Leibetseder Elisabeth N, Mosing Martina, Jones Ronald S
Clinic of Surgery and Ophthalmology, GE (Gemeinsame Einrichtung) of Anaesthesia and Intensive Care, University of Veterinary Medicine, Vienna, Austria.
Vet Anaesth Analg. 2006 Mar;33(2):128-36. doi: 10.1111/j.1467-2995.2005.00239.x.
To compare the effects of intravenous (IV) and extradural (ED) methadone on end-tidal isoflurane concentration (Fe'ISO) and postoperative analgesic requirements in dogs undergoing femoro-tibial joint surgery.
Randomized, blinded, clinical study. Animals Twenty-four healthy client-owned dogs undergoing surgical repair of ruptured cruciate ligaments.
Dogs were randomly assigned to two groups of 12 animals and received either ED or IV methadone (0.3 mg kg(-1) diluted with saline to 0.2 mL kg(-1)). Pre-anaesthetic medication was IV acepromazine (0.05 mg kg(-1)). Anaesthesia was induced with propofol and maintained initially with an Fe'ISO of 1.0% delivered in oxygen. Methadone was injected with the dogs in sternal recumbency; the observer was unaware of the administration route. At 10 minutes (stimulation 1) and 20 minutes (stimulation 2) after methadone administration pelvic limb reflexes were tested by digit-clamping. The time at skin incision (stimulation 3), joint-capsule incision (stimulation 4), tibial tuberosity drilling (stimulation 5), fabellar suturing (stimulation 6) and extracapsular tightening (stimulation 7) were noted. Changes in heart rate (HR) and respiratory rate and arterial blood pressure associated with surgery were recorded along with the corresponding Fe'ISO. After 20 minutes of anaesthesia, Fe'ISO was decreased to the minimum required to maintain stable anaesthesia. Immediately after tracheal extubation, 1, 2, 3 and 6 hours postoperatively and on the morning after surgery, the degree of pain present was assessed using a numerical rating scale. The HR, respiratory rates and blood pressure were also recorded at these times. Serum cortisol and blood glucose concentrations were measured before pre-anaesthetic medication and at each postoperative pain scoring interval except at 1 and 2 hours. Ketoprofen (2 mg kg(-1)), carprofen (4 mg kg(-1)) or meloxicam (0.2 mg kg(-1)) were given by subcutaneous injection whenever pain scoring indicated moderate discomfort was present.
Controlled ventilation was required in six dogs which stopped breathing after IV methadone. The median Fe'ISO at stimulus 5 was 1.0% in the IV and 0.83% in the ED group. At stimulus 6, Fe'ISO was 1.0% in the IV and 0.8% in the ED group; the difference was statistically significant (p </= 0.05). There was no significant difference in the duration of postoperative analgesia associated with administration route.
Extradural methadone significantly reduces the isoflurane requirement compared with IV methadone during femoro-tibial joint surgery in dogs.
Extradural methadone provides safe and effective pain relief in dogs undergoing cruciate ligament repair.
比较静脉注射（IV）和美沙酮硬膜外注射（ED）对接受股胫关节手术犬的呼气末异氟烷浓度（Fe'ISO）及术后镇痛需求的影响。
随机、盲法临床研究。动物24只健康的客户拥有的犬，接受十字韧带断裂的手术修复。
将犬随机分为两组，每组12只，分别接受硬膜外或静脉注射美沙酮（0.3 mg kg(-1) 用生理盐水稀释至0.2 mL kg(-1)）。麻醉前用药为静脉注射乙酰丙嗪（0.05 mg kg(-1)）。用丙泊酚诱导麻醉，最初以在氧气中输送的1.0%的Fe'ISO维持麻醉。美沙酮在犬处于胸骨卧位时注射；观察者不知道给药途径。在美沙酮给药后10分钟（刺激1）和20分钟（刺激2），通过夹趾测试骨盆肢体反射。记录皮肤切开（刺激3）、关节囊切开（刺激4）、胫骨结节钻孔（刺激5）、豆状骨缝合（刺激6）和关节囊外收紧（刺激7）的时间。记录与手术相关的心率（HR）、呼吸频率和动脉血压变化以及相应的Fe'ISO。麻醉20分钟后，将Fe'ISO降至维持稳定麻醉所需的最低水平。气管插管后立即、术后1、2、3和6小时以及术后次日早晨，使用数字评分量表评估疼痛程度。在这些时间也记录HR、呼吸频率和血压。在麻醉前用药前以及除1和2小时外的每个术后疼痛评分间隔测量血清皮质醇和血糖浓度。每当疼痛评分表明存在中度不适时，皮下注射酮洛芬（2 mg kg(-1)）、卡洛芬（4 mg kg(-1)）或美洛昔康（0.2 mg kg(-1)）。
6只犬在静脉注射美沙酮后停止呼吸，需要控制通气。在刺激5时，静脉注射组的Fe'ISO中位数为1.0%，硬膜外注射组为0.83%。在刺激6时，静脉注射组的Fe'ISO为1.0%，硬膜外注射组为0.8%；差异有统计学意义（p≤0.05）。与给药途径相关的术后镇痛持续时间无显著差异。
在犬的股胫关节手术中，与静脉注射美沙酮相比，硬膜外注射美沙酮显著降低了异氟烷的需求量。
硬膜外注射美沙酮为接受十字韧带修复的犬提供安全有效的疼痛缓解。
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