評估Gabapentin, Buprenorphine及Dexmedetomidine於貓隻眼科學檢查之影響及作為子宮卵巢摘除術術前給藥之效用

Evaluation of the Effects of Gabapentin, Buprenorphine, Dexmedetomidine on Ocular Examination, and as a Premedication Drug in Cats Undergoing Ovariohysterectomy

黃泓康(Huang Hung-Kang)

指導教授 ： 鍾承澍

國立屏東科技大學/獸醫學院/獸醫學系所/碩士(2021年)

https://doi.org/10.6346/NPUST202100451

摘要

鎮靜可能會影響到動物的眼科檢查結果，然而針對會主動攻擊或是容易緊張的貓隻，檢查時給予適當的鎮靜是有幫助的，此外術前的鎮靜給藥也可增加術後恢復的品質及止痛的效果。近年來發現口服gabapentin及經口腔粘膜給予buprenorphine、dexmedetomidine對於貓隻可提供良好的鎮靜效果，並具有高安全性及便利性的特性，因此本研究的目的是評估口服gabapentin及經口腔粘膜給予buprenorphine、dexmedetomidine對眼科檢查這些檢查的影響，同時也對探討這些藥物作為子宮卵巢切除術術前給藥之效用。本研究的對象為麻醉風險等級一到二級且沒有眼科異常的貓隻，隨機分配成四組，每組10隻貓，分別給予單次劑量藥物：安慰劑 (CG)、gabapentin (GG, 100 mg/cat, PO)、buprenorphine (BG, 0.04 mg/kg, OTM)或dexmedetomidine (DG, 7.5 μg/ kg, OTM)；分別於藥物作用前後進行眼內壓 (IOP)、淚液分泌量 (STT-I)、瞳孔直徑 (PD)的測量，經子宮卵巢摘除術後，記錄每隻貓拔除氣管內插管後0.5、1、2和4小時的緊迫反應分數、鎮靜分數、疼痛分數、呼吸速率、心跳速率和平均動脈壓。結果顯示DG組在給予藥物後STT-I出現顯著下降；BG組的PD顯著增加。除CG組外，所有組別術後都表現出顯著的抗緊迫作用。GG組有2隻(2/10, 20%)、DG組有4隻(4/10, 40%)、BG組則有1隻(1/10, 10%)需要術後額外追加止痛，而在CG組則不需要另外追加止痛（0/10, 0%）。根據本研究結論，口服gabapentin（100 mg/cat, PO）可以發揮安全有效的抗緊迫效果，能避免貓隻因緊迫恐懼所導致的反抗攻擊行為，對貓隻是適合的眼科檢查前鎮靜藥物。對於術後止痛效果雖無buprenorphine IV術前給藥效果好，但能使術前血管留置針放置的操作較易施作。

關鍵字

貓 ； 鎮靜 ； 眼科檢查 ； 止痛 ； 抗焦慮

並列摘要

Although the sedation may alter the results of ocular examination in animals, it is still inevitable for aggressive or stressful cats. Moreover, the adoption of sedation procedure prior to surgery could improve the recovery quality and analgesia effects during postoperative period. Recently, the appropriate sedative effects were shown by oral gabapentin, and oral transmucosal administration (OTM) of buprenorphine or dexmedetomidine in cats. The characteristics of high safety and convenience were also noted. Therefore, the aim of the study is to evaluate the effects on ocular examination afterof oral gabapentin, and OTM of buprenorphine or dexmedetomidine in cats. Besides, the effects of these medication were evaluated after ovariohysterectomy as well. ASA I–II cats without ophthalmic abnormalities were enrolled. The cats were randomly assigned and administered one of four single-dose treatments: placebo (CG), gabapentin capsules (GG, 100 mg/cat, PO), buprenorphine (BG, 0.04 mg/kg, OTM) or dexmedetomidine (DG, 7.5 μg/ kg, OTM). Intraocular pressure (IOP), Schirmer’s tear test (STT-I), Pupil diameter (PD) were evaluated before and after the medicine onset. The fear responses, sedation level, pain score, respiratory rate (RR), heart rate (HR) and blood pressure (MAP) were scored at 0.5 h, 1 h, 2 h and 4 h after extubation. Forty cats were recruited. Results indicated that STT-I showed a statistically significant reduction in DG; PD was significant increasing in BG. Except CG, all treatment groups displayed notable sedation and anti-stress effect. Four (4/10, 40%) cats in DG, two (2/10, 20%) in GG, one (1/10, 10%) in BG, and 0(0/10, 0%) in CG required rescue analgesia after surgery. This study concludes that oral gabapentin, which induced a safe and stress reducing effect, and avoided the act of resisting attack caused by the cat's urgent fear, is an appropriate sedative medication for cats prior to an ocular examination if necessary. Although the postoperative analgesia results of oral gabapentin was lower than intravenous buprenorphine, it makes the placement of peripheral intravenous catheter prior to surgery easier.

並列關鍵字

Cat ； gabapentin ； buprenorphine ； dexmedetomidine ； sedation ； ophthalmic examination ； analgesia ； anti-anxiety

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