马的平衡麻醉

Regula Bettschart-Wolfensberger PD DMV, PhD, Dipl. ECVAA, M. Paula Larenza DMV, Dipl. ECVAA
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引用次数: 51

摘要

下面的文章旨在概述目前可用的平衡麻醉方案的马。在马的麻醉过程中,维持心血管功能和肌肉灌注是必不可少的。此外,在停止给药后至少1小时内完成平稳的恢复阶段也是至关重要的。所有吸入麻醉药均有剂量依赖性地抑制心血管功能。因此,减少吸入麻醉剂需求的药物(减少MAC)可能会改善麻醉期间的心血管功能。利多卡因恒速输注(CRI),在临床上使用的剂量率,降低MAC约25%,没有不良心血管副作用的报道。对于麻醉数小时的马,建议小心给药。在麻醉期间被掩盖的累积毒性可能在恢复期间变得明显。氯胺酮是唯一用于平衡麻醉的药物,可能对心血管功能产生积极影响。但在氯胺酮持续使用较长时间(>2小时)后,可能会出现粗略的恢复。s -氯胺酮cri的初步结果在这方面显示更好的结果,但需要进一步的研究。美托咪定CRI在推荐剂量率下确实使MAC降低约30%。与利多卡因平衡相比,心血管功能中度受损,但手术刺激后马的术中觉醒较少。美托咪定平衡后的恢复期明显比任何其他方案更顺利。综上所述,利多卡因、氯胺酮和美托咪定主要用于马的平衡麻醉。对于心血管疾病患者,氯胺酮可能是有利的。如果一个平稳的恢复阶段是至关重要的,美托咪定应该是首选药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Balanced Anesthesia in the Equine

The following article aims at giving an overview on currently available balanced anesthetic regimens for horses. In horses, maintenance of cardiovascular function and thus muscular perfusion during anesthesia is essential. Also, a smooth recovery phase which should be completed within at least 1 hour of termination of drug administration is crucial. All inhalation anesthetics depress cardiovascular function dose dependently. Thus, drugs that decrease the need for inhalation anesthetics (decrease MAC) might improve cardiovascular function during anesthesia. Lidocaine constant rate infusion (CRI), at clinically used dose rates, decreases MAC by about 25%, and no untoward cardiovascular side effects have been reported. In horses anesthetized for several hours, careful dosing is advised. Toxicity due to accumulation, masked during anesthesia, might become apparent during recovery. Ketamine is the only drug used for balanced anesthesia that might positively influence cardiovascular function. But following continuous ketamine administration for longer time periods (>2 hours), rough recoveries can occur. Preliminary results with S-ketamine CRIs showed better results in this respect, but further studies are warranted. Medetomidine CRI does decrease MAC about 30% at recommended dose rates. Cardiovascular function in comparison to lidocaine balance is moderately impaired, but horses show less intraoperative awakening following surgical stimulation. Recovery phase following medetomidine balance is clearly smoother than with any other regimen. In conclusion, lidocaine, ketamine, and medetomidine are mainly used for balanced anesthesia in horses. In cardiovascularly compromised patients, ketamine might be advantageous. If a smooth recovery phase is crucial, medetomidine should be the drug of choice.

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