外科教学中犬的复合麻醉效果观察

目的比较氯胺酮、地西泮和丙泊酚复合麻醉在外科教学中对犬的麻醉效果。方法成年健康杂种犬42条,诱导麻醉相同,均肌注氯胺酮（10 mg/kg）和氟哌利多（0.5 mg/kg）混合液。静脉维持采用不用的方法,分为三组,分别是静脉滴注氯胺酮地西泮混合液（n=12）、静脉推注氯胺酮地西泮混合液（n=12）和静脉滴注丙泊酚利多卡因混合液（n=18）。结果三组麻醉效果显示,静脉滴注丙泊酚利多卡因混合液效果最好,优83.3%,良16.7%,死亡率0%。结论在外科教学中,对犬采用丙泊酚复合麻醉是一种较为理想的麻醉方法。     

一种家兔持续静脉麻醉方法

目的为进行某些特殊项目的实验研究,建立一种持续麻醉实验动物模型。方法戊巴比妥钠粉剂加生理盐水溶解,配成1%水剂,按3 mL/kg（30 mg/kg）耳缘静脉注射。诱导成功后约2 h经留置针使用恒速微量泵1 mL/h.kg给药,维持4 h后调节至2 mL/h.kg给药,并长期维持。每日上午、下午各停止静脉给药1 h,为动物饲食水。结果经实验证明家兔可耐受120 h连续麻醉。实验动物耐受情况好,家兔麻醉前呼吸48～68次/min,心跳140～200次/min,体温为39.4℃±1.0℃。以3～6 mg/s速度,成年兔的正常耳缘静脉注射后,平均3＋2.8 s实验动物呈三度麻醉状态,无自主运动,未见兴奋躁动过程,呼吸24±6.6次/min。死亡率12.5%。持续麻醉期间动物二便正常。结论长期持续麻醉的效果要求是以避免动物挣扎的镇静为主,戊巴比妥适合于建立长期麻醉实验动物模型。该方法在爆炸伤和创面愈合等实验实际应用中效果理想。     

氯胺酮加丙泊酚与芬太尼加丙泊酚用于学龄前 小儿非心脏手术的麻醉效果比较

目的:比较芬太尼加丙泊酚与氯胺酮加丙泊酚用于学龄前小儿非心脏手术的麻醉效果。方法:患儿70例,随机分为两组,F组(n=35),用芬太尼2-3 ug／kg,阿曲库铵0．5 mg／kg,丙泊2-3 mg／kg,静脉注射诱导插管,然后微泵持续注射芬太尼0．03-0．06 ug/kg．min-1,阿曲库铵4-8 ug/kg．min-1,丙泊酚80-150 ug／kg．min-1,K组(n=35),用氯胺酮1-1．5 mg／kg,阿曲库铵0．5 mg/kg,丙泊酚2-3 mg／kg,静脉注射诱导插管,然后微泵持续注射氯胺酮30-60 ug／kg．min-1,阿曲库铵与丙泊酚用量同F组,根据术中的情况予以调整。分别记录两组病例在用药前后的收缩压(SBP)、舒张压(DBP)、心率(HR)、麻醉效果、停药至导管拔除时间,以及拔管后因气道梗阻再次插管等情况。结果:K组病例在麻醉诱导时循环稳定,拔管后无呼吸抑制的发生,但术毕拔管的时间延长,F组病例麻醉诱导时HR、SBP、DBP降低明显,拔管后有3例气管痉挛致呼吸抑制重新插管。结论:氯胺酮复合丙泊酚用于学龄前小儿非心脏手术的麻醉,麻醉效果确切,可控性强,麻醉诱导平稳,术中易于调整,术毕拔管虽时间略为延长,但可避免呼吸抑制的发生,较为安全。     

