilated using CMV. Groups Lat-RM and Dors-RM (each n = 12) were ventilated using CMV with constant PEEP (10 cmH2O) and intermittent RMs (three consecutive breaths with peak inspiratory pressure of 60 cmH2O, 80 cmH2O and 60 cmH2O, respectively). RMs were applied as required to maintain PaO2 at > 400 mmHg (> 53.3 kPa). Dobutamine was given to maintain mean arterial blood pressure at > 60 mmHg. Physiological parameters were recorded every 10 minutes. Arterial blood gases were measured intra- and postoperatively. Statistical analyses were conducted using analyses of variance (anova), t tests and the Mann–Whitney U-test.

Results

Horses in Dors-RM had higher PaO2 values [478 ± 35 mmHg (63.7 ± 4.6 kPa)] than horses in Dors-CMV [324 ± 45 mmHg (43.2 ± 6 kPa)] during anaesthesia and the early recovery period. There were no differences between horses in groups Lat-CMV and Lat-RM. Other measured parameters did not differ between groups.

Conclusions and clinical relevance

Ventilation with CMV, constant PEEP and interposed RM provided improved arterial oxygenation in horses in dorsal recumbency that lasted into the early recovery period, but had no benefit in horses in lateral recumbency. This mode of ventilation may provide a clinically practicable method of improving oxygenation in anaesthetized horses, especially in dorsal recumbency.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号