Long-term anaesthesia with propofol and alfentanil in the dog and its partial reversal with nalbuphine

P. Flecknell, A. Kirk, C. E. Fox, J. Dark
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引用次数: 25

Abstract

Summary Prolonged surgical anaesthesia in the dog was induced with propofol (6.5 ± 1.3 mg/kg) followed by alfentanil (25.5 ± 5 μg/kg) (mean ± 1 sd) and maintained with a continuous infusion of propofol (0.14 to 0.18 mg/kg/min) and alfentanil (2 to 3 μg/kg/min). Neuromuscular blockade was produced with vecuronium (0.1 mg/kg). After induction of anaesthesia with propofol, administration of alfentanil to dogs which had received no pre-anaesthetic medication produced cardiac arrest and apnoea. Administration of atropine intravenously immediately prior to alfentanil prevented these cardiac depressant effects. The cardiac depressant effect of alfentanil was not as severe in a second group of dogs in which anaesthesia was induced with thiopentone. After commencing the continuous infusion anaesthetic regime and establishment of IPPV, blood pressure and heart rate remained stable during the remaining 4 to 6 h period of anaesthesia. Recovery from anaesthesia was smooth and uneventful. The depressant effects of alfentanil on respiration and on consciousness were reversed rapidly by administration of nalbuphine (10 mg total dose). The smooth recovery and the integration of anaesthesia and post operative analgesia attained by the reversal of alfentanil with nalbuphine make this an attractive anaesthetic regime for major surgery in dogs, provided that facilities for IPPV are available.
异丙酚和阿芬太尼长期麻醉在狗和部分逆转纳布啡
手术麻醉犬先用丙泊酚(6.5±1.3 mg/kg),后用阿芬太尼(25.5±5 μg/kg)(平均±1 sd),持续输注丙泊酚(0.14 ~ 0.18 mg/kg/min)和阿芬太尼(2 ~ 3 μg/kg/min)维持麻醉。维库溴铵(0.1 mg/kg)用于神经肌肉阻断。在异丙酚诱导麻醉后,对未接受麻醉前药物的狗给予阿芬太尼,导致心脏骤停和呼吸暂停。在阿芬太尼之前立即静脉注射阿托品可以防止这些心脏抑制剂的作用。在用硫喷妥酮麻醉的第二组狗中,阿芬太尼的心脏抑制作用没有那么严重。在开始持续输注麻醉方案和建立IPPV后,在麻醉剩余的4 ~ 6小时内血压和心率保持稳定。从麻醉中恢复是平稳的。阿芬太尼对呼吸和意识的抑制作用被纳布啡(总剂量10mg)迅速逆转。通过阿芬太尼与纳布啡的逆转,麻醉和术后镇痛的顺利恢复和整合使其成为一种有吸引力的大手术犬麻醉方案,只要有IPPV设施可用。
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