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National Chung Hsing University Institutional Repository - NCHUIR > 獸醫學院 > 獸醫學系所 > 依資料類型分類 > 碩博士論文 >  評估單獨使用Dexmedetomidine或Nalbuphine或合併Dexmedetomidine與Nalbuphine在兔子的鎮靜止痛效果以及生理的影響

Please use this identifier to cite or link to this item: http://nchuir.lib.nchu.edu.tw/handle/309270000/155286

標題: 評估單獨使用Dexmedetomidine或Nalbuphine或合併Dexmedetomidine與Nalbuphine在兔子的鎮靜止痛效果以及生理的影響
Evaluation of the sedative, analgesic, and physical effects of dexmedetomidine, nalbuphine, and dex-medetomidine-nalbuphine in rabbits
作者: 廖耿儀
Liao, Keng-I
Contributors: 董光中
Kwong-Chung Tung
獸醫學系暨研究所
關鍵字: 兔子;麻醉;鎮靜;腎上腺素致效劑
rabbit;dexmedetomidine;nalbuphine;sedation
日期: 2013
Issue Date: 2013-11-21 11:49:31 (UTC+8)
Publisher: 獸醫學系暨研究所
摘要: 近年來,兔子被廣泛當作寵物飼養,故帶寵物兔前來就診的民眾也逐漸增加。由於兔子容易對保定的行為感到緊迫,而產生激烈的掙扎以及踢腿,導致脊椎或後腿骨折等傷害,所以視治療的需要,進行適當的鎮靜有助於實行臨床的檢查或小型手術,例如拍攝X光,口腔檢查或修剪牙齒。在選擇鎮藥物方面,dexmedetomidine 為α2的腎上腺性受器致效劑,具有良好的鎮靜、放鬆肌肉,以及止痛的效果。雖有顯著心血管的抑制,然而在呼吸的副作用小。Nalbuphine 屬於作用於鴉片類受器的止痛劑,致效於kappa鴉片類受器,拮抗mu鴉片類受器。在人可以使用在牙科方面的止痛,且呼吸抑制小。在兔子身上亦有止痛效果。而合併α2的腎上腺素性受器致效劑與制效kapp受器,拮抗mu受器的混合型鴉片類藥物,其鎮靜與止痛效果增強。故本實驗嘗試合併使用dexmedetomidine 和nalbuphine兩者,評估其效果並比較單獨使用dexmedetomidine以及nalbuphine的鎮靜與止痛效果以及生理的影響。
本研究共使用七隻紐西蘭大白兔,使用交叉試驗(crossover design)和盲試驗(blind test)。每隻兔子接受五組劑量如下:water+0.04mg/kg dexmedetomidine(WD2)、1mg/kg nalbuphine+0.025mg/kg dexmedetomidine(ND)、water+0.025mg/kg dexmedetomidine(WD)、1mg/kg nalbuphine+water(NW),water1+water2(WW)。五組皆為靜脈注射,每組間隔兩個禮拜。注射後每五分鐘測量其生理數值及鎮靜止痛指數。結果顯示,注射後5分鐘及10分鐘後,WD2組鎮靜指數高於其它各組。但在第15分鐘,ND組鎮靜指數高於WD組,其中顎張力消失程度ND組高於WD組。在WD2組有最長的鎮靜作用時間。在止痛方面,WD2組在十五分鐘止痛指數高於WD組。然而在NW與WW組皆無觀察到有明顯鎮靜及止痛指數。在生理數值方面,WD2、ND、WD在鎮靜期的心搏速率皆低於基礎值,其中注射高劑量的dexmedetomidine的WD2組更低於其它組。WD2、ND、WD三組其平均動脈壓以及收縮壓皆有低於基礎值的趨勢。在呼吸方面的影響,ND組的呼吸速率低於基礎值且低於其它組,然而在血氧濃度與其它組無顯著差異。WD2、ND、WD在15分鐘時體溫皆下降。
綜合以上結果,WD2組的鎮靜效果最好及鎮靜作用時間最長,但心跳抑制卻也高於各組。而ND組比起WD組的鎮靜效果較佳,雖然在呼吸速率低於其它組別,但血氧濃度未有降低的趨勢。ND與WD兩組鎮靜時間並無明顯差異。雖然還要評估臨床上使用的效果,但推測若需短時間的鎮靜,可使用dexmedetomidine合併nalbuphine的劑量,其鎮靜效果較佳。若需較長時間且較深層的鎮靜,可使用高劑量的dexmedetomidine。但需注意心血管抑制的副作用,以及給予保溫,且鎮靜時期皆需給予氧氣。以改善呼吸抑制的影響。未來仍須更多臨床的使用資料,才能確立本實驗劑量在臨床的使用效果。
Recently, rabbits gradually become popular pets, so more people take them to the hos-pital for their healthy. Because the rabbits are sensitive to forceful handling and other medical process, they may kick or struggle violently. That may cause spinal fracture or other traumatic injury. Therefore, good sedation can reduce risks and may be sufficient for some medical procedure, including radiography, dental treatment, and dental examination. Dexmedetomidine is the α2-adrenoceptor agonist, providing good sedation, muscle re-laxation, and analgesia. It has notable cardiovascular effect and limited respiratory inhi-bition. Nalbuphine is primarily a kappa agonist/partial mu antagonist. In humans, it was used for oral surgery with minimal respiratory inhibition. It also provides analgesia in rabbits. Combination of α2-adrenoceptor agonist and a kappa agonist/partial mu antago-nist provides better sedation and analgesia. The first objective of the study is to evaluate the sedative and analgesic effects of dexmedetomidine, nalbuphine and the combination of dexmedetomidine and nalbuphine. The second objective of the study was to evaluate and compare the cardiovascular and pulmonary effects of these groups in rabbits. This study is a crossover design with blind test. Seven rabbits were used. Each rabbit received intravenous five different dose groups which were WD2(water + 0.04mg/kg dexme-detomidine), ND(1mg/kg nalbuphine + 0.025 dexmedetomidine), WD(water + 0.025mg/kg dexmedetomidine), NW(1mg/kg nalbuphine + water) and WW(water1 + water2). These groups were separated by period of 14 days. The sedation score, analge-sia score, and the data of physical examination were recorded after injection. The result appeared that sedative score of WD2 group was highest within 5 and 10 minutes after injection in all groups. WD2 also had the longest period of sedation. At 15 minutes, the sedative score of ND group was higher than WD, NW, or WW group, but there were no significant differences in sedation scores between WD2 and ND group. Moreover, jaw muscle relaxation of ND group was better than WD in 15 minutes. The analgesic score of WD2 group was higher than WD at 15 minute. However, NW and WW group had no significant sedative and analgesic effect. The heart rates of WD, ND, and WD2 group decreased significantly, especially for WD2 group which showed lowest heart rate in all groups. Their mean arterial pressures and systolic blood pressures also were lower than their baselines. Respiratory rate of ND group was lowest in all groups, but there was not a significant difference among treatments for Spo2 values. The rectal temperatures of WD, ND, and WD2 group decreased within 15 minutes after injection. In conclusion, WD2 group provides greatest sedative effect and longest sedation time, but the lowest heart rate. ND group has better effect and longer sedation time than WD group, alt-hough the lowest respiratory rate. There was not a significant difference among treat-ments for Spo2 values. According to these results, we expect that we may use the com-bination of nalbuphine and dexmedetomidine if rabbits need short sedation. When rab-bits need longer or deeper sedation, 0.04mg/kg dexmedetomidine should be used. Rab-bits also need oxygen support and remain body temperature during the period of seda-tion, however, we still need further research for clinical use.
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