Objective

To compare the effects of intravenous (IV) lidocaine and fentanyl on the cough reflex and autonomic response during endotracheal intubation in dogs.

Study design

Randomized, blinded, superiority clinical trial.

Animals

A total of 46 client-owned dogs undergoing magnetic resonance imaging.

Methods

After intramuscular methadone (0.2 mg kg^–1), dogs were randomized to be administered either IV lidocaine (2 mg kg^–1; group L) or fentanyl (7 μg kg^–1; group F). After 5 minutes, alfaxalone was administered until endotracheal intubation was possible (1 mg kg^–1 IV over 40 seconds followed by 0.4 mg kg^–1 increments to effect). Total dose of alfaxalone was recorded and cough reflex at endotracheal intubation was scored. Heart rate (HR) was continuously recorded, Doppler systolic arterial blood pressure (SAP) was measured every 20 seconds. Vasovagal tonus index (VVTI) and changes (Δ) in HR, SAP and VVTI between pre-intubation and intubation were calculated. Groups were compared using univariate and multivariate analysis. Statistical significance was set as p < 0.05.

Results

Group F included 22 dogs and group L 24 dogs. The mean (± standard deviation) alfaxalone dose was 1.1 (± 0.2) and 1.35 (± 0.3) mg kg^–1 in groups F and L, respectively (p = 0.0008). At intubation, cough was more likely in group L (odds ratio = 11.3; 95% confidence intervals, 2.1 – 94.2; p = 0.01) and HR increased in 87.5% and 54.5% of groups L and F, respectively (p = 0.02). The median (range) ΔHR between pre-intubation and intubation was higher (13.1%; – 4.3 to + 55.1) in group L (p = 0.0021). Between groups, SAP and VVTI were similar.

Conclusion and clinical relevance

At the stated doses, whilst reducing the alfaxalone dose, fentanyl is superior to lidocaine in suppressing the cough reflex and blunting the increase in HR at endotracheal intubation in dogs premedicated with methadone.

中文翻译：

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静脉注射利多卡因和芬太尼对犬气管插管时咳嗽反射和交感反应的比较。

目的

比较静脉内（IV）利多卡因和芬太尼对犬气管插管过程中咳嗽反射和自主神经反应的影响。

学习规划

随机，盲法，优越性临床试验。

动物

共有46位客户拥有的狗正在接受磁共振成像。

方法

肌内注射美沙酮（0.2 mg kg ^–1）后，将狗随机分为静脉注射利多卡因（2 mg kg ^–1； L组）或芬太尼（7μgkg ^–1； F组）。5分钟后，开始使用艾法沙酮，直到可以进行气管插管（在40秒内进行1 mg kg ^–1的IV注射，然后进行0.4 mg kg ^–1的静脉注射增加效果）。记录紫杉醇的总剂量，并在气管插管时记录咳嗽反射。连续记录心率（HR），每20秒测量一次多普勒收缩期动脉血压（SAP）。计算了插管前和插管之间的迷走神经张力指数（VVTI）以及HR，SAP和VVTI的变化（Δ）。使用单变量和多变量分析比较各组。统计学显着性设为p＜0.05。

结果

F组包括22只狗，L组24只。F组和L组的阿尔法沙酮平均剂量（±标准偏差）分别为1.1（±0.2）和1.35（±0.3）mg kg ^-1（p  = 0.0008）。插管时，L组更容易发生咳嗽（优势比= 11.3； 95％的置信区间为2.1 – 94.2；p  = 0.01），L和F组的心率分别为87.5％和54.5％（p  = 0.02） 。L组中，插管前和插管之间的中位（范围）ΔHR较高（13.1％； – 4.3至+ 55.1）（p  = 0.0021）。组之间，SAP和VVTI相似。

结论与临床意义

在规定的剂量下，芬太尼在减少阿法沙酮剂量的同时，在抑制咳嗽反射和气管插管的HR升高方面优于利多卡因。