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术前硬膜外注射布比卡因和吗啡对犬股骨-胫骨关节手术应激反应的影响。

The effects of preoperative extradural bupivacaine and morphine on the stress response in dogs undergoing femoro-tibial joint surgery.

作者信息

Sibanda Sithembile, Hughes J M Lynne, Pawson Patricia E, Kelly Gabrielle, Bellenger Christopher R

机构信息

Department of Veterinary Surgery, University College Dublin, Dublin, Ireland.

出版信息

Vet Anaesth Analg. 2006 Jul;33(4):246-57. doi: 10.1111/j.1467-2995.2005.00261.x.

Abstract

OBJECTIVE

To evaluate the efficacy of preoperative extradural bupivacaine and morphine in attenuating the stress response in dogs undergoing femoro-tibial joint surgery.

STUDY DESIGN

Prospective clinical study. Animal population Twelve client-owned dogs undergoing surgery for either repair of cruciate ligament rupture (ten) or correction of luxating patella (two). Body masses ranged from 12 to 45 kg (mean: 28.58 +/- 18.38). Age ranged from 19 to 121 months (mean: 66.5 +/- 49.5).

MATERIALS AND METHODS

Six of the dogs received extradural bupivacaine (up to 1.5 mg kg(-1)) combined with morphine (0.1 mg kg(-1); ED) while the other six received no extradural analgesia (C). The levels of cortisol, acute phase proteins (APPs), and red and white blood cell variables were measured in both groups of dogs before, and at various times after surgery. Pain was also assessed at various times after surgery. The number of postoperative morphine doses required, and their time of administration, was recorded for each animal. Method of statistical analysis Data were analysed using anova for repeated measures with p-values of <0.05 considered significant.

RESULTS

Cortisol levels in the ED group were significantly (p < 0.05) lower than those of the control group at the end of surgery. No statistically significant differences were found in APPs or red and white cell variables between dogs receiving, and those not receiving extradural bupivacaine and morphine. Four dogs in the control group and one in the ED group required postoperative morphine.

CONCLUSIONS AND CLINICAL RELEVANCE

Pre-emptive extradural bupivacaine and morphine was effective in lowering the neuroendocrine stress response (cortisol) in the ED group but had no effect on the inflammatory response (acute phase response).

摘要

目的

评估术前硬膜外注射布比卡因和吗啡对接受股骨-胫骨关节手术的犬应激反应的缓解效果。

研究设计

前瞻性临床研究。动物群体 12 只客户拥有的犬,其中 10 只接受十字韧带断裂修复手术,2 只接受髌骨脱位矫正手术。体重范围为 12 至 45 千克(平均:28.58±18.38)。年龄范围为 19 至 121 个月(平均:66.5±49.5)。

材料与方法

6 只犬接受硬膜外布比卡因(最高 1.5 毫克/千克)联合吗啡(0.1 毫克/千克;ED 组),另外 6 只不接受硬膜外镇痛(C 组)。在两组犬手术前及术后不同时间测量皮质醇、急性期蛋白(APPs)以及红细胞和白细胞变量水平。术后不同时间也对疼痛进行评估。记录每只动物术后所需吗啡剂量及其给药时间。统计分析方法 采用重复测量方差分析对数据进行分析,p 值<0.05 被认为具有统计学意义。

结果

手术结束时,ED 组的皮质醇水平显著低于对照组(p<0.05)。接受和未接受硬膜外布比卡因和吗啡的犬在 APPs 或红细胞和白细胞变量方面未发现统计学显著差异。对照组 4 只犬和 ED 组 1 只犬术后需要吗啡。

结论及临床意义

预防性硬膜外注射布比卡因和吗啡可有效降低 ED 组的神经内分泌应激反应(皮质醇),但对炎症反应(急性期反应)无影响。

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