臺灣博碩士論文加值系統

台灣黑眉曙蛇(黑眉錦蛇)是台灣的保育類物種，由於生活環境與人類重疊性高，常會遭到誤傷或是捕捉，是救傷單位常見的蛇種。野生蛇類較掙扎且容易扭動，進行醫療處置時施予鎮靜或麻醉能降低蛇隻緊迫並減少操作時間，提升醫療照護水準。進行爬蟲類麻醉具有很大的挑戰性，因為他們的生理與解剖構造都與哺乳類差異極大。Alfaxalone(A)是一種合成神經性類固醇藥物，能提供良好的肌肉放鬆效果且對心肺功能的抑制較小，可以靜脈或肌肉注射使用，只是單次所需注射的藥量較大。Dexmedetomidine(D)為高度選擇性的α2腎上腺素型受體致效劑，具有鎮靜與止痛作用。若能合併這兩種藥物使用，希望能達到減少藥量與藥物副作用的效果。
由於蛇類鎮靜麻醉相關的研究較缺乏，希望能尋找適合的藥物，以期達到更佳的醫療效率。本實驗的研究目的是評估合併使用D與A兩種藥物在黑眉錦蛇的效果。實驗共使用二十隻黑眉曙蛇，共有三組不同劑量之麻醉，每組會隨機選擇十隻曙蛇進行實驗，劑量組合分別為(1) 10 mg/kg A + 0.05 mg/kg D (10A+0.05D) (2) 10 mg/kg A + 0.1 mg/kg D (10A+0.1D) (3) 20 mg/kg A + 0.05 mg/kg D (20A+0.05D)，藥物以肌肉注射於曙蛇前三分之一段之軸上肌群，結果顯示10A+0.1D與20A+0.05D可以達到中度至深度鎮靜；10A+0.05D只有輕微鎮靜效果。10A+0.1D與20A+0.05D平均鎮靜效果約39與37分鐘，大部分蛇隻可進行插管。20A+0.05D組可以快速導入且鎮靜效果最穩定，10A+0.1D麻醉回復時間與總實驗時間的個體差異較大。三個組別皆會造成一定程度的心跳減緩與呼吸抑制。結論為肌肉注射給予20A+0.05D，在黑眉曙蛇可以達到有效且穩定的鎮靜效果並能進行插管。

The Beauty Snake (Orthriophis taeniurus friesei) is a protected species in Taiwan. Due to the overlapping habitat with human activities, the beauty snake often received inexplicable injuries and became a common rescued species in Taiwan. Therefore, immobilization or anesthesia of the beauty snake may be necessary for some medical procedures. Anesthesia of snakes can be challenging because of the unique anatomical and physiological structure. Alfaxalone is a synthetic neuroactive steroid which provides good muscle relaxation and has minimal cardio-respiratory side effects. Alfaxalone can be administered via the intramuscular access but may be limited by large volume. Dexmedetomidine is an alpha-2 adrenergic receptor agonist which provides sedation and analgesia. The combination of dexmedetomidine may reduce the required dose of alfaxalone for anesthesia.
The aim of this study is to evaluate the effects of dexmedetomidine (D)-alfaxalone (A) on the beauty snakes. Twenty beauty snakes were used in the study and randomly assigned to one of three different protocols, ten snakes were involved in each protocol: (1) 10 mg/kg A + 0.05 mg/kg D (10A+0.05D) (2) 10 mg/kg A + 0.1 mg/kg D (10A+0.1D) (3) 20 mg/kg A + 0.05 mg/kg D (20A+0.05D). The drugs was administrated intramuscularly to the epaxial muscles in the cranial half of the body. The results showed that intramuscular administration of 10A+0.05D and 20A+0.05D can provided moderate to deep sedative effect while 10A+0.05D provided only mild sedation. 10A+0.1D and 20A+0.05D provided average sedative effects of 39.37 ± 36.63 and 37.17 ± 20.65 minutes duration and most of the snakes were appropriate for intubation. The group 20A+0.05D provided rapid induction and stable effect. There was a large standard deviation of group 10A+0.1D in recovery and total sedation time, which was be due to the individual differences. Respiratory depression and mild decrease in the heart rate had been noticed in all groups. The conclusion is that combination of 20A+0.05D intramuscularly induced stable sedation and was appropriate for intubation.

