Intravenous sufentanil‐midazolam versus sevoflurane anaesthesia in medetomidine pre‐medicated Himalayan rabbits undergoing ovariohysterectomy          下载免费PDF全文

Patricia Hedenqvist  Marianne Jensen‐Waern  Åsa Fahlman  Ragnvi Hagman  Anna Edner 《Veterinary anaesthesia and analgesia》2015,42(4):377-385

ObjectiveTo compare physiological effects of sufentanil-midazolam with sevoflurane for surgical anaesthesia in medetomidine premedicated rabbits.Study designProspective, randomized controlled experimental study.AnimalsEighteen female Himalayan rabbits, weight 2.1 ± 0.1 kg.MethodsPremedication with 0.1 mg kg⁻¹ medetomidine and 5 mg kg⁻¹ carprofen subcutaneously, was followed by intravenous anaesthetic induction with sufentanil (2.3 μg mL⁻¹) and midazolam (0.45 mg mL⁻¹). After endotracheal intubation, anaesthesia was maintained with sufentanil-midazolam (n = 9) or sevoflurane (n = 9). Ovariohysterectomy was performed. Intermittent positive pressure ventilation was performed as required. Physiological variables were studied perioperatively. Group means of physiologic data were generated for different anaesthetic periods. Data were compared for changes from sedation, and between groups by anova. Post-operatively, 0.05 mg kg⁻¹ buprenorphine was administered once and 5 mg kg⁻¹ carprofen once daily for 2–3 days. Rabbits were examined and weighed daily until one week after surgery.ResultsSmooth induction of anaesthesia was achieved within 5 minutes. Sufentanil and midazolam doses were 0.5 μg kg⁻¹ and 0.1 mg kg⁻¹, during induction and 3.9 μg kg⁻¹ hour⁻¹ and 0.8 mg kg⁻¹ hour⁻¹ during surgery, respectively. End-tidal sevoflurane concentration was 2.1% during surgery. Assisted ventilation was required in nine rabbits receiving sufentanil-midazolam and four receiving sevoflurane. There were no differences between groups in physiologic data other than arterial carbon dioxide. In rabbits receiving sevoflurane, mean arterial pressure decreased pre-surgical intervention, heart rate increased 25% during and after surgery and body weight decreased 4% post-operatively. Post-operative problems sometimes resulted from catheterization of the ear artery.ConclusionSevoflurane and sufentanil-midazolam provided surgical anaesthesia of similar quality. Arterial blood pressure was sustained during sufentanil-midazolam anaesthesia and rabbits receiving sevoflurane lost body weight following ovariohysterectomy. Mechanical ventilation was required with both anaesthetic regimens.Clinical relevanceAnaesthesia with sufentanil-midazolam in medetomidine premedicated healthy rabbits is useful in the clinical and the research setting, as an alternative to sevoflurane.  相似文献   

右美托咪定复合舒芬太尼用于老年患者术后自控静脉镇痛的效果观察     

马华山  刘金山  李田华  邱银兰  李帅  赵爱香  陈立勇 《吉林林学院学报》2014,(1):58-62

目的观察盐酸右美托咪定复合舒芬太尼用于老年患者术后自控静脉镇痛（PCIA）的有效性和安全性．方法所有患者手术均采用咪达唑仑、顺式阿曲库铵、丙泊酚、芬太尼行麻醉诱导,顺式阿曲库铵、芬太尼与丙泊酚维持麻醉,术后患者随机分为A,B,C3组,使用PCA泵镇痛;分别记录苏醒后（T0）,术后4h（T1）,8h（T2）,12h（T3）,24h（T4）VAS评分;Ramsay镇静评分;术后不同时点PCA按压次数;24h舒芬太尼累计用量;镇痛期间低血压等不良反应的发生情况．结果术后24h内VAS评分A,B组高于C组（P〈0．05）;Ramsay镇静评分：A,B组低于C组（P〈0．05）;24h镇痛泵的总按压次数A组高于B组（P〈0．05）,B组高于c组（P〈0．05）;与术前相比,A组术后血压、心率变化不明显,而B,C两组术后血压、心率下降（P〈0．05）;3组患者术后均无呼吸抑制和镇静过度等不良反应（P〉0．05）,恶心的不良反应发生率B,C组明显少于A组（P〈0．05）．结论盐酸右美托咪定复合舒芬太尼用于老年患者术后自控静脉镇痛安全、有效．  相似文献   

Investigation of the interaction between buprenorphine and sufentanil during anaesthesia for ovariectomy in dogs     

Goyenechea Jaramillo LA  Murrell JC  Hellebrekers LJ 《Veterinary anaesthesia and analgesia》2006,33(6):399-407