丙泊酚复合瑞芬太尼用于无肌松药气管插管的临床研究

目的:探讨丙泊酚复合瑞芬太尼用于无肌松药气管插管的最佳剂量,评估诱导期应用此种方法的有效性。方法:择期全麻的患者100例,ASAⅠ~Ⅱ级,随机分为三组。麻醉诱导为丙泊酚2 mg/kg,瑞芬太尼为2μg/kg(Ⅰ组)、3μg/kg(Ⅱ组)和4μg/kg(Ⅲ组),待两种药物达到药效高峰时行气管插管。观察诱导期和插管后1 min,3 min的血流动力学的变化情况,评估插管满意度。结果:各组的插管满意度如下:Ⅰ组54.2%(19/35)、Ⅱ组83.3%(25/30)、Ⅲ组97.1%(34/35),随着瑞芬太尼剂量的增加,气管插管满意度增高,气管插管操作时间缩短(P0.05)。在诱导过程中,三组患者的MAP和HR下降幅度均较显著(P0.05)。结论:丙泊酚复合瑞芬太尼用于无肌松药气管插管是可行的,与复合瑞芬太尼2μg/kg或3μg/kg相比,丙泊酚2 mg/kg复合瑞芬太尼4μg/kg能明显提供更好的气管插管条件,且插管操作时间明显缩短。     

小剂量利多卡因在无痛宫腔镜术中的应用

目的:观察静注利多卡因在无痛宫腔镜术的应用效果。方法:120例择期宫腔镜手术患者,随机均分为L、C两组。L组麻醉诱导前缓慢静脉推注利多卡因1 mg/kg;C组以生理盐水替代。两组均静注丙泊酚1-1.5mg/kg进行麻醉诱导至睫毛反射消失,术中酌情追加丙泊酚。麻醉开始后,询问患者是否有静脉注射痛,观察记录术中及术后疼痛情况。结果:两组术中血压、心率平稳。L组较C组丙泊酚注射痛及术中术后疼痛程度减轻(P<0.05)。结论:利多卡因复合丙泊酚用于无痛宫腔镜不良反应小,有利于病人术后恢复。     

丙泊酚复合蓝博刻宁对无痛人流术麻醉效果的临床观察

目的：观察丙泊酚复合蓝博刻宁对无病人流术麻醉效果的临床效果。方法：100例无病人流患者随机分为A、B两组;A组给予丙泊酚2—3mg/kg,缓慢推注。B组首先缓慢推入蓝博刻宁（氢溴酸高乌甲素）8mg,然后给予丙泊酚2—3mg/kg．术中根据需要分次推注丙泊酚以满足手术要求。结果：B组丙泊酚用量明显少于A组（P〈0．05）,其镇痛作用明显优于A组（P〈0．05）,术后宫缩痛也比A组轻（P〈0．05）。A组住院时间明显短B组（P〈0,05）。结论：丙泊酚伍用小剂量氢溴酸高鸟甲素用于人工流产较单用大剂量丙泊酚具有麻醉效果好,有着人先效减少丙泊酚用量,明显减少术后宫缩痛,缩短患者的住院时间,利于患者早日康复出院。     

不同剂量氯胺酮复合顺式阿曲库铵预注对肌松效应的影响

目的比较顺式阿曲库铵预注、不同剂量氯胺酮复合顺式阿曲库铵预注对顺式阿曲库铵起效时间、血流动力学的影响。方法选择全麻下行择期手术的患者120例随机分成4组,即Ⅰ(生理盐水0.5ml)组、Ⅱ(顺式阿曲库铵0.01mg/kg)组、Ⅲ(顺式阿曲库铵0.01mg/kg预注复合氯胺酮0.5mg/kg)组、Ⅳ(顺式阿曲库铵0.01mg/kg预注复合氯胺酮1mg/kg)组,预注、预处理3min后,Ⅰ组静注插管剂量顺式阿曲库铵0.15mg/kg,Ⅱ、Ⅲ、Ⅳ组静注剩余插管剂量顺式阿曲库铵0.14mg/kg。使用四个成串刺激(TOF),待T1达最大抑制程度时行气管插管,记录肌松起效时间,同时观察HR、BP的变化。结果Ⅱ、Ⅲ、Ⅳ组肌松起效时间明显短于Ⅰ组(P0.05),且Ⅲ、Ⅳ组起效时间较Ⅱ组短(P0.05),但Ⅲ、Ⅳ组起效时间比较无统计学意义(P0.05);各组麻醉诱导期间均无明显心血管不良反应。结论氯胺酮0.5mg/kg复合顺式阿曲库铵0.01mg/kg、氯胺酮1mg/kg复合顺式阿曲库铵0.01mg/kg均能进一步缩短肌松起效时间,且无明显心血管不良反应。     

