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犬开胸术后镇痛:布比卡因肋间神经阻滞与纳布啡对呼吸功能影响的评估

Post-operative analgesia following thoracotomy in the dog: an evaluation of the effects of bupivacaine intercostal nerve block and nalbuphine on respiratory function.

作者信息

Flecknell P A, Kirk A J, Liles J H, Hayes P H, Dark J H

机构信息

Comparative Biology Centre Medical School, Newcastle upon Tyne, UK.

出版信息

Lab Anim. 1991 Oct;25(4):319-24. doi: 10.1258/002367791780810029.

Abstract

Pain following thoracotomy reduces pulmonary ventilation in man and a similar effect is believed to occur in animals. The effects of two analgesic regimens on arterial blood gas parameters were studied in dogs following thoracotomy. Post-Operative analgesia was provided with intermittent nalbuphine, either alone or in combination with an intercostal nerve block using bupivacaine. Arterial blood gas analysis was carried out at 4, 8 and 16 h post-operatively, both before the administration of nalbuphine and again 30 min later. Animals which received nalbuphine alone had a significant rise in arterial oxygenation following administration of this analgesic. This effect was not observed at 4 and 8 h post-operatively in dogs which had an intercostal block with bupivacaine, but was seen at 16 h post-operatively when it could be anticipated that the effects of bupivacaine would have waned. These results suggest that intercostal block with bupivacaine can provide analgesia for over 8 h, and that the duration of action of nalbuphine in controlling post-operative pain in the dog is probably less than 4 h.

摘要

开胸术后疼痛会降低人体的肺通气量,并且据信在动物中也会出现类似的效果。在开胸术后的犬类中研究了两种镇痛方案对动脉血气参数的影响。术后镇痛采用间歇性纳布啡,单独使用或与布比卡因肋间神经阻滞联合使用。术后4、8和16小时,在给予纳布啡之前以及给药30分钟后进行动脉血气分析。单独接受纳布啡的动物在给予这种镇痛药后动脉氧合有显著升高。在接受布比卡因肋间阻滞的犬类中,术后4小时和8小时未观察到这种效果,但在术后16小时观察到了这种效果,此时可以预期布比卡因的作用已经减弱。这些结果表明,布比卡因肋间阻滞可以提供超过8小时的镇痛效果,并且纳布啡在控制犬类术后疼痛中的作用持续时间可能小于4小时。

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