兽医实践中的术后呼吸抑制和其他术后肺部并发症：叙述性综述
Postoperative Respiratory Depression and Other Postoperative Pulmonary Complications in Veterinary Practice: A Narrative Review.
摘要(中文译文)
术后呼吸抑制（PORD）及其他术后肺部并发症（PPCs）是伴侣动物临床中围手术期发病率和死亡率的重要 contributing 因素。围手术期小动物死亡保密调查（CEPSAF）确认，心血管和呼吸系统原因分别约占犬和猫围手术期死亡的74%和72%，其中47%的犬麻醉相关死亡和61%的猫麻醉相关死亡发生在术后期间。PORD源于阿片类药物诱导的呼吸抑制（OIRD）、吸入麻醉药残留效应、其他药物诱导效应（如神经肌肉阻滞）以及患者特异性易感因素的共同作用。PPCs涵盖广泛的病症谱，包括肺不张、吸入性肺炎、肺炎、通气不足、急性呼吸窘迫综合征（ARDS）和呼吸骤停，剖腹手术研究报告犬PPCs发生率为22%。本叙述性综述综合了当前兽医学实践中关于PORD和PPCs的病理生理学、危险因素、诊断方法、预防策略和治疗方面的证据，融合了兽医专科和转化人类麻醉文献的见解，同时明确指出了兽医特异性证据仍然有限的领域。本文强调麻醉后期间持续监测、多模式镇痛以减少阿片类药物暴露、保护性肺通气策略和早期干预作为改善预后的关键策略的重要性，以及目前尚缺乏能够不受致病因素影响而对抗PORD的非逆转依赖性（“不可知论”）呼吸兴奋剂这一未满足的需求。
Abstract
Postoperative respiratory depression (PORD) and other postoperative pulmonary complications (PPCs) represent significant contributors to perioperative morbidity and mortality in companion animal practice. The Confidential Enquiry into Perioperative Small Animal Fatalities (CEPSAF) established that cardiovascular and respiratory causes account for approximately 74% and 72% of perioperative deaths in dogs and cats, respectively, with 47% of canine and 61% of feline anesthetic-related deaths occurring in the postoperative period. PORD arises from a convergence of opioid-induced respiratory depression (OIRD), residual inhalant anesthetic effects, other drug-induced effects (e.g., neuromuscular blockade), and patient-specific vulnerabilities. PPCs encompass a broad spectrum of conditions, including atelectasis, aspiration pneumonia, pneumonia, hypoventilation, acute respiratory distress syndrome (ARDS), and respiratory arrest, with laparotomy studies reporting a PPC incidence of 22% in dogs. This narrative review synthesizes current evidence on the pathophysiology, risk factors, diagnostic approaches, prevention strategies, and treatment of PORD and PPCs in veterinary practice, incorporating insights from both veterinary-specific and translational human anesthesia literature, while explicitly identifying areas where veterinary-specific evidence remains limited. The importance of continuous monitoring during the postanesthetic period, multimodal analgesia to reduce opioid exposure, protective lung ventilation strategies, and early intervention is highlighted as a key strategy to improve outcomes, together with the unmet need for reversal-independent ("agnostic") respiratory stimulants capable of countering PORD irrespective of the causative agent.
如何引用
AMA
Robert B Raffa, Joseph V Pergolizzi, Mohadeseh Abouhosseini-Tabari, Morgan Wagner King. Postoperative Respiratory Depression and Other Postoperative Pulmonary Complications in Veterinary Practice: A Narrative Review.. Cureus. 2026; doi:10.7759/cureus.112870.
APA
Robert B Raffa, Joseph V Pergolizzi, Mohadeseh Abouhosseini-Tabari, Morgan Wagner King (2026). Postoperative Respiratory Depression and Other Postoperative Pulmonary Complications in Veterinary Practice: A Narrative Review.. Cureus. https://doi.org/10.7759/cureus.112870
GB/T 7714
Robert B Raffa, Joseph V Pergolizzi, Mohadeseh Abouhosseini-Tabari, Morgan Wagner King. Postoperative Respiratory Depression and Other Postoperative Pulmonary Complications in Veterinary Practice: A Narrative Review.[J]. Cureus, 2026 doi:10.7759/cureus.112870.
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