Carpenter Rachael E, Wilson Deborah V, Evans A Thomas
Department of Large Animal Clinical Sciences, Michigan State University College of Veterinary Medicine, East Lansing, MI, USA.
Vet Anaesth Analg. 2004 Jan;31(1):46-52. doi: 10.1111/j.1467-2995.2004.00137.x.
To determine if intraperitoneal (i.p.) and incisional (s.c.) lidocaine or bupivacaine provide analgesia following ovariohysterectomy (OHE).
Prospective, randomized, controlled, blinded clinical trial.
Thirty dogs presenting to the Veterinary Teaching Hospital for elective OHE.
Dogs were pre-medicated with acepromazine and butorphanol, induced with thiopental and maintained with isoflurane. They were randomly assigned to three groups: 10 received 8.8 mg kg(-1) 2% lidocaine with epinephrine i.p. (LID); 10 received 4.4 mg kg(-1) 0.75% bupivacaine i.p. (BUP); and 10 received 0.9% saline i.p. (SAL) upon completion of OHE. All i.p. doses were standardized to 0.88 mL kg(-1) with saline. An additional 2 mL of undiluted solution was placed s.c. prior to incisional closure. Dogs were scored at 0.5, 1, 2, 3, 6, 8 and 18 hours post-extubation by one observer. Dogs were evaluated using a visual analogue scale (VAS) for pain and sedation, and a composite pain scale (CPS) that included physiologic and behavioral variables. Dogs were treated with 0.22 mg kg(-1) butorphanol + acepromazine if their VAS (pain) score was >50. Parametric variables were analyzed using Student's t-test or repeated measures ANOVA as appropriate. Non-parametric variables were analyzed by chi2-test.
There were no significant differences in age, weight, incision length, surgery time, anesthesia time, or total thiopental dose among groups. Peak post-surgical pain scores for all groups occurred at 0.5 hours and returned to baseline by 18 hours. Dogs in the BUP group had significantly lower VAS-pain scores overall than dogs in the SAL group. Seven out of 10 dogs in the SAL group, 4/10 in the LID group and 2/10 in the BUP group were treated with supplemental acepromazine and butorphanol. No differences between groups were detected with the CPS. No adverse side-effects were observed.
Our findings support the use of i.p. and s.c. bupivacaine for post-operative analgesia following OHE in the dog.
确定腹腔内（i.p.）和切口处（s.c.）注射利多卡因或布比卡因能否在卵巢子宫切除术（OHE）后提供镇痛效果。
前瞻性、随机、对照、双盲临床试验。
30只到兽医教学医院接受择期OHE的犬。
犬只术前用乙酰丙嗪和布托啡诺进行预处理，用硫喷妥钠诱导麻醉，并用异氟醚维持麻醉。它们被随机分为三组：10只在OHE完成后腹腔内注射8.8 mg kg⁻¹ 2%含肾上腺素的利多卡因（LID）；10只腹腔内注射4.4 mg kg⁻¹ 0.75%布比卡因（BUP）；10只腹腔内注射0.9%生理盐水（SAL）。所有腹腔内注射剂量均用生理盐水标准化为0.88 mL kg⁻¹。在切口缝合前，在皮下额外注射2 mL未稀释溶液。由一名观察者在拔管后0.5、1、2、3、6、8和18小时对犬进行评分。使用视觉模拟评分法（VAS）评估犬的疼痛和镇静情况，并使用包括生理和行为变量的综合疼痛评分（CPS）进行评估。如果犬的VAS（疼痛）评分>50，则用0.22 mg kg⁻¹布托啡诺+乙酰丙嗪进行治疗。参数变量根据情况使用学生t检验或重复测量方差分析进行分析。非参数变量用卡方检验进行分析。
各组之间在年龄、体重、切口长度、手术时间、麻醉时间或硫喷妥钠总剂量方面无显著差异。所有组的术后疼痛评分峰值均出现在0.5小时，到18小时恢复至基线水平。BUP组犬的总体VAS疼痛评分显著低于SAL组犬。SAL组10只犬中有7只、LID组4/10只、BUP组2/10只犬接受了补充乙酰丙嗪和布托啡诺的治疗。CPS未检测到组间差异。未观察到不良副作用。
我们的研究结果支持在犬OHE术后使用腹腔内和皮下注射布比卡因进行镇痛。
