Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
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Effect of Glycopyrrolate on Cardiovascular System in Dogs Sedated with Medetomidine-Midazolam Combination

개에서 Medetomidine과 Midazolam 병용 투여 시 Glycopyrrolate가 심맥관계에 미치는 영향

  • Han, Dae-Kyung (College of Veterinary Medicine.Research Institute of Veterinary Medicine, Chungnam National University) ;
  • Shin, Beom-Jun (College of Veterinary Medicine.Research Institute of Veterinary Medicine, Chungnam National University) ;
  • Lee, Jae-Yeon (College of Veterinary Medicine.Research Institute of Veterinary Medicine, Chungnam National University) ;
  • Jee, Hyun-Chul (College of Veterinary Medicine.Research Institute of Veterinary Medicine, Chungnam National University) ;
  • Park, Ji-Young (College of Veterinary Medicine.Research Institute of Veterinary Medicine, Chungnam National University) ;
  • Kim, Myung-Cheol (College of Veterinary Medicine.Research Institute of Veterinary Medicine, Chungnam National University) ;
  • Jeong, Seong-Mok (College of Veterinary Medicine.Research Institute of Veterinary Medicine, Chungnam National University)
  • 한대경 (충남대학교 수의과대학.동물의과학연구소) ;
  • 신범준 (충남대학교 수의과대학.동물의과학연구소) ;
  • 이재연 (충남대학교 수의과대학.동물의과학연구소) ;
  • 지현철 (충남대학교 수의과대학.동물의과학연구소) ;
  • 박지영 (충남대학교 수의과대학.동물의과학연구소) ;
  • 김명철 (충남대학교 수의과대학.동물의과학연구소) ;
  • 정성목 (충남대학교 수의과대학.동물의과학연구소)
  • Published : 2009.08.31
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Abstract

This study was performed to evaluate the effect of intravenous administration of glycopyrrolate on cardiovascular and respiratory system in dogs given intravenous medetomidine (20 ${\mu}g$/kg) and intramuscular midazolam (0.3 mg/kg) (MM). Prior to administration of MM, glycopyrrolate was administered intravenously at doses of 5 ${\mu}g$/kg (Gly-5), 10 ${\mu}g$/kg (Gly-10) or 20 ${\mu}g$/kg (Gly-20), respectively. For the control group saline was administered intravenously. In the cardiovascular system, HR, BP, RAP, PAWP, CI, SI, SVR, and PVR were measured. RR, $V_T$, $P_{ETCO2}$, and arterial blood gas analysis were measured for respiratory system. Although rapid and satisfied depth of sedation was obtained by MM, life-threatening bradycardia, the outstanding side-effect on cardiovascular system in dogs were observed. This combination also decreased CO and increased SVR, RAP, and PAWP significantly. The bradycardia could be prevented in all the glycopyrrolate treated groups, but tachycardia was observed in Gly-10 and Gly-20 groups. Significant increases in blood pressure were shown in glycopyrrolate treated groups. Also, tachycardia depends on dose of glycopyrrolate, compensating the CO. However, these were not fully reserved. In conclusion, MM combination could induce rapid and satisfied depth of sedation but was not the suitable method for the deep sedation of dogs with cardiovascular or circulatory problems.

이 연구는 혈관 내로 medetomidine (20 ${\mu}g$/kg)을 투여하고, 근육 내로 midazolam (0.3 mg/kg)을 투여한 개에서 혈관 내로 glycopyrroate를 투여하였을 때 심혈관계와 호흡기계에 미치는 영향을 평가하기 위해 실시하였다. 임상적으로 건강한 16마리의 중성화 하지 않은 비글견 (BW: 평균 8.35 kg)이 사용되었다. 혈관 내로 medetomidine과 근육내로 midazolam을 투여하기 전에 glycopyrrolate를 5 ${\mu}g$/kg (Gly-5), 10 ${\mu}g$/kg (Gly-10), 또는 20 ${\mu}g$/kg (Gly-20)의 용량으로 혈관 내로 투여하고, 대조군은 생리식염수를 혈관 내로 투여하였다. 심박수, 혈압(수축기 동맥압, 이완기 동맥압, 평균 동맥압), 우심방 동맥압, 폐동맥압, 폐동맥 쐐기압, 호흡수, 일회호흡량, 호기말 이산화탄소 분압을 환축감시기를 통해 직접 측정하였다. 심박출량을 측정하고, 계산공식으로 심박출계수, 일회심박출지수, 전신혈관 저항, 폐혈관 저항을 산출했다. 동맥혈을 채취하여 동맥혈 가스를 분석기로 분석하였다. Medetomidine/midazolam병용 투여의 부작용으로 심혈관계에서 서맥이 나타나고, 심박출량 감소와 전신혈관저항, 우심방압, 폐동맥 쐐기압은 증가 현상을 보였다. 서맥은 glycopyrrolate를 투여한 군에서는 나타나지 않았다. 그러나 Gly-10, Gly-20군에서는 빈맥이 관찰되었다. 전반적으로 glycopyrrolate를 투여한 군에서는 혈압은 상승하였으나, Gly-5 군의 경우 대조군과 유의적인 차이는 없었다. 심박출량 지수는 Gly-20군을 제외한 모든 군에서 medetomidine/ midazolam병용 투여 10분과 20분에 큰 차이는 보이지 않았다. 이상의 결과로 medetomidine/midazolam병용 투여는 빠르고 만족할 만한 진정을 보여주나, 현저한 심혈관 부작용이 관찰되고 혈관 내로 glycopyrrolate를 투여에 의해서도 큰 역전을 보이지 않는다. 이러한 결과로 medetomidine/midazolam병용 투여는 심폐기능 변화에 적응할 수 있는 건강한 개에서만 고려될 수 있는 방법이라고 생각된다.

Keywords

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