Alfaxalone for total intravenous anaesthesia in dogs undergoing ovariohysterectomy: a comparison of premedication with acepromazine or dexmedetomidine
Alfaxalone for total intravenous anaesthesia in dogs undergoing ovariohysterectomy: a comparison of premedication with acepromazine or dexmedetomidine
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DOI：
10.1111/j.1467-2995.2012.00752.x
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发表时间：
2013-03-01
影响因子：
1.7
通讯作者：
Murrell, Joanna C.
中科院分区：
文献类型：
--
作者：
Herbert, Georgina L.;Bowlt, Kelly L.;Murrell, Joanna C.
目的描述阿法沙酮全静脉麻醉（TIVA）后，预先用药丁丙诺啡和乙酰丙嗪（ACP）或右美托咪定（DEX）在母犬接受卵巢子宫切除术。方法健康雌性犬38只，肌肉注射丁丙诺啡后，（20 μ g kg（-1））和乙酰丙嗪（0.05 mg kg（-1））或右美托咪定（约10 μ g kg（-1），根据体表面积调整），用静脉内阿法沙酮诱导并维持麻醉。通过合适的麻醉回路给予氧气。根据临床评估，调整阿法沙龙输注速率（最初为0.07 mg kg（-1）min（-1）），以维持足够的麻醉深度。如果需要，给予阿法沙龙推注。必要时辅助通气。每5分钟记录一次阿法沙酮剂量和生理参数。对术前用药后镇静深度、诱导质量、苏醒时间和质量进行评分。学生t检验、Mann-Whitney U和卡方检验确定组间差异的显著性。数据以平均值+/- SD或中位数（范围）表示。显著性定义为p < 0.05。结果两组在人口统计学、诱导质量、阿法沙酮的诱导（1.5 +/- 0.57 mg/kg（-1））和总推注剂量[1.2（0 - 6.3）mg/kg（-1）]、麻醉持续时间（131 +/- 18分钟）或拔管时间[16.6（3-50）分钟]方面没有差异。DEX犬比ACP犬更镇静。DEX组的阿法沙龙输注速率[0.08（0.06-0.19）mg kg（-1）min（-1）]显著低于ACP组[0.11（0.07-0.33）mg kg（-1）min（-1）]。与基线值相比，两组的心血管变量在卵巢和宫颈结扎和伤口闭合期间显著增加。呼吸暂停和通气不足很常见，两组之间无显著差异。所有动物的动脉血红蛋白氧饱和度均保持在95%以上。恢复质量评分显着较差的DEX比ACP dogs.Conclusions和临床相关性阿法沙酮TIVA是一种有效的麻醉手术程序，但在本研究的协议，导致呼吸抑制手术所需的输注速率。
Objective To describe alfaxalone total intravenous anaesthesia (TIVA) following premedication with buprenorphine and either acepromazine (ACP) or dexmedetomidine (DEX) in bitches undergoing ovariohysterectomy.Study design Prospective, randomised, clinical study.Animals Thirty-eight healthy female dogs.Methods Following intramuscular buprenorphine (20 mu g kg(-1)) and acepromazine (0.05 mg kg(-1)) or dexmedetomidine (approximately 10 mu g kg(-1), adjusted for body surface area), anaesthesia was induced and maintained with intravenous alfaxalone. Oxygen was administered via a suitable anaesthetic circuit. Alfaxalone infusion rate (initially 0.07 mg kg(-1) minute(-1)) was adjusted to maintain adequate anaesthetic depth based on clinical assessment. Alfaxalone boluses were given if required. Ventilation was assisted if necessary. Alfaxalone dose and physiologic parameters were recorded every 5 minutes. Depth of sedation after premedication, induction quality and recovery duration and quality were scored. A Student's t-test, Mann-Whitney U and Chi-squared tests determined the significance of differences between groups. Data are presented as mean +/- SD or median (range). Significance was defined as p < 0.05. Results There were no differences between groups in demographics; induction quality; induction (1.5 +/- 0.57 mg kg(-1)) and total bolus doses [1.2 (0 -6.3) mg kg(-1)] of alfaxalone; anaesthesia duration (131 +/- 18 minutes); or time to extubation [16.6 (3-50) minutes]. DEX dogs were more sedated than ACP dogs. Alfaxalone infusion rate was significantly lower in DEX [0.08 (0.06-0.19) mg kg(-1) minute(-1)] than ACP dogs [0.11 (0.07-0.33) mg kg(-1) minute(-1)]. Cardiovascular variables increased significantly during ovarian and cervical ligation and wound closure compared to baseline values in both groups. Apnoea and hypoventilation were common and not significantly different between groups. Arterial haemoglobin oxygen saturation remained above 95% in all animals. Recovery quality scores were significantly poorer for DEX than for ACP dogs.Conclusions and clinical relevance Alfaxalone TIVA is an effective anaesthetic for surgical procedures but, in the protocol of this study, causes respiratory depression at infusion rates required for surgery.