异丙酚与硫喷妥钠治疗犬癫痫持续状态和难治性癫痫持续状态的比较。

IF 1.1 4区 农林科学 Q3 VETERINARY SCIENCES New Zealand veterinary journal Pub Date : 2023-05-01 DOI:10.1080/00480169.2023.2172089
I Espiñeira, D Alzate, J Araos, F Pellegrino, M Tunesi, M Jensen, P A Donati
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引用次数: 1

摘要

目的:比较异丙酚与硫喷妥钠对癫痫持续状态(SE)和难治性癫痫持续状态(RSE)治疗犬的死亡率和住院时间的影响。方法:在这项队列研究中,回顾性检索了阿根廷一家兽医转诊诊所的医疗记录,其中包括因任何原因的SE或RSE而需要用异丙酚或硫喷妥钠诱导治疗性昏迷(TC)的住院犬。采用逻辑回归模型来评估使用的麻醉药类型与调整癫痫类型(特发性、结构性或反应性)的住院死亡率之间的关系。使用对数秩检验比较麻醉药物类型对住院时间的Kaplan-Meier估计生存曲线(死亡被认为是审查事件)。采用Cox比例风险回归来估计住院时间、未调整和调整癫痫类型的风险比。结果:共纳入24只SE犬,其中异丙酚组8只,硫喷妥钠组16只。异丙酚治疗犬4只(比例= 0.50;95% CI = 0.15-0.84),用硫喷妥钠治疗8例(比例= 0.50;95% CI = 0.50-0.74)在住院期间死亡。异丙酚组的平均住院时间为43 (IQR 24-56)小时,硫喷妥钠组的平均住院时间为72 (IQR 64-96)小时。异丙酚组(12 (IQR 8-24)小时)和硫喷妥钠组(12 (IQR 7.5-20)小时)的TC中位持续时间无差异;p = 0.946)。在logistic回归模型中,经癫痫类型调整后,未发现麻醉方案治疗RSE与住院死亡率之间存在关联的证据(OR 1.09 (95% CI = 0.17-6.87);p = 0.925)。Cox回归分析显示,治疗组间癫痫类型调整后的出院时间差异有统计学意义(HR = 0.05 (95% CI = 0.01-0.54);p = 0.013)。结论及临床意义:与异丙酚组相比,硫喷妥钠组RSE患者出院前住院时间更长。然而,由于样本量很小,本研究的结果需要谨慎分析。需要进一步的研究,包括更多的狗。
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Propofol versus sodium thiopentone for the treatment of status epilepticus and refractory status epilepticus in dogs.

Aims: To compare the effect on mortality and length of hospital stay of propofol with that of sodium thiopentone for the management of dogs with status epilepticus (SE) and refractory status epilepticus (RSE).

Methods: In this cohort study, medical records of a veterinary referral clinic in Argentina were retrospectively searched for dogs that were hospitalised and required induction of therapeutic coma (TC) with either propofol or sodium thiopentone for the management of SE or RSE of any cause. A logistic regression model was performed to evaluate the association between the type of anaesthetic used and in-hospital mortality adjusting for the type of epilepsy (idiopathic, structural, or reactive). Kaplan-Meier estimated survival curves for the length of hospital stay by the type of anaesthetic drug were compared using the log-rank test (deaths were considered censored events). Cox proportional hazards regression was used to estimate hazard ratios for time to hospital discharge, unadjusted and adjusted for type of epilepsy.

Results: A total of 24 dogs with SE were included in the study: eight treated with propofol and 16 treated with sodium thiopentone. Four dogs treated with propofol (proportion = 0.50; 95% CI = 0.15-0.84), and eight treated with sodium thiopentone (proportion = 0.50; 95% CI = 0.50-0.74) died during hospitalisation. The median hospitalisation time was 43 (IQR 24-56) hours for dogs that were treated with propofol and 72 (IQR 64-96) hours for dogs that were treated with sodium thiopentone. There was no evidence of a difference in the median duration of TC in dogs treated with propofol (12 (IQR 8-24) hours) or with sodium thiopentone (12 (IQR 7.5-20) hours; p = 0.946). In the logistic regression model, no evidence of association between the anaesthetic protocol for the management of RSE and in-hospital mortality, adjusted for the type of epilepsy, was found (OR 1.09 (95% CI = 0.17-6.87); p = 0.925). Cox regression analysis revealed a difference in the time to hospital discharge, adjusted by the type of epilepsy, between treatment groups (HR = 0.05 (95% CI = 0.01-0.54); p = 0.013).

Conclusions and clinical relevance: The time spent in hospital before discharge was longer in dogs with RSE treated with sodium thiopentone compared to those treated with propofol. However, as the sample size was very small, the results obtained in the present study should be analysed with caution. Further studies including a greater number of dogs are required.

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来源期刊
New Zealand veterinary journal
New Zealand veterinary journal 农林科学-兽医学
CiteScore
3.00
自引率
0.00%
发文量
37
审稿时长
12-24 weeks
期刊介绍: The New Zealand Veterinary Journal (NZVJ) is an international journal publishing high quality peer-reviewed articles covering all aspects of veterinary science, including clinical practice, animal welfare and animal health. The NZVJ publishes original research findings, clinical communications (including novel case reports and case series), rapid communications, correspondence and review articles, originating from New Zealand and internationally. Topics should be relevant to, but not limited to, New Zealand veterinary and animal science communities, and include the disciplines of infectious disease, medicine, surgery and the health, management and welfare of production and companion animals, horses and New Zealand wildlife. All submissions are expected to meet the highest ethical and welfare standards, as detailed in the Journal’s instructions for authors.
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