A retrospective study of the isoflurane-sparing and cardiovascular effects of combined remifentanil-ketamine infusions with and without lidocaine in cats.
M Kim, D Shin, T Sung, S Rhee, C Nam, I Lee, W G Son
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引用次数: 0
Abstract
Objective: This retrospective study aimed to evaluate the intraoperative isoflurane-sparing and cardiovascular effects of a combined infusion of remifentanil-lidocaine-ketamine versus remifentanil-ketamine for balanced anaesthesia in cats to investigate the effect of lidocaine infusion in various clinical situations.
Materials and methods: Among patients with various health statuses undergoing surgical procedures, 18 cats administered remifentanil-lidocaine-ketamine were compared with 20 cats administered remifentanil-ketamine. In the remifentanil-lidocaine-ketamine group, lidocaine was initially infused at 50 μg/kg/minute with a loading dose of 0.6 mg/kg, and the infusion rate was controlled depending on cardiovascular alterations. Linear regression was used to relate end-tidal isoflurane and cardiovascular effects, including blood pressure [expressed as the ratio of mild hypotension duration (mean arterial pressure <60 mmHg) to total anaesthesia time] and heart rate (interquartile range) with patient, surgical and anaesthetic variables including lidocaine infusion.
Results: In the remifentanil-lidocaine-ketamine group, the average lidocaine infusion rate during the entire anaesthetic period was 46.00 ± 12.00 (range: 22.67 to 64.63) μg/kg/minute. The multivariable regression model of end-tidal isoflurane showed a correlation with the duration of the procedure and lidocaine infusion. The end-tidal isoflurane concentration exhibited a significant reduction in the remifentanil-lidocaine-ketamine group (1.16% ± 0.19%), compared with that of the remifentanil-ketamine group (1.27% ± 0.14%). The association between lidocaine administration and hypotension was not significant, nor was that with heart rate.
Clinical significance: Although the use of intravenous lidocaine in cats has been associated with concerns regarding cardiovascular toxicity, the findings of this study suggest that lidocaine infusion, as part of the remifentanil-lidocaine-ketamine combination, can be considered a component of balanced anaesthesia in cats.
期刊介绍：
Journal of Small Animal Practice (JSAP) is a monthly peer-reviewed publication integrating clinical research papers and case reports from international sources, covering all aspects of medicine and surgery relating to dogs, cats and other small animals. These papers facilitate the dissemination and implementation of new ideas and techniques relating to clinical veterinary practice, with the ultimate aim of promoting best practice. JSAP publishes high quality original articles, as well as other scientific and educational information. New developments are placed in perspective, encompassing new concepts and peer commentary. The target audience is veterinarians primarily engaged in the practise of small animal medicine and surgery.
In addition to original articles, JSAP will publish invited editorials (relating to a manuscript in the same issue or a topic of current interest), review articles, which provide in-depth discussion of important clinical issues, and other scientific and educational information from around the world.
The final decision on publication of a manuscript rests with the Editorial Board and ultimately with the Editor. All papers, regardless of type, represent the opinion of the authors and not necessarily that of the Editor, the Association or the Publisher.
The Journal of Small Animal Practice is published on behalf of the British Small Animal Veterinary Association and is also the official scientific journal of the World Small Animal Veterinary Association
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