盐酸戊乙奎醚与丙泊酚联合用于无痛人工流产术的临床研究

目的:评价盐酸戊乙奎醚联合丙泊酚减轻人工流产术后疼痛的效果.方法:ASAⅠ-H级人工流产术患者100例,随机分为观察组和对照组.处理组先缓慢静脉注射盐酸戊乙奎醚注射剂1mg,30min后静脉注射丙泊酚2.5mg/kg;;对照组单独静脉注射丙泊酚2.5mg/kg.两组丙泊酚静注速率均为5mg/s.结果:处理组苏醒即刻苏醒后15min和30min宫缩痛的VAS评分分别为(3.13±0.15)、(2.02±0.11)和(0.87±0.09)分,明显低于对照组的(4.47± 0.35)、(3.54± 0.14)及(2.01±0.12)(P＜0.01).结论:盐酸戊乙奎醚联合丙泊酚镇痛能减轻人工流产术后的疼痛.     

BIS监测下两种快通道麻醉方式应用于鼻内镜手术的比较

目的:观察BIS指导两种快通道麻醉在鼻内镜手术中的应用及麻醉效果。方法:选择60例ASAⅠ-Ⅱ级择期行功能性鼻内镜手术(FESS)患者,随机分为七氟醚诱导维持麻醉组(VIMA组)与异丙酚全凭静脉麻醉组(TIVA组)。VIMA组:8%七氟醚,氧流量8L/min,潮气量法吸入诱导,七氟醚维持麻醉;TIVA组:异丙酚2 mg/kg诱导,异丙酚维持麻醉。两组诱导时都静脉注射瑞芬太尼1μg/kg,罗库溴铵0.6 mg/kg,监测TOF值为0、BIS60并维持5 s后行气管插管。术中静脉泵注瑞芬太尼0.2μg·kg~(-1)·min~(-1),分别调整七氟醚和异丙酚维持剂量使BIS值在气管插管后至手术结束前15 min左右保持在40~60之间,手术最后15 min保持于60~70之间。两组术后进行Steward评分,并比较两组各时点SBP、DBP、HR,拔管时间,快通道麻醉成功率和苏醒期不良反应发生率。结果:VIMA组拔管时间(11.60±2.55 min)比TIVA组的(7.13±3.26 min)明显延长(P0.05);TIVA组快通道成功率显著高于VIMA组(P0.05)。两组苏醒期不良反应的发生情况比较差异无统计学意义(P0.05)。结论:异丙酚全凭静脉麻醉用于鼻内镜手术拔管时间比七氟醚诱导维持麻醉短,快通道麻醉效果更好。     

BIS监测下右美托咪啶复合丙泊酚与舒芬太尼在老年患者无痛肠镜中的麻醉效果

目的探讨老年无痛肠镜患者在脑电双频指数(BIS)监测下实施右美托咪定复合丙泊酚与舒芬太尼麻醉的效果。方法选择2014年6月~2016年6月在我院行无痛肠镜检查的老年患者200例为研究对象,按就诊先后顺序将患者分为观察组和对照组各100例,观察组患者在BIS监测下给予右美托咪定复合丙泊酚与舒芬太尼麻醉,对照组在BIS监测下给予丙泊酚与舒芬太尼麻醉,比较两组麻醉效果。结果两组患者给药后5min、10min时的平均动脉压、心率均低于入室时,差异均有统计学意义(均P0.05);观察组给药后5min、10 min平均动脉压、心率下降幅度均大于对照组,差异有显著统计学意义(P0.05)。两组患者的麻醉起效时间、丙泊酚用量、麻醉苏醒时间比较,差异均有统计学意义(P0.05)。两组不良反应发生率比较,差异亦有统计学意义(P0.05)。结论在老年无痛肠镜患者的临床检查过程中,在BIS监测下行右美托咪定复合丙泊酚与舒芬太尼麻醉,能获得较好的麻醉效果,值得临床推广。     

