Objective

To compare the isoflurane-sparing effects of sufentanil–lidocaine–ketamine (SLK) and fentanyl–lidocaine–ketamine (FLK) infusions in dogs undergoing total ear canal ablation and lateral bulla osteotomy (TECA–LBO).

Study design

Randomized blinded clinical study.

Animals

A group of 20 client-owned dogs undergoing TECA–LBO.

Methods

Intravenous (IV) administration of lidocaine (3 mg kg^–1) and ketamine (0.6 mg kg^–1) with fentanyl (5.4 μg kg^–1; n = 10; FLK group) or sufentanil (0.72 μg kg^–1; n = 10; SLK group) was immediately followed by the corresponding constant rate infusion (CRI) (lidocaine 3 mg kg^–1 hour^–1; ketamine 0.6 mg kg^–1 hour^–1; either fentanyl 5.4 μg kg^–1 hour^–1 or sufentanil 0.72 μg kg^–1 hour^–1). Anaesthesia was induced with propofol 3–5 mg kg^–1 IV and was maintained with isoflurane. End-tidal isoflurane concentration (Fe′Iso) was decreased in 0.2% steps every 15 minutes until spontaneous movements were observed (treated with propofol 1 mg kg^–1 IV) or an increase of > 30% in heart rate or mean arterial pressure from baseline occurred (treated with rescue fentanyl or sufentanil). Quality of recovery and pain were assessed at extubation using the short-form Glasgow Composite Pain Scale (SF-GCPS), Colorado State University Canine Acute Pain scale (CSU-CAP), and visual analogue scale (VAS). Data were analysed with analysis of variance, t tests, Fisher test and Spearman coefficient (p < 0.05).

Results

Fe′Iso decreased significantly in SLK group (45%; p = 0.0006) but not in FLK (15%; p = 0.1135) (p = 0.0136). SLK group had lower scores for recovery quality (p = 0.0204), SF-GCPS (p = 0.0071) and CSU-CAP (p = 0.0273) than FLK at extubation. Intraoperative rescue analgesia and VAS were not significantly different between groups.

Conclusions and clinical relevance

Compared with FLK infusion, CRI of SLK at these doses decreased isoflurane requirements, decreased pain scores and improved recovery quality at extubation in dogs undergoing TECA–LBO.

中文翻译：

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芬太尼-利多卡因-氯胺酮与舒芬太尼-利多卡因-氯胺酮对接受全耳道消融和外侧大疱截骨术的狗的异氟烷需求量的影响。

目的

比较舒芬太尼–利多卡因–氯胺酮（SLK）和芬太尼–利多卡因–氯胺酮（FLK）输注对接受全耳道消融和外侧大疱截骨术（TECA – LBO）的狗的异氟烷保护作用。

学习规划

随机盲临床研究。

动物

一群正在接受TECA – LBO的客户拥有的狗。

方法

利多卡因（3 mg kg ^–1）和氯胺酮（0.6 mg kg ^–1）与芬太尼（5.4μgkg ^–1；n  = 10； FLK组）或舒芬太尼（0.72μgkg ^–1；n  = 10； SLK组）后立即进行相应的恒速输注（CRI）（利多卡因3 mg kg ^–1小时^–1；氯胺酮0.6 mg kg ^–1小时^–1；芬太尼5.4μgkg ^–1小时^–1或舒芬太尼0.72μgkg ^–1小时^–1）。异丙酚3–5 mg kg ^–1诱导麻醉IV并用异氟烷维持。呼气末异氟烷浓度（F Ë 'ISO）在0.2％降至每15分钟，直到观察到自发的运动（异丙酚1毫克kg治疗步骤^-1 IV）或在心脏速率或平均动脉压的增加> 30％从基线开始发生（用救援性芬太尼或舒芬太尼治疗）。拔管时使用简短的格拉斯哥综合疼痛量表（SF-GCPS），科罗拉多州立大学犬急性疼痛量表（CSU-CAP）和视觉模拟量表（VAS）评估恢复和疼痛的质量。通过方差分析，t检验，Fisher检验和Spearman系数分析数据（p <0.05）。

结果

˚F è '异在SLK组显著降低（45％; p  = 0.0006），但不是在FLK（15％; p  = 0.1135）（p  = 0.0136）。 拔管时，SLK组的恢复质量得分较低（p = 0.0204），SF-GCPS（p  = 0.0071）和CSU-CAP（p  = 0.0273）。两组之间的术中抢救镇痛和VAS差异无统计学意义。

结论与临床意义

与FLK输注相比，这些剂量的SLK的CRI降低了接受TECA – LBO的狗的异氟烷需求量，降低的疼痛评分并改善了拔管时的恢复质量。