摘要………………………………………………………………………………… i
Abstract…………………………………………………………………………… ii
目次………………………………………………………………………………… iii
表目次……………………………………………………………………………… v
圖目次……………………………………………………………………………… vi
第一章 緒言………………………………………………………………………… 1
第二章 文獻探討…………………………………………………………………… 2
第一節 黑眉曙蛇介紹……………………………………………………………… 2
一、科學分類………………………………………………………………………… 2
二、外型特徵………………………………………………………………………… 2
三、食性……………………………………………………………………………… 2
四、棲地類型………………………………………………………………………… 2
第二節 生理構造介紹……………………………………………………………… 3
一、感官……………………………………………………………………………… 3
二、表皮系統與脫皮……………………………………………………………… 4
三、溫度調節……………………………………………………………………… 4
四、解剖構造……………………………………………………………………… 5
五、呼吸系統……………………………………………………………………… 5
六、心血管系統…………………………………………………………………… 6
七、消化系統……………………………………………………………………… 6
八、泌尿系統……………………………………………………………………… 7
九、生殖系統……………………………………………………………………… 7
第三節 爬蟲類鎮靜與麻醉………………………………………………………… 8
一、鎮靜前準備…………………………………………………………………… 8
二、鎮靜與麻醉…………………………………………………………………… 9
三、麻醉監控……………………………………………………………………… 12
第四節 藥物簡介…………………………………………………………………… 13
一、Dexmedetomidine……………………………………………………………… 13
二、Alfaxalone……………………………………………………………………… 17
三、Alfaxalone與dexmedetomidine的合併使用………………………………… 20
第三章 材料與方法………………………………………………………………… 21
第一節 實驗動物…………………………………………………………………… 21
一、實驗動物介紹………………………………………………………………… 21
二、飼養環境……………………………………………………………………… 21
三、實驗動物性別與體重……………………………………………………… 21
第二節 實驗設計………………………………………………………………… 22
一、實驗目的………………………………………………………………………… 22
二、實驗藥物………………………………………………………………………… 22
三、藥物注射方式…………………………………………………………………… 23
四、實驗前測試…………………………………………………………………… 23
五、實驗設計……………………………………………………………………… 23
六、實驗監控………………………………………………………………………… 24
七、統計分析方法…………………………………………………………………… 27
第四章 結果………………………………………………………………………… 28
一、實驗前測試……………………………………………………………………… 28
二、致鎮靜時間……………………………………………………………………… 29
三、鎮靜總時間……………………………………………………………………… 30
四、回復時間………………………………………………………………………… 31
五、麻醉總時間…………………………………………………………………… 32
六、各組間對反射的影響…………………………………………………………… 33
七、各組間插管比例與平均時間………………………………………………… 34
八、各組間對呼吸的影響………………………………………………………… 35
九、各組間對心跳的影響………………………………………………………… 36
十、各組間對痛覺反應的影響…………………………………………………… 37
第五章 討論………………………………………………………………………… 39
參考文獻…………………………………………………………………………… 43

1.曾家豪。評估使用 Dexmedetomidine 於食蛇龜之鎮靜作用。中興大學獸醫學系暨研究所學位論文。台中市，中華民國。2014。
2.蔣馨儀、柯依廷、馮啟文、董光中、楊志寰。Zoletil、Zoletil-Medetomidine和Zoletil-Xylazine於斑龜之麻醉作用。中華民國獸醫學會，九十六年度春季學術研討會：9, 2007。
3.楊甯雅。評估Tiletamine-zolazepam、Medetomidine-tiletamine-zolazepam和Xylazine-tiletamine-zolazepam於綠鬣蜥的麻醉效果及Atipamezole和Yohimbine的翻轉作用。國立中興大學碩士論文。台中市，中華民國。2009。
4.Aantaa R, Kallio A, Virtanen R. Dexmedetomidine, a novel a2-adrenergic agonist. A review of its pharmacodynamic characteristics. Drugs Future. 1993; 18: 49–56.
5.Anderson N, Wack R, et al. Cardiopulmonary effects and efficacy of propofol as an anesthetic agent in brown tree snakes, Boiga irregularis. Bull Assoc Reptilian Amphib Vet. 1999; 9: 9–15.