Propofol anesthesia in loggerhead (Caretta caretta) sea turtles

Rapid, safe, and effective methods of anesthetic induction and recovery are needed for sea turtles, especially in cases eligible for immediate release. This study demonstrates that intravenous propofol provides a rapid induction of anesthesia in loggerhead (Caretta caretta) sea turtles and results in rapid recovery, allowing safe return to water shortly after the procedure. Forty-nine loggerhead sea turtles were recovered as local fishery by-catch in pound nets and transported to a surgical suite for laparoscopic sex determination. Treatment animals (n = 32) received 5 mg/kg propofol intravenously (i.v.) as a rapid bolus, whereas control animals (n = 17) received no propofol. For analgesia, all animals received a 4 ml infusion of 1% lidocaine, locally, as well as 2 mg/kg ketoprofen intramuscularly (i.m.). Physiologic data included heart and respiratory rate, temperature, and a single blood gas sample collected upon termination of the laparoscopy. Subjective data included jaw tone and ocular reflex: 3 (vigorous) to 0 (none detected). Anesthetic depth was scored from 1, no anesthesia, to 3, surgical anesthesia. Turtles receiving propofol became apneic for a minimum of 5 min with a mean time of 13.7 +/- 8.3 min to the first respiration. Limb movement returned at a mean time of 21.1 +/- 16.8 min. The treatment animals were judged to be sedated for approximately 30 min (mean anesthetic depth score > or = 1.5) when compared to controls. Median respiratory rates for treatment animals were slower compared to controls for the first 15 min, then after 35 min, they became significantly faster than the controls. Median heart rates of control animals became significantly slower than treatment animals between 40 and 45 min. Physiologic differences between groups persisted a minimum of 55 min. Possible explanations for heart rate and respiratory rate differences later in the monitoring period include a compensatory recovery of treatment animals from anesthesia-induced hypoxia and hypercapnia or, alternatively, an induced response of the nonsedated control animals. The animals induced with propofol were easier to secure to the restraint device and moved less during laparoscopy. In conclusion, propofol is a safe and effective injectable anesthetic for use in free-ranging loggerhead sea turtles that provides rapid induction and recovery.     

小型猪生物可降解支架置入术中不同麻醉方法的研究

目的比较两种不同麻醉方法对小型猪的麻醉效果。方法将12头小型猪随机分成两组,每组6头,一组是戊巴比妥钠复合氯胺酮静脉麻醉（Ⅰ组）,另一组是丙泊酚复合氯胺酮静脉麻醉（Ⅱ组）。麻醉后对动物实施心脏生物可降解支架置入术,观察动物麻醉起效时间、苏醒时间、麻醉效果、呼吸频率（RR）、心率（HR）、血氧饱和度（SpO2）及术后苏醒情况。结果两种方法麻醉后,动物分别在7.6±2.4 min（Ⅰ组）、2.4±1.4 min（Ⅱ组）进入麻醉状态（P〈0.05）。术后苏醒时间分别为30.8±8.8 min（Ⅰ组）、16.5±2.8min（Ⅱ组）（P〈0.05）,Ⅱ组动物比Ⅰ组动物苏醒平稳（P〈0.05）。两组心率及呼吸频率变化无明显差别,而氧饱和度在第10 min（Ⅰ组87%,Ⅱ组92%）和30 min（Ⅰ组94%,Ⅱ组89%）由于追加麻醉药后,两组值差异较大,但很快恢复正常。Ⅱ组麻醉效果较Ⅰ组麻醉效果好。结论两种麻醉方法均能达到良好的麻醉效果,丙泊酚复合氯胺酮麻醉较戊巴比妥钠复合氯胺酮麻醉的效果强且术后苏醒快,是一种比较理想的麻醉方法。     

