Haiumy G. Cardozo, Eduardo R. Monteiro, Bárbara S. Correia, João Victor B Ferronatto, Fábio TD. Almeida-Filho, Marcelo M. Alievi, Stella F. Valle
{"title":"静脉注射芬太尼或右美托咪定以及利多卡因和氯胺酮对单侧乳房切除术麻醉犬的心血管反应、七氟烷需求量和术后疼痛的影响","authors":"Haiumy G. Cardozo, Eduardo R. Monteiro, Bárbara S. Correia, João Victor B Ferronatto, Fábio TD. Almeida-Filho, Marcelo M. Alievi, Stella F. Valle","doi":"10.1016/j.vaa.2024.04.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To compare the effects of constant rate infusions (CRI) of fentanyl or dexmedetomidine, combined with lidocaine and ketamine, on cardiovascular response during surgery, sevoflurane requirement and postoperative pain in dogs undergoing mastectomy.</p></div><div><h3>Study design</h3><p>Prospective, randomized, blinded, clinical trial.</p></div><div><h3>Animals</h3><p>A total of 29 female dogs with mammary tumors.</p></div><div><h3>Methods</h3><p>Premedication consisted of intramuscular acepromazine and morphine. General anesthesia was induced with intravenous propofol and maintained with sevoflurane. Dogs were randomized to be administered intravenous DLK [dexmedetomidine 1 μg kg<sup>–1</sup> loading dose (LD) and 1 μg kg<sup>–1</sup> hour<sup>–1</sup>; lidocaine 2 mg kg<sup>–1</sup> LD and 3 mg kg<sup>–1</sup> hour<sup>–1</sup>; ketamine 1 mg kg<sup>–1</sup> LD and 0.6 mg kg<sup>–1</sup> hour<sup>–1</sup>; <em>n</em> = 14] or FLK (fentanyl 5 μg kg<sup>–1</sup> LD and 9 μg kg<sup>–1</sup> hour<sup>–1</sup>; same doses of lidocaine and ketamine; <em>n</em> = 15) during anesthesia. Cardiorespiratory variables and end-tidal sevoflurane (F<span>e′</span>Sevo) were recorded during surgery. The number of dogs administered ephedrine to treat arterial hypotension [mean arterial pressure (MAP) < 60 mmHg] was recorded. Meloxicam was administered to both groups. Postoperative pain and rescue analgesia requirement were assessed for 24 hours using the short form of the Glasgow Composite Measure Pain Scale. Data were compared using a mixed effects model or a Mann–Whitney test.</p></div><div><h3>Results</h3><p>More dogs required ephedrine in FLK than in DLK (67% <em>versus</em> 7%). Heart rate was not significantly different between groups, whereas lower values of MAP (<em>p</em> ≤ 0.01) and F<span>e′</span>Sevo (<em>p</em> = 0.018) were observed in FLK than in DLK. Rescue analgesia was administered to 2/15 dogs in FLK and 0/14 dogs in DLK.</p></div><div><h3>Conclusions and clinical relevance</h3><p>Based on the cardiovascular response during surgery, intraoperative infusions of FLK and DLK provided adequate antinociception. Infusion of DLK provided greater stability of blood pressure. Both protocols resulted in minimal need for additional analgesia within 24 hours postoperatively.</p></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Influence of intravenous fentanyl or dexmedetomidine infusions, combined with lidocaine and ketamine, on cardiovascular response, sevoflurane requirement and postoperative pain in dogs anesthetized for unilateral mastectomy\",\"authors\":\"Haiumy G. Cardozo, Eduardo R. Monteiro, Bárbara S. Correia, João Victor B Ferronatto, Fábio TD. Almeida-Filho, Marcelo M. Alievi, Stella F. Valle\",\"doi\":\"10.1016/j.vaa.2024.04.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To compare the effects of constant rate infusions (CRI) of fentanyl or dexmedetomidine, combined with lidocaine and ketamine, on cardiovascular response during surgery, sevoflurane requirement and postoperative pain in dogs undergoing mastectomy.</p></div><div><h3>Study design</h3><p>Prospective, randomized, blinded, clinical trial.</p></div><div><h3>Animals</h3><p>A total of 29 female dogs with mammary tumors.</p></div><div><h3>Methods</h3><p>Premedication consisted of intramuscular acepromazine and morphine. General anesthesia was induced with intravenous propofol and maintained with sevoflurane. Dogs were randomized to be administered intravenous DLK [dexmedetomidine 1 μg kg<sup>–1</sup> loading dose (LD) and 1 μg kg<sup>–1</sup> hour<sup>–1</sup>; lidocaine 2 mg kg<sup>–1</sup> LD and 3 mg kg<sup>–1</sup> hour<sup>–1</sup>; ketamine 1 mg kg<sup>–1</sup> LD and 0.6 mg kg<sup>–1</sup> hour<sup>–1</sup>; <em>n</em> = 14] or FLK (fentanyl 5 μg kg<sup>–1</sup> LD and 9 μg kg<sup>–1</sup> hour<sup>–1</sup>; same doses of lidocaine and ketamine; <em>n</em> = 15) during anesthesia. Cardiorespiratory variables and end-tidal sevoflurane (F<span>e′</span>Sevo) were recorded during surgery. The number of dogs administered ephedrine to treat arterial hypotension [mean arterial pressure (MAP) < 60 mmHg] was recorded. Meloxicam was administered to both groups. Postoperative pain and rescue analgesia requirement were assessed for 24 hours using the short form of the Glasgow Composite Measure Pain Scale. Data were compared using a mixed effects model or a Mann–Whitney test.