6.Ansah OB, Raekallio M, Vainio O. Comparison of three doses of dexmedetomidine with medetomidine in cats following intramuscular administration. J Vet Pharmacol Ther.1998a; 21: 380–387.
7.Ansah OB, Raekallio M, Vainio O. Comparing oral and intramuscular administration of medetomidine in cats. J Vet Anaesth 1998b; 25: 41–46.
8.Arena P, Richardson K, Cullen L. Anaesthesia in two species of large Australian skink. Vet Rec. 1988; 123: 155–158.
9.Barletta, Michele, et al. Evaluation of dexmedetomidine and ketamine in combination with opioids as injectable anesthesia for castration in dogs. J Am Vet Med Assoc. 2011; 238.9: 1159-1167.
10.Bellairs A, Weidenfeld and Nicolson. Nervous system, psychology and sex organs. The life of reptiles. 1969; 2: 332–390.
11.Bennett RA. Neurology. In Mader DR, ed. Reptile medicine and surgery. WB Saunders, Philadelphia.1996; 141–148.
12.Bennett RA, Schumacher J, et al. Cardiopulmonary and anesthetic effects of propofol administered intraosseously to green iguanas. J Am Vet Med Assoc. 1998; 212: 93-98.
13.Bertelsen MF. Squamates (lizards and snakes). In West G, Heard D, Caulkett N, ed. Zoo Animal and Wildlife Immobilization and Anesthesia. Ames, IA, Blackwell Publishing. 2007; 233-244
14.Bertelsen MF, Sauer CD. Alfaxalone anaesthesia in the green iguana (Iguana iguana). Vet Anaesth Analg. 2011; 38:461-466.
15.Bettschart‐Wolfensberger R, Freeman SL, et al. Cardiopulmonary effects and pharmacokinetics of IV dexmedetomidine in ponies. Equine Vet J. 2005; 37: 60–64.
16.Blanshard W, Bodley K. Koalas. In Vogelnest L, Woods R, eds. Medicine of Australian Mammals. Csiro Publishing, Collingwood, Vic, 2008: 227-327.
17.Bloor BC, Frankland M, et al. Hemodynamic and sedative effects of dexmedetomidine in dog. J Pharm Exp Ther. 1992; 263: 690–697.
18.Bouts, Tim, et al. Evaluation of medetomidine-alfaxalone and medetomidine-ketamine in semi-free ranging Bennett's wallabies (Macropus rufogriseus). Journal of Zoo and Wildlife Medicine. 2011; 42.4: 617-622.
19.Chittick EJ, Stamper MA, et al: Medetomidine, ketamine, and sevoflurane for anesthesia of injured loggerhead sea turtles: 13 cases (1996-2000). J Am Vet Med Assoc. 2002; 221:1019-1025.
20.Coulthard P. Conscious sedation guidance. Evid Based Dent. 2006; 7: 90-91.
21.Cullen LK. Medetomidine sedation in dogs and cats: a review of its pharmacology, antagonism and dose. Br Vet J. 1996; 152: 519–535.
22.Denardo D. Reproductive Biology. In Mader DR, ed. Reptile Medicine and Surgery 2nded. Saunders Elsevier, Missouri. 2006; 376-390
23.Dennis PM, Heard DJ. Cardiopulmonary effects of a medetomidine-ketamine combination administered intravenously in gopher tortoises. J Am Vet Med Assoc. 2002 220: 1516-1519.
24.Dohm L, Brunson D. Effective dose of isoflurane for the desert iguana (Diposaurus dorsalis) and the effect of hypothermia on effective dose. Proc Am Col Vet Anesth. 1998; 543.
25.Eatwell, Kevin. Options for analgesia and anaesthesia in reptiles. In practice 2010; 32.7: 306.
26.Escobar A, Pypendop BH, Siao KT, et al. Effect of dexmedetomidine on the minimum alveolar concentration of isoflurane in cats. J Vet Pharmacol Ther. 2011; 35: 163–168.
27.Fournier-Chambrillon C, Chusseau J, et al.Immobilization of free-ranging European mink (Mustela lutreola) and polecat (Mustela putorius) with medetomidine-ketamine and reversal by atipamezole. J Wildl Dis. 2003; 39: 393-399.