OBJECTIVE: To investigate the effect of buprenorphine pre-treatment on sufentanil requirements in female dogs undergoing ovariectomy. STUDY DESIGN: Randomized, 'blinded', prospective clinical study. ANIMALS: Thirty healthy female dogs referred for ovariectomy. MATERIALS AND METHODS: Dogs were randomly assigned to one of two pre-anaesthetic treatment groups. Those in the buprenorphine group (B) received buprenorphine 20 microg kg(-1) and acepromazine 0.03 mg kg(-1) IM. Control group (C) animals received an equal volume of NaCl 0.9% and acepromazine 0.03 mg kg(-1) IM. The anaesthetic technique was identical in both groups. Pre-anaesthetic medication consisted of intravenous (IV) sufentanil (1.0 microg kg(-1)) and midazolam (0.05 mg kg(-1)) and intramuscular atropine (0.03 mg kg(-1)). Anaesthesia was induced with propofol and maintained with a constant rate infusion of sufentanil (1.0 microg kg(-1) hour(-1)) and with oxygen-isoflurane. Ventilation was controlled mechanically. Ovariectomy was performed using a standard technique. Baseline heart rate (HR) and direct mean arterial blood pressure (MAP) were recorded before the first incision. Increases in HR and MAP of > or =20% over baseline and, or spontaneous ventilation were controlled using IV sufentanil (1.0 microg kg(-1)) repeated after 5 minutes if haemodynamic variables remained elevated or attempts at spontaneous ventilation persisted. Analysis of variance was used to determine group differences in mean and median HR and MAP and to compare the maximum HR and MAP attained during surgery. Poisson regression was used to compare the number of sufentanil injections required in both groups. RESULTS: Group B required 2.46 times more sufentanil injections (p = 0.00487) than dogs in group C to maintain haemodynamic stability and prevent spontaneous ventilation during surgery. Group B dogs also had a significantly higher (p = 0.034) marginal mean of the log maximum MAP (4.756 +/- 0.036) compared with group C (4.642 +/- 0.036). CONCLUSIONS: Pre-treatment with buprenorphine appears to negatively influence the antinociceptive efficacy of intra-operative sufentanil. CLINICAL RELEVANCE: Withholding buprenorphine therapy 6-8 hours before anaesthesia incorporating pure mu receptor agonists is probably advisable. Alternative methods of analgesia should be provided in this period.  相似文献   

A comparison between pre-operative carprofen and a long-acting sufentanil formulation for analgesia after ovariohysterectomy in dogs     

Slingsby LS  Murison PJ  Goossens L  Engelen M  Waterman-Pearson AE 《Veterinary anaesthesia and analgesia》2006,33(5):313-327

OBJECTIVE: To assess the analgesic efficacy and adverse effects of a novel, long-acting sufentanil preparation in dogs undergoing ovariohysterectomy (OHE). STUDY DESIGN: Blinded, positively controlled, randomized field trial with four parallel treatment groups. ANIMALS: Eighty client owned dogs undergoing elective OHE randomly allocated into four treatment groups (each n = 20). MATERIALS AND METHODS: Three groups received intramuscular (IM) sufentanil (at 10, 15 and 25 microg kg(-1), respectively) and the control group received subcutaneous (SC) carprofen 4 mg kg(-1) SC plus acepromazine 0.05 mg kg(-1) IM as pre-anaesthetic medication. OHE was performed under thiopental/halothane anaesthesia. Visual Analogue Scale (VAS) scores for pain and sedation were awarded and mechanical nociceptive thresholds were measured at the wound and hock before surgery and up to 24 hours after tracheal extubation. Serum cortisol was measured before surgery, during surgery and up to 24 hours after tracheal extubation. Animals with inadequate post-operative analgesia were given rescue medication. RESULTS: In the carprofen group, VAS pain scores were significantly higher, wound tenderness was greater and requirement for rescue analgesia was more than in the sufentanil-treated groups. Sufentanil produced dose dependent analgesia and sedation. All treatment groups showed similar patterns of change for cortisol concentrations. Use of the sufentanil preparation was associated with a relatively high incidence of adverse events. CONCLUSIONS: The long-acting preparation of sufentanil provided excellent post-operative analgesia that was significantly better than that provided by carprofen. However, use of this formulation, in the anaesthetic technique used in the study, resulted in a relatively high incidence of adverse effects. CLINICAL RELEVANCE: Full mu (MOP) opioid agonists provide significantly better post-operative analgesia than nonsteroidal anti-inflammatory drugs after moderately painful surgery. However, the widely recognized adverse effects of opioids may preclude the use of these agents.  相似文献   

