臺灣博碩士論文加值系統

剖腹產是臨床獸醫師常做的手術，然而麻醉劑對母犬之制動效果以及新生仔犬活力之影響更是大家所關切的話題。在文獻探討的過程中，我們發現其中影響最大的是麻醉藥物之選擇。臨床上，可用於剖腹產之麻醉藥物種類繁多，但大多對新生仔犬的活力都有相當程度的抑制作用。根據文獻報告，Guaifenesin可以通過胎盤，但對胎兒作用極為有限，故本研究以11隻實驗母犬 ( 實驗組7隻，對照組4隻 )，進行自然交配、受孕；即將分娩時，實驗組以Acepromazine - guaifenesin靜脈注射，對照組則以 2％ Lidocaine 作硬膜外腔麻醉進行剖腹產，手術期間評估母犬之理學、血液學及血液生化學變化；此外，亦進行新生仔犬活力之評估，並於仔犬出生後2分鐘，2小時及7天，分別觀察其呼吸、活動狀態、和哭叫聲來評估其活力指數。實驗結果，實驗組仔犬33隻，對照組仔犬13隻中，實驗組之活力指數平均值在出生後2分鐘為5.39 ± 0.56，出生後2小時為5.70 ±0.53，出生後7天為5.82 ± 1.04，對照組在出生後2分鐘為4.85 ± 0.38，出生後2小時為5.23 ± 0.60，出生後7天為5.00 ± 1.58；綜合分析結果發現兩組間的仔犬活力具有顯著差異 ( P < 0.05 )。由實驗結果得知 Acepromazine - Guaifenesin對母犬的制動效果雖不理想，但對新生仔犬的活力而言卻較硬膜外腔麻醉為佳。

Cesarean section is a common surgery for small animal practitioner. Good immobility for the dam with minimal or no suppressive on the new-born is an ideal anesthetic drug for the surgery. There are many anesthetics for Cesarean section, but most of them are suppressive to the fetus. Some reference note that guaifenesin may cross the placenta, but has little effect on the fetus. So we used 11 pregnant bitches ( 7 for experiment, 4 for control ) to do the anesthetic experiment for Cesarean section. In the experiment, 7 pregnant bitches were anesthetized by intravenous injection of acepromazine and guaifenesin . In the control, 4 dams were done the surgery by epidural anesthesia. Physical examination, hematology and blood chemistry were checked for the dams; while the new-borns were checked viability of 2 minutes, 2 hours, and 7 days after birth. The valuation items of fetal viability were breathing, movement, and crying. The results showed that the immobility of guaifenesin was not good, but the viability of the new-borns was much better then epidural anesthesia.

