唑拉西泮與替來他明
**唑拉西泮/替來他明**（常見商品名為 Zoletil 舒泰或 Telazol）是獸醫學中廣泛用於犬貓全身麻醉的複方注射麻醉劑。它結合了解離性麻醉劑（替來他明）與苯二氮平類藥物（唑拉西泮），在提供麻醉的同時產生肌肉鬆弛效果。 > **臨床警告：** 此複方產品**不應**作為疼痛手術的唯一麻醉劑。它缺乏足夠的內臟鎮痛效果，必須與適當的鎮痛藥（如鴉片類藥物、非類固醇消炎藥）合併使用。 **臨床提示：** 從此藥物組合中甦醒的時間可能較長（2-6小時），且有時過程會較為躁動或不平穩，特別是在給予高劑量的犬隻。術前給藥（例如使用 alpha-2 作用劑或吩噻嗪類藥物，但需注意藥物交互作用）通常能使甦醒過程更平穩。貓的甦醒時間通常比狗更長。
作用機制: The drug is a 1:1 combination of two active principles with complementary mechanisms: * **Zolazepam:** A benzodiazepine that enhances the activity of **GABA** (gamma-aminobutyric acid) → the major inhibitory neurotransmitter within the CNS. This provides sedative, anxiolytic, and muscle-relaxing actions, counteracting the muscle rigidity typically caused by dissociative agents. * **Tiletamine:** A dissociative anesthetic (pharmacologically similar to ketamine) that antagonizes **NMDA (glutamic acid) receptors** → depresses certain cerebral regions (thalamus and cortex) while the limbic system remains active, generating a state of dissociative anesthesia.
各物種劑量
- General anaesthesia · 5-10 mg/kg · IV · single dose · Duration of anaesthesia is 20-60 minutes · Dose refers to the combined tiletamine/zolazepam (100 mg/ml). Adjust depending on degree of pain expected and depth required.
- General anaesthesia · 7-25 mg/kg · IM · single dose · Duration of anaesthesia is 20-60 minutes · Dose refers to the combined tiletamine/zolazepam (100 mg/ml). Adjust depending on degree of pain expected and depth required.
- General anaesthesia · 5-7.5 mg/kg · IV · single dose · Duration of anaesthesia is 20-60 minutes · Dose refers to the combined tiletamine/zolazepam (100 mg/ml). Adjust depending on degree of pain expected and depth required.
- General anaesthesia · 10-15 mg/kg · IM · single dose · Duration of anaesthesia is 20-60 minutes · Dose refers to the combined tiletamine/zolazepam (100 mg/ml). Adjust depending on degree of pain expected and depth required.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
給藥途徑
禁忌症
- Severe cardiac disease
- Severe respiratory disease
- Hypertensive disease
- Renal insufficiency
- Pancreatic insufficiency
- Hepatic insufficiency
- Head trauma or intracranial tumours
- Pregnancy (crosses the placenta and causes fatal respiratory depression in neonates)
不良反應
- Excessive salivation (ptyalism)
- Muscle rigidity during recovery
- Prolonged and excitable recovery (especially in dogs at higher doses)
- Pain on intramuscular injection (particularly in cats)
- Respiratory depression (can be fatal in neonates)
- Hypothermia
藥物相互作用
- Phenothiazines (e.g., Acepromazine) · Increased cardiorespiratory depression and increased hypothermic effect during the last phase of anesthesia. · major
- Chloramphenicol · Slows down the elimination of the anesthetics if used during the pre- or intraoperative period. · moderate
監測
- Heart rate and rhythm
- Respiratory rate and depth
- Body temperature (monitor closely for hypothermia)
- Depth of anesthesia (jaw tone, palpebral reflex)
- Quality of recovery (monitor for excitation or rigidity)
過量
Overdosage increases the risk of severe **cardiorespiratory depression**, prolonged anesthesia, and highly excitable or rough recoveries. Treatment is supportive, including mechanical ventilation if respiratory failure occurs, thermal support for hypothermia, and potentially benzodiazepine antagonists (flumazenil) for the zolazepam component, though this leaves the tiletamine unopposed.
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。