吸入麻醉诱导用于小型猪经口气道建立的研究
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1.武汉大学人民医院麻醉科;2.武汉大学人民医院动物实验中心

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湖北省实验动物资源开发及利用项目(2021DFE029)


Evaluation of Inhalation Anesthesia Induction for Tracheal?Intubation in Miniature Pigs
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Affiliation:

1.Department of Anesthesiology, Renmin hospital of Wuhan university;2.The Animal Experiment Center, Renmin hospital of Wuhan university

Fund Project:

Hubei Province Development and Utilization of Experimental Animal Resources Funding (2021DFE029).

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    摘要:

    目的 制备小型猪实验动物模型是目前医学研究的重要手段。由于小型猪的口咽解剖结构特殊,声门暴露困难,气道的建立是小型猪围术期最关键的步骤,如何在保留自主呼吸的状态下进行气管插管操作,一直是小型猪实验研究领域的热点之一。本研究拟探讨小剂量舒泰肌注复合异氟烷吸入用于保留自主呼吸的小型猪气管插管中的效果,并探讨直接喉镜用于小型猪气管插管时异氟烷吸入半数肺泡气浓度(Minimum alveolar effective inhaled concentrations in 50%,MAC EI50)和95%有效肺泡气浓度(MAC EI95),为实践提供参考。方法 26例全身麻醉手术的巴马小型猪,舒泰肌注进行基础镇静后,专用面罩吸入异氟烷进行麻醉诱导,监测心率、血压、呼吸、体温、氧饱和度、呼末二氧化碳浓度和呼末异氟烷浓度。初始呼末异氟烷浓度设置为2.0%,采用Cooper's评分评价气管插管条件和效果,异氟烷的浓度按改良序贯法增加或减少一级,相邻浓度比为1.1。Probit 回归法计算出小型猪直接喉镜气管插管时异氟烷吸入诱导的肺泡气浓度MAC EI50和EI95及相应的95%可信区间。结果 舒泰基础麻醉复合异氟烷吸入诱导直接喉镜喉镜气管插管时小型猪肺泡气浓度的MAC EI50为3.07%,95% CI为2.70-3.61%;MAC EI95为3.82%,95% CI为3.41-7.49%。结论 舒泰肌注基础镇静复合异氟烷吸入用于保留自主呼吸的小型猪气管插管是建立小型猪经口气道较好且安全的麻醉方法。舒泰复合异氟烷吸入气管插管肺泡气浓度的MAC EI50为3.10%,95% CI为2.79-3.56%;MAC EI95为3.77%,95% CI为3.41-6.42%。

    Abstract:

    Objective Medical Research cannot be separated from miniature pigs animal models. Due to the special anatomical structure of the oropharynx and the glottis is difficult to be exposured by laryngeal, the establishment of the airway is the most critical step in the perioperative period of miniature pigs. How to perform intubation while preserves spontaneous breathing has been one of the hot spots in the experimental research field of miniature pigs. This study intends to investigate the effect of small-dose Zoletil combined isoflurane inhalation in preserved spontaneous breathing endotracheal intubation of miniature pigs and to explore the minimum alveolar effective inhaled concentrations in 50% (MAC EI50) and minimum alveolar effective inhaled concentrations in 95% (MAC EI95) to provide a reference for clinical practice. Methods 26 miniature pigs were plan to be operated under general anesthesia. Anesthesia was conducted by Zoletil intramuscular?inject and isoflurane inhalation. Heart rate, blood pressure, respiration rate, body temperature, oxygen saturation, end-tidal CO2 partial pressure and end-tidal isoflurane concentration were monitored. The initial end-tidal isoflurane concentration was set 2.0% isoflurane increased or decreased according to a modified sequential method with an adjacent concentration ratio of 1.1. Tracheal intubation conditions and efficacy were evaluated by Cooper's score. MAC EI50, MAC EI95 and corresponding 95% CI of alveolar isoflurane concentration during endotracheal intubation with direct laryngoscope was calculated by Probit regression. Results The MAC EI50 of alveolar isoflurane concentration in miniature pigs during endotracheal intubation with direct laryngoscope was 3.07% (95% CI 2.70-3.61%), MAC EI95 was 3.82% (95% CI 3.41-7.49%). Conclusion Small-dose Zoletil combined with isoflurane inhalation is a better and safe anesthesia method for preserved spontaneous breathing endotracheal intubation in miniature pigs. The MAC EI50 of alveolar isoflurane concentration in miniature pigs during endotracheal intubation with direct laryngoscope was 3.07% (95% CI 2.70-3.61%), MAC EI95 was 3.82% (95% CI 3.41-7.49%).

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  • 收稿日期:2023-12-07
  • 最后修改日期:2024-02-07
  • 录用日期:2024-06-19
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