28.Funk, RS. Biology – snakes. In Mader DR, ed. Reptile medicine and surgery. Philadelphia, WB Saunders. 1996; 39–46.
29.Gilron I, Coderre TJ. Preemptive analgesic effects of steroid anesthesia with alphaxalone in the rat formalin test. Anesthesiology. 1996; 84: 572-579.
30.Giovannitti J, Joseph A, et al. "Alpha-2 adrenergic receptor agonists: a review of current clinical applications." Anesthesia progress 62.1 (2015): 31-38.
31.Goodwin, Wendy A, et al. The pharmacokinetics and pharmacodynamics of the injectable anaesthetic alfaxalone in the horse. Vet Anaesth Analg. 2011; 38.5: 431-438.
32.Granholm, Mikael, et al. Evaluation of the clinical efficacy and safety of dexmedetomidine or medetomidine in cats and their reversal with atipamezole. Vet Anaesth Analg. 2006; 33.4: 214-223.
33.Green C, Knight J, Precious S, et al. Ketamine alone and combined with diazepam or xylazine in laboratory animals: a 10 year experience. Lab Anim 1981; 15: 163–170.
34.Greer LL, Jenne KJ, Diggs HE. Medetomidine-ketamine anesthesia in red-eared slider turtles (Trachemys scripta elegans). Contemp Top Lab Anim Sci. 2001; 40:9-11.
35.Grimm, Kurt A., et al. eds. Veterinary anesthesia and analgesia. John Wiley & Sons. 2015.
36.Grubb, T.L., Greene, S.A., et al. Cardiovascular and respiratory effects, and quality of anesthesia produced by alfaxalone administered intramuscularly to cats sedated with dexmedetomidine and hydromorphone. J Feline Med Surg. 2013; 15: 858–865.
37.Grundon RA, Anderson GA, Lynch M, et al. Schirmer tear tests and intraocular pressures in conscious and anesthetized koalas (Phascolarctus cinereus). Vet Ophthalmol. 2011; 14: 292-295.
38.Hansen LL, Mads FB. Assessment of the effects of intramuscular administration of alfaxalone with and without medetomidine in Horsfield's tortoises (Agrionemys horsfieldii). Vet Anaesth Analg. 2013; 40.6: 68-75.
39.Heisler N, Glass M. Mechanisms and regulation of central vascular shunts in reptiles. In Johansen K, Burggren W, eds. Cardiovascular Shunts: Phylogenetic, Ontogenetic, and Clinical Aspects. Copenhagen: Munksgaard. 1985; 334–353.
40.Hernandez-Divers SM, Sladky KK, Buhlman KA, et al. Safety, utility and efficacy of intramuscular administration of ketamine/medetomidine/morphine combinations for immobilization of aquatic chelonians. Proc Conf Am Assoc Zoo Vet, Knoxville, TN. 2007; 34-35.
41.Hernandez-Divers SJ, Hensel P, Gladden J, et al: Investigation of shell disease in map turtles (Graptemys spp.). J Wildl Dis. 2009; 45:637-652.
42.Hicks J, Comeau S. Vagal regulation of intracardiac shunting in the turtle Pseudemys scritpa. J Exp Biol. 1994; 186: 109-126.
43.Hicks J, Krosniunas E. Physiological states and intracardiac shunting in non-crocodilian reptiles. Exp Biol Online 1996; 1: 1-12.
44.Hlastala M, Standaert D, Pierson D, et al. The matching of ventilation and perfusion in the lung of the tegu lizard, Tupinambis nigropunctatus. Respir Physiol 1985; 60: 277–294.
45.Holz P, Barker IK, Burger JP, et al. The effect of the renal portal system on pharmacokinetic parameters in the red-eared slider, (Trachemys scripta elegans). J Zoo Wildl Med. 1997a; 28: 386-393.
46.Holz P, Barker IK, Crawshaw GJ, et al. The anatomy and perfusion of the renal portal system in the red-eared slider, (Trachemys scripta elegans). J Zoo Wildl Med. 1997b; 28: 378-385.
47.Holz P. Renal anatomy and physiology. In Mader DR, ed. Reptile Medicine and Surgery. Saunders Elsevier. St. Louis. 2006; 135-144.
