七氟醚麻醉在临床马病例中的维持与恢复

N.S. Matthews, S.M. Hartsfield, G.L. Carroll, E.A. Martinez
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引用次数: 12

摘要

一种新的吸入性麻醉剂七氟醚用于维持40只动物(2头骡子和38匹马,9个品种)的麻醉,这些动物接受了各种手术。18匹母马、11匹种马和11只阉割马接受了6次整形手术和34次软组织手术。使用甲苯噻嗪(0.5–1.1 mg/kg)、地西泮(0.03–0.1 mg/kg)、布托啡醇(0.02 mg/kg)、愈创木酚(50–84 mg/kg)和氯胺酮(1.1 mg/kg)进行麻醉诱导。气管插管后,使用精密蒸发器输送的七氟醚维持手术麻醉平面。监测体温、心电图、动脉血压和呼出气体成分。由于通气不足(PaCO2>;7.31 kPa[55 mmHg]),在大多数动物(n=37)中使用机械通气。手术后,马匹被转移到康复室,并允许单独康复(n=36)或在辅助下康复(n=4)。记录胸骨卧位时间、站立时间、出现满意协调的时间(站立后)以及尝试站立的次数。恢复质量按1(最好)至6(最差)的评分标准进行评分。麻醉30、60、90、120和150分钟时的平均血压分别为72、73、74、75和72毫米汞柱。麻醉30、60、90、120和150分钟时的收缩压和舒张压分别为97、97、94、96、93和59、63、64、68、67毫米汞柱。在23匹马中使用多巴酚丁胺以维持平均动脉血压>;60毫米汞柱。麻醉30、60、90、120和150分钟时的平均心率和呼吸频率分别为36、38、39、38和38次/分,以及9、8、8和8次呼吸/分。平均麻醉持续时间为121 rnin(sd:56 min),胸骨卧位的平均时间为27 min(sd:13 min),站立的平均时间(所有马)为33 min(sd:12 min),达到令人满意的协调状态的时间为44 min(sd:13 min)。大多数马(n=37)在恢复期间接受了甲苯噻嗪(平均剂量0.18mg/kg iv)。胸骨卧位和站立的尝试次数中位数分别为1.0(范围;1-7)和2.0(范围;1-20),而恢复得分中位数为1.5(范围;14)。麻醉的“深度”很容易控制,恢复情况通常非常令人满意。
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Sevoflurane anaesthesia in clinical equine cases: maintenance and recovery

A new inhalant anaesthetic, sevoflurane, was used to maintain anaesthesia in 40 animals (2 mules and 38 horses of 9 breeds) presented for various surgical procedures. Eighteen mares, 11 stallions and 11 geldings underwent 6 orthopaedic and 34 soft tissue operations. Induction of anaesthesia was achieved with combinations of xylazine (0.5–1.1 mg/kg), diazepam (0.03–0.1 mg/kg), butorphanol (0.02 mg/kg), guaifenesin (50–84 mg/kg) and ketamine (1.1 mg/kg). Following tracheal intubation, a surgical plane of anaesthesia was maintained with sevoflurane in oxygen delivered from a precision vaporiser. Temperature, ECG, arterial blood pressure and expired gas composition were monitored. Mechanical ventilation was used in most animals (n=37) because of hypoventilation (PaCO2 > 7.31 kPa [55 mmHg]). Following surgery, horses were moved to a recovery room and allowed to recover alone (n=36) or with assistance (n=4). Time to sternal recumbency, standing, the time when satisfactory coordination was present (after standing) and the number of attempts to stand were recorded. The quality of recovery was scored on a 1 (best) to 6 (worst) scale. Mean blood pressures at 30, 60, 90, 120 and 150 min of anaesthesia were 72, 73, 74, 75 and 72 mmHg, respectively. Systolic and diastolic pressures at 30, 60, 90, 120 and 150 min of anaesthesia were 97, 97, 94, 96, 93 and 59, 63, 64, 68, 67 mmHg, respectively. Dobutamine was used in 23 horses to maintain mean arterial blood pressure > 60 mmHg. Mean heart and respiratory rates at 30, 60, 90, 120 and 150 min of anaesthesia were 36, 38, 39, 38 and 38 beats/min, and 9, 8, 8, 8 and 8 breaths/min. Mean duration of anaesthesia was 121 rnin (sd: 56 min), mean time to sternal recumbency was 27 min (sd: 13 min), average time to standing (all horses) was 33 min (sd: 12 min) and time to satisfactory coordination was 44 min (sd: 13 min). Most horses (n=37) received xylazine during recovery (mean dose 0.18 mg/kg iv). The median number of attempts to sternal recumbency and standing were 1.0 (range; 1–7) and 2.0 (range; 1–20), respectively, while the median recovery score was 1.5 (range; 14). The ‘depth’ of anaesthesia was easy to control and recoveries were generally very satisfactory.

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