Camprodon R A M, Bowles M J
Institute of Liver Studies, Liver Transplant Surgical Service, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
Transplant Proc. 2006 Jul-Aug;38(6):1857-8. doi: 10.1016/j.transproceed.2006.05.005.
Despite numerous studies in experimental rat small bowel transplantation (SBT), few authors make reference to perioperative analgesia. Recent changes to the Animals (Scientific Procedures) Act 1986 in the United Kingdom have made the use of analgesia in laboratory animals compulsory because pain is unnecessary in the majority of scientific procedures.
Heterotopic SBT (PVG-->DA) was performed on male rat recipients weighing 220 to 250 mg under isoflurane with a mean anesthetic time of 100 minutes. Recovery from anesthesia was usually within 15 minutes. Analgesia regimens were based on those in common use for other procedures. All drugs were administered in the 30 minutes prior to recovery from anesthesia. Group A received carprofen (2 mg/kg IM or SC). Group B was given buprenorphine (0.05 mg/kg either IM or SC). Group C received paracetamol (10- 30 mg) rectally. An early postoperative scoring system of four criteria was used, giving a maximum (least desirable) score of 16. Sixty transplants were performed, divided between the three groups.
In group A animals scored a median of 1 of 16 but all except three recipients died within 3 hours. Those in group B scored a median of 8 of 16, but all animals except one died between 4 to 16 hours after surgery. Group C had a median score of 11 of 16, but there was no early mortality. Postmortem examination excluded technical failures in all but three animals.
We recommend the use of paracetamol for perioperative analgesia in SBT because of the high mortality associated with other drugs when used in this procedure.
尽管在实验性大鼠小肠移植（SBT）方面有大量研究，但很少有作者提及围手术期镇痛。英国1986年的《动物（科学程序）法案》最近有所修订，规定在实验动物中使用镇痛剂为强制性要求，因为在大多数科学程序中疼痛是不必要的。
对体重220至250毫克的雄性大鼠受体进行异位SBT（PVG→DA），采用异氟烷麻醉，平均麻醉时间为100分钟。麻醉恢复通常在15分钟内。镇痛方案基于其他程序中常用的方案。所有药物均在麻醉恢复前30分钟给药。A组接受卡洛芬（2毫克/千克，肌肉注射或皮下注射）。B组给予丁丙诺啡（0.05毫克/千克，肌肉注射或皮下注射）。C组直肠给予对乙酰氨基酚（10 - 30毫克）。采用一个早期术后四分制评分系统，最高（最不理想）评分为16分。共进行了60例移植手术，分为三组。
A组动物评分中位数为16分中的1分，但除三只受体外，所有动物均在3小时内死亡。B组评分中位数为16分中的8分，但除一只动物外，所有动物均在术后4至16小时内死亡。C组评分中位数为16分中的11分，但无早期死亡情况。尸检排除了除三只动物外的所有技术失误。
我们建议在SBT围手术期镇痛中使用对乙酰氨基酚，因为在此手术中使用其他药物会导致高死亡率。