48.Hopkins S, Wang T, Hicks J. The effect of altering pulmonary blood flow on pulmonary gas exchange in the turtle Trachemys (Pseudemys) Scripta. J Exp Biol 1996; 199: 2207-2214.
49.Huynh, Minh, et al. Intramuscular administration of alfaxalone for sedation in rabbits. Vet Rec. 2015; 176.10: 255-255.
50.Jacobson, Elliott R. Overview of reptile biology, anatomy, and histology. Infectious diseases and pathology of reptiles: color atlas and text. CRC Press, 2007: 1-130.
51.Jansson CC, Marjamaぴki A, Luomala K, et al. Coupling of human a2-adrenoceptor subtypes to regulation of cAMP production in transfected S115 cells. Eur J Pharmacol. 1994; 266, 165-174.
52.Jansson CC, Kukkonen JP, Naぴsman J, et al. Protean agonism at a2A-adrenoceptors. Mol Pharmacol. 1998; 53, 963-968.
53.Jones, Krista L. Therapeutic review: alfaxalone. J EXOT PET MED. 2012; 21.4: 347-353.
54.Jurox Pty Ltd: Alfaxan Anaesthetic Injection—Technical Notes. Rutherford, Australia, 2010
55.Kamibayashi T, Maze M. Clinical uses of a2 adrenergic agonists. Anesthesiology. 2000; 93:1345-1349.
56.Katzung BG, ed. Basic and Clinical Pharmacology, 9th edn. New York: McGraw Hill. 2004.
57.Kik, Marja JL, and Mark AM. Reptile cardiology: a review of anatomy and physiology, diagnostic approaches, and clinical disease. Seminars in Avian and Exotic Pet Medicine. WB Saunders. 2005; 14.1.
58.Kischinovsky, Michelle, et al. Intramuscular administration of alfaxalone in red‐eared sliders (Trachemys scripta elegans)–effects of dose and body temperature. Vet Anaesth Analg. 2013; 40.1: 13-20.
59.Ko JC, Knesl O, Weil AB, et al. FAQs—analgesia, sedation, and anesthesia: making the switch from medetomidine to dexmedetomidine. Compend Contin Educ Vet Pract. 2009; 31: 1-24.
60.Knafo SE, Divers SJ, Rivera S, et al. Sterilisation of hybrid Galapagos tortoises (Geochelone nigra) for island restoration. Part 1: endoscopic oophorectomy of females under ketamine-medetomidine anaesthesia. Vet Rec. 2011; 168:47.
61.Knotek Z, Hrda S, Trnkova S. Alfaxalone anesthesia in green iguanas (Iguana iguana). Proc 1st. Sci Meet Euro College Zoo Med. Madrid, Spain. 2011; 68.
62.Kuusela E, Raekallio M, Anttila M, et al. Clinical effects and pharmacokinetics of medetomidine and its enantiomers in dogs. J Vet Pharmcol Ther. 2000; 23: 15-20.
63.Lawrence CJ, Prinzen FW, de Lange S. The effect of dexmedetomidine on nutrient organ blood flow. Anesth Analg. 1996; 83: 1160-1165.
64.Lewington JH. Anaesthesia and radiology. In Lewington JH, ed. Ferret Husbandry, Medicine, and Surgery 2nd ed. Philadelphia, PA. Saunders/Elsevier. 2007; 393-416.
65.Liem KF, Bemis WE, et al. eds. Functional anatomy of the Vertebrates, 3rd edn. Fort Worth, 2001.
66.Longley LA. Reptile anesthesia. Anaesthesia of exotic pets. Edinburgh: Saunders. 2008: 185-241.
67.Kischinovsky M, et al. Intramuscular administration of alfaxalone in red-eared sliders (Trachemys scripta elegans) – effects of dose and body temperature. Vet Anaesth Analg. 2012: 1467-2995
68.Mans C, Steagall PVM, Lahner LL, et al. Efficacy of intrathecal lidocaine, bupivacaine, and morphine for spinal anesthesia and analgesia in red-eared slider turtles (Trachemys scripta elegans). Proc Conf Am Assoc Zoo Vet. Kansas City, MO. 2011a: 135.
69.Mans C, Drees R, Sladky KK, et al. Effect of body position, leg and neck extension, and sedation on lung volume in red-eared slider turtles (Trachemys scripta elegans). Proc Conf Am Assoc Zoo Vet. Kansas City, MO. 2011b: 27.
