Objective

To determine the dose and cardiopulmonary effects of propofol alone or with midazolam for induction of anesthesia in American Society of Anesthesiologists status ≥III dogs requiring emergency abdominal surgery.

Study design

Prospective, randomized, blinded, clinical trial.

Animals

A total of 19 client-owned dogs.

Methods

Dogs were sedated with fentanyl (2 μg kg^–1) intravenously (IV) for instrumentation for measurement of heart rate, arterial blood pressure, cardiac index, systemic vascular resistance index, arterial blood gases, respiratory rate and rectal temperature. After additional IV fentanyl (3 μg kg^–1), the quality of sedation was scored and cardiopulmonary variables recorded. Induction of anesthesia was with IV propofol (1 mg kg^–1) and saline (0.06 mL kg^–1; group PS; nine dogs) or midazolam (0.3 mg kg^–1; group PM; 10 dogs), with additional propofol (0.25 mg kg^–1) IV every 6 seconds until endotracheal intubation. Induction/intubation quality was scored, and anesthesia was maintained with isoflurane. Variables were recorded for 5 minutes with the dog in lateral recumbency, breathing spontaneously, and then in dorsal recumbency with mechanical ventilation for the next 15 minutes. A general linear mixed model was used with post hoc analysis for multiple comparisons between groups (p < 0.05).

Results

There were no differences in group demographics, temperature and cardiopulmonary variables between groups or within groups before or after induction. The propofol doses for induction of anesthesia were significantly different between groups, 1.9 ± 0.5 and 1.1 ± 0.5 mg kg^–1 for groups PS and PM, respectively, and the induction/intubation score was significantly better for group PM.

Conclusions and clinical relevance

Midazolam co-induction reduced the propofol induction dose and improved the quality of induction in critically ill dogs without an improvement in cardiopulmonary variables, when compared with a higher dose of propofol alone.

中文翻译：

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丙泊酚单独或与咪达唑仑一起在重症犬中诱导麻醉的剂量和心肺作用。

目的

在美国麻醉医师学会中确定丙泊酚单独或与咪达唑仑一起诱导麻醉的剂量和心肺作用，状态≥III的狗需要进行紧急腹部手术。

学习规划

前瞻性，随机，盲法临床试验。

动物

共有19只客户拥有的狗。

方法

给犬静脉注射芬太尼（2μgkg ^–1）镇静剂，以测量心率，动脉血压，心脏指数，全身血管阻力指数，动脉血气，呼吸频率和直肠温度。静脉补充芬太尼（3μgkg ^–1）后，对镇静质量进行评分并记录心肺变量。静脉注射丙泊酚（1 mg kg ^–1）和生理盐水（0.06 mL kg ^–1； PS组； 9只狗）或咪达唑仑（0.3 mg kg ^–1； PM组； 10只狗），再加异丙酚（0.25 mg ）麻醉。毫克公斤^–1）每6秒静脉输注直至气管插管。对诱导/插管质量进行评分，并使用异氟烷维持麻醉。记录5分钟的变量，使狗侧卧，自发呼吸，然后在背卧位并机械通气，持续15分钟。普通线性混合模型与事后分析一起用于各组之间的多次比较（p <0.05）。

结果

各组之间或各组之间在诱导之前或之后，组人口统计学，温度和心肺变量无差异。两组之间的异丙酚诱导麻醉剂量明显不同，PS和PM组分别为1.9±0.5和1.1±0.5 mg kg ^–1，而PM组的诱导/插管评分明显更好。

结论与临床意义

与单独使用更高剂量的丙泊酚相比，咪达唑仑共诱导降低了危重犬的异丙酚诱导剂量，并提高了诱导质量，但并未改善心肺功能。