The use of propofol for electroejaculation in domestic cats

The objective was to evaluate the use of propofol as an anesthetic drug for electroejaculation in the domestic cat. Cortisol concentrations, heart rates and respiratory rates of 20 male domestic cats were examined. The animals were randomly allocated into three groups. Group A (n = 8), were anesthetized with propofol (10 mg/kg) and underwent electroejaculation. Group B (n = 6), were pre-medicated with buprenorphine (0.01 mg/kg), anesthetized with propofol (5 mg/kg) and underwent electroejaculation. Group C (n = 6), the cats were anesthetized with propofol (10 mg/kg) without electroejaculation (control group). Blood samples were collected at four time points (30 min before propofol administration, immediately after the surgical plane of anesthesia was induced, immediately post-electroejaculation, and at the onset of anesthetic recovery). In the control group, the sampling time coincident with the end of electroejaculation was assigned as 21 min after the induction of anesthesia. The mean (+/- S.E.M.) duration time for electroejaculation was 18 +/- 3 min. The duration of anesthesia did not differ (P > 0.05) among the three groups of cats (26 +/- 2 min). Most of the cats (17/20) recovered smoothly. Pre-anesthetic medication with buprenorphine did not reduce the requirement of propofol for anesthesia. The cortisol concentrations, heart rates and respiratory rates of the three groups of cats did not differ (P > 0.05). A marked decline in cortisol levels was observed immediately post-electroejaculation. Propofol was a useful anesthetic for electroejaculation in felids with rapid onset, optimal duration of anesthesia for performing electroejaculation, and smooth recovery.     

Anesthesia in female white-tailed deer using Telazol and xylazine

Thirty two free-ranging female white-tailed deer (Odocoileus virginianus) were anesthesized with varying Telazol and xylazine HCl combinations in Front Royal (Virginia, USA) between August 1992 and September 1992. All animals were caught in baited box traps, manually restrained, and hand injected with a combination of Telazol and xylazine administered intramuscularly. Deer received mean +/- SE dosages of 2.53+/-0.16 mg/kg Telazol and 0.69+/-0.05 mg/kg of xylazine. These dosages achieved a rapid and effective anesthetic plane for short-term procedures such as weighing, blood collection, and translocation. Eight of 32 deer (25%) required an intravenous (i.v.) supplement of ketamine HCl (100 mg) to maintain a safe plane of anesthesia. Ketamine supplementation provided an average of 11.8+/-2.0 min additional safe handling. Satisfactory reversals were achieved in all deer by administering yohimbine HCl 16 mg i.v. (dose range, 0.22 to 0.48 mg/kg) to all animals.     

Hepatic adrenoceptors involved in the glycogenolytic response to exogenous (-)-norepinephrine in the dog liver in vivo

Effects of various sympathomimetic amines on the hepatic glucose mobilization were studied in anesthetized dogs. Phenylephrine (30, 100, 300 micrograms), isoproterenol (0.1, 1, 10 micrograms) and (-)-norepinephrine (0.5, 5, 50 micrograms) were injected into the common hepatic artery in three separate groups of dogs. Dose-dependent increases in hepatic venous glucose concentration were observed following the injections of these drugs. Aortic glucose concentration also increased significantly, but to a lesser extent as compared with that in hepatic venous blood. Peak responses were obtained 3 to 5 min after the drug administrations. The increases in hepatic venous glucose concentration induced by the injections of (-)-norepinephrine were significantly diminished to a similar extent in dogs treated with either phentolamine (2 mg/kg, i.v.) or (-)-propranolol (0.2 mg/kg, i.v.). The results indicate that in the dog liver in vivo, both hepatic alpha- and beta-adrenoceptors can be involved in the hepatic glycogenolysis. The glycogenolytic response to exogenously administered (-)-norepinephrine is mediated via alpha- as well as beta-adrenoceptors in the liver of anesthetized dogs.     

Herbal monoterpene alcohols inhibit propofol metabolism and prolong anesthesia time

2,6-Diisopropylphenol (Propofol) is a short-acting intravenous anesthetic that is rapidly metabolized by glucuronidation and ring hydroxylation catalyzed by cytochrome P450. The goal of this research was to determine whether dietary monoterpene alcohols (MAs) could be used to prolong the anesthetic effect of propofol by inhibiting propofol metabolism in animals. Mice were injected intraperitoneally (i.p.) with MAs (100-200) mg/kg followed by the administration of 100 mg/kg propofol 40 min later via an i.p. injection. The time of the anesthesia of each mouse was recorded. It was found that (+/-)-borneol, (-)-carveol, trans-sobrerol, and menthol significantly extended the anesthetic effect of propofol (>3 times). The concentration of propofol in the mouse blood over time (up to 180 min) also increased in mice pre-treated with (-)-borneol, (-)-carveol, and trans-sobrerol. The volume of distribution of propofol decreased in the (-)-borneol (p<0.05), pre-treated group as compared to the propofol control group. Moreover, the maximum blood concentration of propofol and the concentration of propofol in the blood as indicated by the area under the curve were significantly increased in (-)-borneol and (-)-carveol pre-treated groups. Additional evidence using rat hepatocytes showed that (-)-borneol inhibited propofol glucuronidation whereas trans-sobrerol and (-)-carveol inhibited cytochrome P450 dependent microsomal aminopyrine N-demethylation. These results suggest that (-)-borneol extends propofol-induced anesthesia by inhibiting its glucuronidation in the mouse whereas trans-sobrerol (-)-carveol extends propofol-induced anesthesia by inhibiting P450 catalyzed propofol metabolism.     