目 錄
中文摘要........................................................................................................ Ⅰ
英文摘要........................................................................................................ Ⅱ
誌謝................................................................................................................ Ⅲ
目錄................................................................................................................ Ⅳ
圖表目錄........................................................................................................ Ⅵ
第1章 前言.................................................................................................... 1
第2章 文獻回顧............................................................................................ 3
2. 1 Guaifenesin之介紹................................................................................ 3
2. 1. 1 Guaifenesin之理化性狀................................................................ 3
2. 1. 2 Guaifenesin之投予方式及作用時間............................................ 4
2. 1. 3 Guaifenesin之藥理學.................................................................... 4
2. 1. 4 Guaifenesin之藥物動力學............................................................ 5
2 1. 5 Guaifenesin之藥物配伍禁忌........................................................ 5
2. 1. 6 Guaifenesin之治療劑量與副作用................................................ 5
2. 1. 7 Guaifenesin 過量投予之臨床症狀............................................... 6
2. 1. 8 Guaifenesin於醫藥上之使用........................................................ 6
2. 1. 8. 1 Guaifenesin運用於人類之醫療............................................ 6
2. 1. 8. 2 Guaifenesin運用於大動物之醫療........................................ 6
2. 1. 8. 3 Guaifenesin運用於犬之醫療................................................ 7
2. 2 Acepromazine maleate........................................................................... 7
2. 2. 1 Acepromazine之藥理學................................................................ 7
2. 2. 2 Acepromazine之給予方式及作用時間........................................ 9
2. 2. 3 Acepromazine之吸收、代謝.......................................................... 9
2. 2. 4 Acpromazine的配伍禁忌.............................................................. 9
2. 2. 5 Acepromazine之副作用............................................................... 10
2. 3 剖腹產的麻醉管理.............................................................................. 10
2. 3. 1 懷孕期間的生理變化.................................................................. 11
2. 3. 2 剖腹產的麻醉方式...................................................................... 12
2. 3. 3 仔犬活力評估之探討.................................................................. 13
第3章 材料與方法..................................................................................... 15
3. 1 實驗材料............................................................................................ 15
3. 1. 1 實驗犬......................................................................................... 15
3. 1. 2 藥品.............................................................................................. 15
3. 1. 3 儀器及其相關器材...................................................................... 15
3. 2 Guaifensin 之配製............................................................................. 17
3. 3 母犬懷孕之檢測................................................................................ 17
3. 3. 1 陰道抹片檢查.............................................................................. 17
3. 3. 2 超音波影像學檢查...................................................................... 17
3. 3. 2. 1 動物之準備.......................................................................... 17
3. 3. 3 X-光影像學檢查.......................................................................... 17
3. 3. 4 母犬體溫監控.............................................................................. 18
3. 3. 5 血液及血漿學檢查...................................................................... 18
3. 3. 6 麻醉期間母犬體溫、脈搏、呼吸、血氧濃度及心縮壓之測量 19
3. 3. 6. 1 麻醉期間血壓測量的方式...................................................... 19
3. 4 仔犬之監測........................................................................................ 19
3. 4. 1 仔犬之接生.................................................................................. 19
3. 4. 2 仔犬之活力評估.......................................................................... 19
3. 5 實驗方法............................................................................................ 20
3. 5. 1 實驗分組..................................................................................... 20
3. 6 統計分析............................................................................................ 20
第4章 結果................................................................................................ 22
4. 1 剖腹產前後血液學及血漿生化學變化............................................ 22
4. 2 麻醉期間母犬溫度、脈搏、呼吸、血氧濃度、心縮壓之變化........... 25
4. 3 仔犬的活力評估結果........................................................................ 36
第5章 討論................................................................................................. 38
參考文獻......................................................................................................... 43
附錄................................................................................................................. 50
作者簡介......................................................................................................... 56


圖表目錄
Fig. 1 Comparsion of systolic blood pressure of the pregnant bitches between acepromazine - guaifenesin intravenous anesthesia ( experimental group ) and lidocaine epidural anesthesia ( control group )............................................................................................... 31
Fig. 2 Comparsion of blood oxygen concentration of the pregnant bitches between acepromazine - guaifenesin intravenous anesthesia ( experimental group ) and lidocaine epidural anesthesia ( control group )............................................................................................... 32
Fig. 3 Comparsion of respiratory rates of the pregnant bitches between acepromazine - guaifenesin intravenous anesthesia ( experimental group ) and lidocaine epidural anesthesia ( control group ).............. 33
Fig. 4 Comparsion of pulse rates of the pregnant bitches between acepromazine - guaifenesin intravenous anesthesia ( experimental group ) and lidocaine epidural anesthesia ( control group ).............. 34
Fig. 5 Comparsion of body temperature of the pregnant bitches between acepromazine - guaifenesin intravenous anesthesia ( experimental group ) and lidocaine epidural anesthesia ( control group ).............. 35
Fig. 6 Comparison of activity scores for the puppies delivered by Cesarean section, whose the dams were anesthetized by the two different anesthetic protocols........................................................... 37
Table 1 Hematology of the pregnant bitches under intravenous anesthesia with acepromazine-guaifenes in for Cesarean section..................... 23
Table 2 Hematology of the pregnant bitches under epidural anesthesia with lidocaine for Cesarean section.......................................................... 24
Table 3 Blood chemistries of the pregnant bitches under intravenous anesthesia with acepromazine-guaifenesin for Cesarean section...... 24
Table 4 Blood chemistries of the pregnant bitches under epidural anesthesia with lidocaine for Cesarean section................................. 25
Table 5 Systolic blood pressure of the pregnant bitches during the anesthetic period............................................................................... 26
Table 6 Blood oxygen concentration of the pregnant bitches during the anesthetic period............................................................................... 27
Table 7 Respiratory rates of the pregnant bitches during the anesthetic period................................................................................................ 28
Table 8 Pulse rate of the pregnant bitches during the anesthetic period................................................................................................ 29
Table 9 Body temperature of the pregnant bitches during the anesthetic period................................................................................................ 30
Table 10 Evaluation of the fetal activity......................................................... 36
Reference Table 1. Anesthetic techniques by species...................................... 51
Reference Table 2. Apgar scores test................................................................ 54

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