</p></div><div><h3>Results</h3><p>More dogs required ephedrine in FLK than in DLK (67% <em>versus</em> 7%). Heart rate was not significantly different between groups, whereas lower values of MAP (<em>p</em> ≤ 0.01) and F<span>e′</span>Sevo (<em>p</em> = 0.018) were observed in FLK than in DLK. Rescue analgesia was administered to 2/15 dogs in FLK and 0/14 dogs in DLK.</p></div><div><h3>Conclusions and clinical relevance</h3><p>Based on the cardiovascular response during surgery, intraoperative infusions of FLK and DLK provided adequate antinociception. Infusion of DLK provided greater stability of blood pressure. Both protocols resulted in minimal need for additional analgesia within 24 hours postoperatively.</p></div>\",\"PeriodicalId\":23626,\"journal\":{\"name\":\"Veterinary anaesthesia and analgesia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-04-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Veterinary anaesthesia and analgesia\",\"FirstCategoryId\":\"97\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1467298724000722\",\"RegionNum\":2,\"RegionCategory\":\"农林科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"VETERINARY SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Veterinary anaesthesia and analgesia","FirstCategoryId":"97","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1467298724000722","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
Influence of intravenous fentanyl or dexmedetomidine infusions, combined with lidocaine and ketamine, on cardiovascular response, sevoflurane requirement and postoperative pain in dogs anesthetized for unilateral mastectomy
Objective
To compare the effects of constant rate infusions (CRI) of fentanyl or dexmedetomidine, combined with lidocaine and ketamine, on cardiovascular response during surgery, sevoflurane requirement and postoperative pain in dogs undergoing mastectomy.
Study design
Prospective, randomized, blinded, clinical trial.
Animals
A total of 29 female dogs with mammary tumors.
Methods
Premedication consisted of intramuscular acepromazine and morphine. General anesthesia was induced with intravenous propofol and maintained with sevoflurane. Dogs were randomized to be administered intravenous DLK [dexmedetomidine 1 μg kg–1 loading dose (LD) and 1 μg kg–1 hour–1; lidocaine 2 mg kg–1 LD and 3 mg kg–1 hour–1; ketamine 1 mg kg–1 LD and 0.6 mg kg–1 hour–1; n = 14] or FLK (fentanyl 5 μg kg–1 LD and 9 μg kg–1 hour–1; same doses of lidocaine and ketamine; n = 15) during anesthesia. Cardiorespiratory variables and end-tidal sevoflurane (Fe′Sevo) were recorded during surgery. The number of dogs administered ephedrine to treat arterial hypotension [mean arterial pressure (MAP) < 60 mmHg] was recorded. Meloxicam was administered to both groups. Postoperative pain and rescue analgesia requirement were assessed for 24 hours using the short form of the Glasgow Composite Measure Pain Scale. Data were compared using a mixed effects model or a Mann–Whitney test.
Results
More dogs required ephedrine in FLK than in DLK (67% versus 7%). Heart rate was not significantly different between groups, whereas lower values of MAP (p ≤ 0.01) and Fe′Sevo (p = 0.018) were observed in FLK than in DLK. Rescue analgesia was administered to 2/15 dogs in FLK and 0/14 dogs in DLK.
Conclusions and clinical relevance
Based on the cardiovascular response during surgery, intraoperative infusions of FLK and DLK provided adequate antinociception. Infusion of DLK provided greater stability of blood pressure. Both protocols resulted in minimal need for additional analgesia within 24 hours postoperatively.
期刊介绍:
Veterinary Anaesthesia and Analgesia is the official journal of the Association of Veterinary Anaesthetists, the American College of Veterinary Anesthesia and Analgesia and the European College of Veterinary Anaesthesia and Analgesia. Its purpose is the publication of original, peer reviewed articles covering all branches of anaesthesia and the relief of pain in animals. Articles concerned with the following subjects related to anaesthesia and analgesia are also welcome:
the basic sciences;
pathophysiology of disease as it relates to anaesthetic management
equipment
intensive care
chemical restraint of animals including laboratory animals, wildlife and exotic animals
welfare issues associated with pain and distress
education in veterinary anaesthesia and analgesia.
Review articles, special articles, and historical notes will also be published, along with editorials, case reports in the form of letters to the editor, and book reviews. There is also an active correspondence section.