70.Mans C, Sladky KK. Endoscopy-guided cloacal calculi removal in three African spurred tortoises (Geochelone sulcata). J Am Vet Med Assoc (in press).
71.Markey B, Wan C, Hanger J, et al. Use of quantitative real-time PCR to monitor the shedding and treatment of chlamydiae in the koala (Phascolarctos cinereus). Vet Microbiol. 2007; 120:334-342.
72.Mauthe von Degerfeld M. Personal experiences in the use of association tiletamine/zolazepam for anaesthesia of the green iguana (Iguana iguana). Vet Res Commun. 2004; 28: 351–353.
73.Miller RE and Murray EF, ed. Fowler's zoo and wild animal medicine. Vol. 8. Elsevier Health Sciences. 2014.
74.Mosley CA. Anesthesia and analgesia in reptiles. Semin Avian Exot Pet Med. 2005; 14: 243-262.
75.Mosley, Craig AE, Doris D, et al. The cardiovascular dose–response effects of isoflurane alone and combined with butorphanol in the green iguana (Iguana iguana). Vet Anaesth Analg. 2004; 31.1: 64-72.
76.Muir W, Lerche P, Wiese A, et al. Cardiorespiratory and anesthetic effects of clinical and supraclinical doses of alfaxalone in dogs. Vet Anaesth Analg. 2008; 35: 451-462.
77.Murison PJ, Martinez TF. Effect of propofol and alfaxalone on pain after ovariohysterectomy in cats. Vet Rec. 2010; 166.11: 334-335.
78.Murray MJ. Aural abscess. In Mader DR, ed. Reptile medicine and surgery. Philadelphia: WB Saunders. 1996; 349–352.
79.Murrell JC, Hellebrekers LJ. Medetomidine and dexmedetomidine: a review of cardiovascular effects and antinociceptive properties in the dog. Vet Anaesth Analg 2005; 32: 117–127.
80.Olsson A, Phalen D. Medetomidine immobilisation and atipamezole reversal in large estuarine crocodiles (Crocodylus porosus) using metabolically scaled dosages. Aust Vet J. 2012; 90.6: 240-244.
81.O'Malley, Bairbre, ed. Clinical anatomy and physiology of exotic species. WB Saunders Company, 2005.
82.Oppenheim YC, Moon PF. Sedative effects of midazolam in red-eared slider turtles (Trachemys scripta elegans). J Zoo Wildl Med. 1995; 26: 409-413.
83.Pascoe PJ, Raekallio M, Kuusela E, et al. Changes in the minimum alveolar concentration of isoflurane and some cardiopulmonary measurements during three continuous infusion rates of dexmedetomidine in dogs. Vet Anesth Analg 2005; 33: 97–103.
84.Pathirathna S, Todorovic SM, Covey DF, et al. 5α-reduced neuroactive steroids alleviate thermal and mechanical hyperalgesia in rats with neuropathic pain. 2005; 117: 326-339.
85.Perry SF. Structure and function of the reptilian respiratory system. In Wood SC, ed. Comparative pulmonary physiology – current concepts. New York: Dekker. 1989; 193–237.
86.Plumb DC. Plumb’s Veterinary Drug Handbook, Pharma Vet. Inc., Stockholm, WI, USA. 2008.
87.Porters N, Bosmans T, Debille M, et al. Sedative and antinociceptive effects of dexmedetomidine and buprenorphine after oral transmucosal or intramuscular administration in cats. Vet Anaesth Analg 2014; 41: 90–96.
88.Posner LP, Burns P. Injectable anaesthetic agents. J Vet Pharmacol Ther. 2009; 266-300.
89.Pough FH, Herpetology. 1998; 75–133.
90.Pypendop BH, Barter LS, Stanley SD, et al. Hemodynamic effects of dexmedetomidine in isoflurane‐anesthetized cats. Vet Anaesth Analg 2011; 38: 555–567.
91.Ramoo S, Bradbury LA, Anderson GA, et al. Sedation of hyperthyroid cats with subcutaneous administration of a combination of alfaxalone and butorphanol. Aust Vet J. 2013; 91: 131–136
92.Raske, Matthew, et al. Body temperatures of selected amphibian and reptile species. J Zoo Wildl Med. 2012; 3.3: 517-521.
