目的:评价阿法沙酮单药和美托咪定联合IM和IV给药的效果,咪达唑仑,或异氟醚麻醉猫卵巢子宫切除术或去势的关键应激相关神经激素和代谢变化。
方法:在2018年10月4日至2020年1月10日期间,72只客户拥有的混合品种猫接受卵巢子宫切除术或去势。
方法:对于每种类型的手术,猫被分配到6个药物治疗方案组中的1个,6只猫/组:生理盐水(0.9%NaCl)溶液(0.5mL,IM)和阿法沙酮(5mg/kg,IV);生理盐水溶液(0.5mL,IM)和阿法沙酮(5mg/kg,IM);美托咪定(50μg/kg,IM)和阿法沙酮(5mg/kg,IV);美托咪定(50μg/kg,IM)和阿法沙酮(5mg/kg,IM);咪达唑仑(0.5mg/kg,IM),美托咪定(50μg/kg,IM),和阿法沙酮(5毫克/千克,IV);或咪达唑仑(0.5mg/kg,IM),美托咪定(50μg/kg,IM),和阿法沙酮(5毫克/千克,IM)。预处理前取静脉血,术前和术后用异氟醚和氧气麻醉,在早期和完全恢复期间。
结果:与基线浓度相比,在单独使用阿法沙松和美托咪定联合用药的猫麻醉期间,血浆肾上腺素和去甲肾上腺素浓度降低。美托咪定的组合,咪达唑仑,和阿法沙酮可以防止猫在麻醉和手术期间儿茶酚胺的过度增加。卵巢子宫切除术后的血浆皮质醇浓度较低,对于接受美托咪定和阿法沙酮联合用药或美托咪定联合用药的猫,咪达唑仑,还有Alfaxalone,与单独服用阿法沙酮的猫相比。使用包括美托咪定和咪达唑仑的组合治疗的猫在麻醉期间出现高血糖。使用美托咪定或美托咪定和咪达唑仑联合阿法沙酮治疗的猫,与单独的alfaxalone相比,麻醉期间非酯化脂肪酸浓度较低。除了阿尔法沙松之外,接受美托咪定的猫的行为恢复评分更低(更好)。与单独的alfaxalone相比。
结论:结果表明,美托咪定和阿法沙酮或美托咪定预处理,咪达唑仑,和阿法沙酮可用于预防与压力相关的激素和代谢反应,除了高血糖,在猫的异氟烷麻醉和手术期间。
OBJECTIVE: To evaluate the effects of IM and IV administration of alfaxalone alone and in combination with medetomidine, midazolam, or both on key stress-related neurohormonal and metabolic changes in isoflurane-anesthetized cats undergoing ovariohysterectomy or castration.
METHODS: 72 client-owned mixed-breed cats undergoing ovariohysterectomy or castration between October 4, 2018, and January 10, 2020.
METHODS: For each type of surgery, cats were assigned to 1 of 6 premedication protocols groups, with 6 cats/group: physiologic saline (0.9% NaCl) solution (0.5 mL, IM) and alfaxalone (5 mg/kg, IV); physiologic saline solution (0.5 mL, IM) and alfaxalone (5 mg/kg, IM); medetomidine (50 μg/kg, IM) and alfaxalone (5 mg/kg, IV); medetomidine (50 μg/kg, IM) and alfaxalone (5 mg/kg, IM); midazolam (0.5 mg/kg, IM), medetomidine (50 μg/kg, IM), and alfaxalone (5 mg/kg, IV); or midazolam (0.5 mg/kg, IM), medetomidine (50 μg/kg, IM), and alfaxalone (5 mg/kg, IM). Venous blood was taken before pretreatment, pre- and postoperatively during anesthesia with isoflurane and oxygen, and during early and complete recovery.
RESULTS: Compared with baseline concentrations, plasma adrenaline and noradrenaline concentrations decreased during anesthesia in cats premedicated with alfaxalone alone and in combination with medetomidine. The combination of medetomidine, midazolam, and alfaxalone prevented an excessive increase in catecholamines during anesthesia and surgery in cats. Postoperative plasma cortisol concentration after ovariohysterectomy was lower for cats premedicated with the combination of medetomidine and alfaxalone or the combination of medetomidine, midazolam, and alfaxalone, compared with cats premedicated with alfaxalone alone. Cats treated with combinations that included medetomidine and midazolam had hyperglycemia during anesthesia. Cats treated with medetomidine or medetomidine and midazolam in combination with alfaxalone, compared with alfaxalone alone, had lower concentrations of nonesterified fatty acids during anesthesia. Behavioral recovery scores were lower (better) for cats that received medetomidine in addition to alfaxalone, compared with alfaxalone alone.
CONCLUSIONS: Results indicated that pretreatments with medetomidine and alfaxalone or with medetomidine, midazolam, and alfaxalone were useful for preventing stress-related hormonal and metabolic responses, other than hyperglycemia, during isoflurane anesthesia and surgery in cats.