Comparative Responses to Propofol Anaesthesia alone and with α2-Adrenergic Medications in a Canine Model

Cardiovascular and pulmonary effects of pro-pofol, a relatively new nonbarbiturate intravenous anaesthetic, were assessed and com-pared in 22 male and female dogs. Dogs in group 1 did not receive any premedication prior to 6.6 mg/kg IV propofol, group 2 was premedicated with atropine (0.02 mg/kg IM) and the α2-agonist medetomidine (10 μg/kg IM), and group 3 received the same premedication agents as group 2, but the medetomidine effects were reversed by the α2-antagonist atipamezole (30 μg/kg IV) after 30 min of anaesthesia. Each dog in groups 2 and 3 received a propofol induction dose of 2.2 mg/kg IV The anaesthetic du-ration was shortest with propofol alone and prolonged with medetomidine as a premedication which was reversible with atipamezole. In group 1, the most prominent effects were a temporary drop in diastolic arterial blood pressure (26% and 24%) at 2 and 5 min post-propofol, respectively and a drop in respiratory frequency (41%) 2 min after pro-pofol induction. Similar respiratory depression was observed in groups 2 and 3 (20% and 48%, respectively) at the same time. Apnea was not observed. An increase in systemic arterial blood pressure was observed throughout the trial in groups 2 and 3 un-til dogs recovered or were reversed with atipamezole. Medetomidine significantly re-duces propofol dosage requirements. Safe and effective injectable anaesthesia was pro-duced by propofol in this group of dogs. The frequency of respiratory depression would suggest in clinical usage, the practitioner should be aware oxygen supplementation is the treatment of choice should apnea occur.     

Effects of naloxone and fentanyl in acutely decerebrated dogs

Cardiovascular, respiratory and analgesic effects of fentanyl and naloxone were studied in normotensive acutely decerebrated dogs. Naloxone (1 mg/kg, i.v.) increased skin twitch reflex latency, mean blood pressure, pulse pressure, respiratory rate and minute volume. Fentanyl (50 μg/kg, i.v.) decreased heart rate and blood pressure while the animals were artificially ventilated. The skin twitch reflex latency was not significantly altered. Nine minutes later, naloxone (1 mg/kg, i.v.) was administered and the fentanyl-induced cardiovascular depression was reversed above the control level. The skin twitch reflex latency remained unchanged. These findings give further evidence that the endogenous opioid system plays an important role in the brainstem control of circulation and respiration. The mechanism of the anomalous analgesic response of the acutely decerebrated dog requires further investigation.     

The anaesthetic agent propofol interacts with GABA(B)-receptors: an electrophysiological study in rat

The mode of action by which propofol induces anaesthesia is not fully understood, although several studies suggest that the compound acts via potentiation of brain GABA(A)-receptors. The aim of the present study is to investigate a putative GABA(B)-receptor agonistic action of propofol. For this purpose the action of propofol on a GABA-receptor mediated regulation of dopamine neurons was analyzed with extracellular single unit recordings of dopaminergic neurons of the substantia nigra in chloral hydrate anaesthetized rats.Intravenous administration of propofol (1-16 mg/kg) was found to dose-dependently decrease the firing rate and burst firing activity of nigral DA neurons. These effects by propofol were effectively antagonized by pretreatment with the selective GABA(B)-receptor antagonist CGP 35348 (200 mg/kg, i.v.) but not by pretreatment with the GABA(A)-receptor antagonist picrotoxin (4.5 mg/kg, i.v.).It is proposed that an activation of central GABA(B)-receptors may, at least partially, contribute to the anesthetic properties of propofol.