Klinische Anwendbarkeit und Praktikabilität von Alfaxalon zur Kurzanästhesie bei der Katze nach Prämedikation mit Buprenorphin^[*]

 

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Zusammenfassung

Ziel dieser Studie war, Praktikabilität und Anwendbarkeit des Injektionsanästhetikums Alfaxalon bei gesunden und erkrankten Katzen zu evaluieren. Im Vordergrund standen Einleitungs-und Aufwachqualität, kardiopulmonale Wirkungen und mögliche Veränderungen bei hämatologischen und blutchemischen Parametern. Material und Methode: Bei 20 felinen Patienten, vorgestellt zu kurzen diagnostischenoder chirurgischen Eingriffen (ASA 1–4), erfolgte eine Anästhesie mit Alfaxalon. Während der Narkose wurden Herz-und Atemfrequenz, endexspiratorischer Kohlendioxidpartialdruck, arterielle Sauerstoffsättigung, mittlerer arterieller Blutdruck und Körperinnentemperatur alle 10 Minuten gemessen und protokolliert. Vor, unmittelbar nach sowie 6 Stunden nach der Anästhesie wurden Blutproben entnommen und hämatologisch sowie blutchemisch untersucht. Die Aufwachphase wurde überwacht und nach einem numerischen Score beurteilt. Ergebnisse: Die Narkoseeinleitung verlief bei allen Patienten ruhig und koordiniert. Die Spontanatmung blieb bei allen Katzen erhalten. Kardiopulmonale Parameter zeigten während der Anästhesie zumeist keine relevanten Veränderungen. Auffällig war eine initial hohe Herzfrequenz (im Durchschnitt > 190/min) nach Narkoseeinleitung, die in den ersten 10 Minuten im Mittel erhöht blieb. Statistisch signifikante Veränderungen (p < 0,05) ergaben sich bei einigen hämatologischen und blutchemischen Parametern sowie dem venösen Säure-Basen-Status, waren jedoch klinisch wenig relevant. Die zwischen 21 und 93 Minuten dauernde Aufwachphase verlief bei den meisten Tieren ruhig. Einige Katzen wiesen milde Anzeichen einer Übererregbarkeit mit Muskelzittern, kurzzeitigem Opisthotonus und Hyperakusis auf. Schlussfolgerung und klinische Relevanz: Alfaxalon eignet sich als Injektionsanästhetikum für Katzen bei kurzen Eingriffen und Behandlungen. Durch seine geringen kardiovaskulären und atemdepressiven Eigenschaften wird es auch von Risikopatienten (ASA 3 und 4) gut toleriert.

Summary

Objective of this clinical study was to assess the anaesthetic quality (induction and recovery) and utility of short term alfaxalone anaesthesia in healthy and diseased cats. Cardiopulmonary effects and the influence on haematological and biochemical blood parameters were evaluated. Material and methods: Twenty feline patients (ASA 1–4) were anaesthetized with alfaxalone for various short surgical or diagnostic procedures. Heart rate, breathing rate, end-tidal CO2 partial pressure, arterial oxygen saturation, mean arterial blood pressure and the body temperature were measured and recorded every 10 minutes. Before, after and 6 hours after anaesthesia venous blood samples were taken and haematologic and blood chemistry parameters were determined. Recovery time and quality were assessed by a numerical rating scale. Results: Anaesthetic induction was rapid and smooth in all cats. Spontaneous respiration was maintained in all cats. Cardiopulmonary parameters mostly remained within a clinically tolerable range. Noticeable was a high heart rate (mean > 190 bpm) at the beginning of anaesthesia lasting up to 10 minutes. Statistically significant changes (p < 0.05) occurred in some haematologic parameters (RBC, haemoglobin, haematocrit and MCV decreased), electrolytes and venous acid-base-status (bicarbonate, chloride and base excess increased, sodium and potassium decreased) and blood chemistry parameters (alanine aminotransferase, glutamate dehydrogenase and creatinine decreased). None of these changes appeared to have clinical relevance. Recovery was smooth in the majority of cats. Mild signs of hyperexcitability (muscle tremor, short term opisthotonus and hyperacusis) occurred in individual animals.The duration of recovery varied between 21 and 93 minutes. Conclusion and clinical relevance: Alfaxalone by repeated intravenous injection is suitable for short-term diagnostic and surgical procedures in cats. Because of its minor cardiovascular effects and slight respiratory depression, it is also well tolerated by patients with increased anaesthetic risk (ASA 3 and 4).

^* Herrn Prof. Dr. Ingo Nolte zum 60. Geburtstag gewidmet.

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