实验犬左心耳封堵麻醉方法探讨

Anesthesia method for left atrial appendage occlusion in dogs

目的探讨适合实验犬左心耳封堵术的麻醉方法。方法 22只行国产新型左心耳封堵器封堵左心耳的拉布拉多犬随机分为戊巴比妥钠组和陆眠宁联合戊巴比妥钠组(联合组),每组11例。戊巴比妥钠组给予3%戊巴比妥钠1 ml/kg腹腔注射,联合组给予陆眠宁0.1 ml/kg肌内注射联合3%戊巴比妥钠0.5 ml/kg腹腔注射。术中保持呼吸道通畅、吸氧,连续监测血压、心率、心电图、呼吸频率、脉搏血氧饱和度。术中使用麻黄碱提升血压,阿托品和异丙肾上腺素提升心率。观察注药后5(T_1)、10(T_2)、15(T_3)、30 min(T_4)各时间点镇静镇痛肌松评分;记录术前(t_0)、术始5 min(t_1)、10(t_2)、20(t_3)、30(t_4)、60(t_5)、90(t_6)、120 min(t_7)各时点血流动力学指标。观察实验犬苏醒时间、进食时间。结果与戊巴比妥钠组比较,联合组阿托品、异丙肾上腺素用量显著减少;T4镇静、镇痛、肌松评分均显著降低;t_3~t_7 MAP、HR显著增高;睁眼、进食时间均提早。结论陆眠宁复合戊巴比妥钠保留自主呼吸的全身麻醉对实验犬左心耳封堵术安全可行。

Objective To investigate the anesthetic methods for occlusion o f left atrial appendage in dogs. Methods Twenty-two Labrador dogs undergoing operation for occlusion of left atrial appendage were randomly assigned into combination group and pentobarbital pentobarbital group with 11 animals in each group. Dogs in pentobarbital group received 3% sodium pentobarbital intraperitoneally for anesthesia and those in combination group received the intramuscular injection with 0. 1 ml/kg xylazole and intraperitoneal injection with 0. 5 ml/kg sodium pentobarbital. During the operation mean blood pressure （MBP）, heart rate （HR）, ECG, respiratory rate, blood oxygen saturation were monitored continuously. Ephedrine, atropine and isoproterenol were used to maintain blood pressure and heart rate, respectively. Sedation, pain scale and effects of muscle relaxation were evaluated at 5 min （Tt） , 10 min （T2）, 15 min （T3） and 30 min （T4） after anesthetic injection. Hemodynamic parameters were measured before operation （t0 ）, and at different time points o f intraoperative 5 min （ t1） , 10 min （t2） , 20 min （t3）, 30 min （t4）, 60 min （t5）, 90 min （t6） and 120 min （t7）. The times ofawakening and eating were observed. R e su lts Compared with pentobarbital group, the dosage of atropine and isoproterenol in combination group were significantly reduced. The sedation, analgesia and muscle relaxation scores at T4 were significantly reduced in combination group. MAP and HR at T3 to T7 in combination group were significantly increased, earlier awaking and eating time were observed in the combination group. Conclusion Combined pentobarbital sodium with pentobarbital is safe and feasible for left atrial appendage occlusion operation under general anesthesia with spontaneous respiration in dogs.