93.Rasmussen NJ, Rosendal T, Overgaard J. Althesin in neurosurgical patients: effects on cerebral hemodynamics and metabolism. Acta Anaesthesiol Scan. 1978; 22: 257-269.
94.Read MR. Evaluation of the use of anesthesia and analgesia in reptiles. JAVMA 2004; 224: 547–552.
95.Redrobe S. Anesthesia and analgesia. In Girling SJ, Raiti P, ed. BSAVA Manual of Reptiles 2nd ed. Glouchester, UK, BSAVA Press. 2004: 131-146.
96.Rodrigo-Mocholí, Diego, et al. Clinical efficacy and cardiorespiratory effects of intramuscular administration of alfaxalone alone or in combination with dexmedetomidine in cats. Vet Anaesth Analg. 2016; 43.3: 291-300.
97.Santos, Martín, Blanca T, et al. Effects of intramuscular dexmedetomidine in combination with ketamine or alfaxalone in swine. Vet Anaesth Analg. 2016; 43.1: 81-85.
98.Savola J-M, Virtanen R. Central alpha-2 adrenoceptors are highly stereoselective for dexmedetomidine, the dextro enantiomer of medetomidine. Eur J Pharmacol 1991; 195: 193–199.
99.Scheelings TF, et al. A preliminary investigation into the chemical restraint with alfaxalone of selected Australian squamate species. J. Herpetol. Med. Surg. 2011; 21.2: 63-67.
100.Scheelings TF. Use of intravenous and intramuscular Alfaxalone in Macquarie River Turtles (Emydura macquarii). J. Herpetol. Med. Surg. 2013; 23.3: 91-94.
101.Schumacher J, Lillywhite H, Norman W, et al. Effects of ketamine HCl on cardiopulmonary function in snakes. Copeia 1997; 395–400.
102.Schumacher J, Yelen T. Anesthesia and analgesia. In Mader DR, ed. Reptile Medicine and Surgery 2nd ed. St. Louis, MO. Elsevier/Saunders. 2006; 442-452.
103.Shepard, Molly K, et al. Pharmacodynamics of alfaxalone after single‐dose intramuscular administration in red‐eared sliders (Trachemys scripta elegans): a comparison of two different doses at two different ambient temperatures. Vet Anaesth Analg. 2013; 40.6: 590-598.
104.Sladky KK, and Christoph M. Clinical anesthesia in reptiles. J EXOT PET MED. 2012; 21.1: 17-31.
105.Sleeman, Jonathan M, and James G. Sedative and cardiopulmonary effects of medetomidine and reversal with atipamezole in desert tortoises (Gopherus agassizii). J. Zoo Wildl. Med. 2000; 31.1: 28-35
106.Souza SS, Intelisano TR, de Biaggi CP, et al. Cardiopulmonary and isoflurane sparing effects of epidural or intravenous infusion of dexmedetomidine in cats undergoing surgery with epidural lidocaine. Vet Anaesth Analg 2010; 37: 106–115.
107.Underwood G. The eye. In Gans C, ed. Biology of the Reptilia. Vol. 2, Morphology B. London: Academic Press. 1970; 1–93.
108.Vasaruchapong, Taksa. Snake Reproductive System. Thai J Vet Med Suppl. 2014; 1.41: 89-91
109.Virtanen R, Savola JM, Saano V, et al. Characterization of the selectivity, specificity and potency of medetomidine as an alpha 2-adrenoceptor agonist. Eur J Pharmacol. 1988; 150: 9–14.
110.Wang T, Hicks J. The interaction of pulmonary ventilation and the right-left shunt on arterial oxygen levels. J Exp Biol 1996; 199: 2121–2129.
111.West, Gary, Darryl Heard, et al. eds. Zoo animal and wildlife immobilization and anesthesia. John Wiley & Sons, 2014.
112.Wyneken, Jeanette. Normal reptile heart morphology and function. Vet Clin North Am Exot Anim Pract. 2009; 12.1: 51-63.
113.Ziolo MS, Bertelsen MF. Effects of propofol administered via the supravertebral sinus in red-eared sliders. J Am Vet Med Assoc. 2009; 234: 390-393.