丙泊酚复合硬膜外麻醉对犬麻醉及镇痛效果的评价

发布时间：2018-03-23 22:15

  本文选题：硬膜外麻醉　切入点：丙泊酚　出处：《东北农业大学》2014年硕士论文

【摘要】：目前,应用于犬临床手术中的麻醉方式主要有全身麻醉、局部麻醉,全身麻醉分为吸入麻醉和非吸入麻醉,单纯非吸入性全身麻醉因其安全性及副作用,在临床上单独应用较少。局部麻醉因维持时间较短,麻醉效果不确实,均很少应用。复合麻醉因其起效快、麻醉稳定,苏醒时间短等优点被广泛地应用于犬的临床研究中。以往的研究中复合麻醉主要采用吸入麻醉与静脉麻醉复合的方式,尚不能达到较为理想的效果,而本研究采用静脉麻醉与硬膜外麻醉复合的方法,为犬的复合麻醉提供一个新思路。 本研究采用丙泊酚复合硬膜外利多卡因的复合麻醉方式,通过对药物的注射剂量及给药时间进行摸索,并对麻醉效果,术后镇痛效果及炎症效果的各项指标进行监测同时对该方法在犬临床手术中的可行性进行了探讨。本实验以犬作为实验动物按照麻醉方式不同分为两组,Ⅰ组采用丙泊酚复合硬膜外利多卡因进行麻醉(丙泊酚麻醉诱导量6mg·kg-1,维持剂量0.4mg·kg-1·min-1,麻醉稳定后,硬膜外注射6mg·kg-1的利多卡因)；Ⅱ组作为对照组,采用静脉连续输注丙泊酚麻醉(丙泊酚麻醉诱导量6mg·kg-1,麻醉维持剂量0.71±0.6mg·kg-1·min-1),待麻醉稳定后,分别进行腹部手术,并对比术后镇痛及炎性效果以及麻醉犬的各项功能指标的变化。实验结果如下结果表明： 与单纯丙泊酚组比较,丙泊酚复合硬膜外麻醉组具有更好的麻醉效果,镇痛、镇静和肌松效果良好；对生物反射影响较小,体温(T)、心率(HR)、每分钟呼吸数(RR)的变化平稳,都在生理范围内；平均动脉压(MAP)和血氧饱和度(SpO2)均表现出下降的趋势,但其幅度较对照组小；潮气量(TV)、通气量(MV)和呼吸频率(RR)都下降,但是这些指标的变化都在犬的生理耐受范围之内；与单纯丙泊酚组比较,复合麻醉组的疼痛指标变化幅度较小,表现为P物质(SP)、缓激肽(BK)、前列腺素(PG)、组胺(HIS)指标的变化为先升高后降低；炎性指标的变化表现为肿瘤坏死因子(TNF)、白介素-6(IL-6)、白介素-1(IL-1)、白介素-8(IL-8)的含量先增高后降低,且变化幅度较小,在犬的生理耐受范围内。 综合结果表明,丙泊酚复合硬膜外麻醉组能达到较理想的麻醉及镇痛效果,与单纯输注丙泊酚比较麻醉起效快、镇静、镇痛、肌松效果较好、对呼吸的抑制作用较小,疼痛和炎性指标变化幅度较小,证明复合麻醉可应用于犬的腹部手术。
[Abstract]:At present, the main anesthetic methods used in canine clinical surgery are general anesthesia, local anesthesia, general anesthesia is divided into inhalation anesthesia and non-inhalation anesthesia, simple non-inhaled general anesthesia because of its safety and side effects. Local anesthesia is less effective and stable because of its short maintenance time and inaccurate anesthetic effect. The advantages of short recovery time have been widely used in the clinical study of dogs. In the previous studies, the compound anesthesia mainly adopted the combination of inhalation anesthesia and intravenous anesthesia, which could not achieve a more ideal effect. In this study, intravenous anesthesia and epidural anesthesia were used to provide a new idea for canine compound anesthesia. In this study, propofol combined with epidural lidocaine was used as a compound anaesthesia. The effect of postoperative analgesia and inflammation were monitored and the feasibility of this method in canine clinical operation was discussed. Dogs as experimental animals were divided into two groups according to different anesthetic methods. Group 鈪，

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