Phenylpiperidine opioid effects on isoflurane minimum alveolar concentration in cats     

Robert J. Brosnan  Bruno H. Pypendop  Scott D. Stanley 《Journal of veterinary pharmacology and therapeutics》2020,43(6):533-537

Different structurally related phenylpiperidine opioids exhibit different isoflurane-sparing effects in cats. Because minimum alveolar concentration (MAC) in cats is affected only by very high plasma concentrations of some phenylpiperidine opioids, we hypothesized these effects are caused by actions on nonopioid receptors. Using a prospective, randomized, crossover design, six cats were anesthetized with isoflurane, intubated, ventilated, and instrumented. Isoflurane MAC was measured in triplicate using a tail-clamp and bracketing technique. A computer-controlled intravenous infusion using prior pharmacokinetic models targeted plasma concentrations of 60 ng/ml fentanyl, 10 ng/ml sufentanil, or 500 ng/ml alfentanil, and isoflurane MAC was measured in duplicate. Next, naltrexone 0.6 mg/kg was administered to cats hourly during the opioid infusion, and isoflurane MAC was measured in duplicate. Blood was collected during MAC determinations to measure opioid concentrations. Responses were analyzed using repeated measures ANOVA with significance at p < .05. Alfentanil and sufentanil decreased isoflurane MAC by 16.4% and 6.4%, respectively, and these effects were completely reversed by naltrexone. Fentanyl had no significant effect on isoflurane MAC. Alfentanil and sufentanil modestly reduce isoflurane MAC via agonist effects on opioid receptors. However, these effects are too small to justify clinical use of phenylpiperidine opioids as single agents to reduce MAC in cats.  相似文献   

Cardiopulmonary effects of sufentanil long acting on sevoflurane anaesthesia in dogs     

Polis I  Moens Y  Hoeben D  Tshamala M  Hoybergs Y  Gasthuys F 《Veterinary anaesthesia and analgesia》2006,33(2):111-121

OBJECTIVE: To evaluate the cardiopulmonary effects of sufentanil long acting (SLA) in sevoflurane-anaesthetized dogs. STUDY DESIGN: Randomized prospective study. Animals Forty female dogs (beagles) aged 1-2 years, weighing 11.97 +/- 1.40 kg. MATERIALS AND METHODS: The dogs were divided into five groups of eight. Two control groups were used: group A received intramuscular (IM), SLA (50 microg kg(-1)) alone, while group B received the SLA vehicle followed by sevoflurane anaesthesia for 90 minutes. In the other groups, SLA (50 microg kg(-1) IM) was given immediately before (group C(0)), 15 minutes before (group D(15)) or 30 minutes (group E(30)) before induction [with intravenous (IV) thiopental] of sevoflurane anaesthesia lasting for 90 minutes. Heart rate, arterial blood pressure, respiratory rate (f(r)), arterial oxygen haemoglobin saturation and end-tidal sevoflurane concentration (Fe'SEVO) were measured every 10 minutes during anaesthesia and at 2, 4 and 24 hours after induction (not Fe'SEVO). Acid-base and blood gas analyses were performed. RESULTS: Sufentanil LA reduced heart rate and increased arterial CO(2) tensions during anaesthesia. Respiratory depression was least in group E(30) compared with groups C(0) and D(15). Bradycardia was present for at least 24 hours. Respiratory rate was least in group B although arterial O(2) and CO(2) tension values were acceptable up to 24 hours after anaesthesia. CONCLUSIONS: Pre-anaesthetic medication with SLA moderately aggravated the cardiopulmonary effects of sevoflurane. CLINICAL RELEVANCE: In spite of a moderate depressant effect on cardiorespiratory parameters, SLA may be of use as pre-anaesthetic medication before sevoflurane anaesthesia in dogs. Intermittent positive pressure ventilation may occasionally be necessary.  相似文献   

舒芬太尼预防腰硬联合麻醉寒战反应的效果观察     

伍国芳  罗玉金 《河北北方学院学报(自然科学版)》2011,27(3):63-65

目的 观察舒芬太尼对预防腰硬联合麻醉寒战反应的临床效果.方法 90例行子宫次全切患者随机分3组,Ⅰ组为对照组(n=30):生理盐水5 mL在蛛网膜下腔注药后即予以静脉注射；Ⅱ组(n=30)舒芬太尼0.2μg/kg用生理盐水稀释至5 mL在蛛网膜下腔注药后即予以静脉注射；Ⅲ组(n=30)舒芬太尼0.2μg/kg用生理盐水...  相似文献