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新斯的明单独或与吗啡联合硬膜外给药对卵巢子宫切除犬的术后镇痛效果。

Postoperative analgesic effects of epidural administration of neostigmine alone or in combination with morphine in ovariohysterectomized dogs.

作者信息

Marucio Rodrigo L, Luna Stelio P L, Neto Francisco J Teixeira, Minto Bruno W, Hatschbach Eduardo

机构信息

Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil, 14870-000.

出版信息

Am J Vet Res. 2008 Jul;69(7):854-60. doi: 10.2460/ajvr.69.7.854.

Abstract

OBJECTIVE

To evaluate analgesic effects of epidurally administered neostigmine alone or in combination with morphine in dogs after ovariohysterectomy. Animals-40 healthy bitches.

PROCEDURES

After acepromazine premedication, anesthesia was induced. Dogs randomly received 1 of the following 4 epidural treatments 30 minutes before ovariohysterectomy (n = 10/group): saline (0.9% NaCl) solution (control), morphine (0.1 mg/kg), neostigmine (10 microg/kg), or morphine-neostigmine (0.1 mg/kg and 10 microg/kg, respectively). Analgesia was assessed for 24 hours after surgery by use of a visual analogue scale (VAS; scale of 0 to 10) or numeric descriptive scale (NDS; scale of 0 to 24) and by the need for supplemental analgesia (morphine [0.5 mg/kg, IM] administered when VAS was > or = 4 or NDS was > or = 8).

RESULTS

Significantly more control dogs (n = 8) received supplemental analgesia, compared with the number of neostigmine-treated dogs (1); no dogs in the remaining groups received supplemental analgesia. Compared with values for the control dogs, the NDS scores were lower for morphine-neostigmine-treated dogs (from 2 to 6 hours and at 12 hours) and for morphine-treated dogs (all time points). The NDS scores were lower for morphine-treated dogs at 3, 12, and 24 hours, compared with values for neostigmine-treated dogs. The VAS was less sensitive than the NDS for detecting differences among groups.

CONCLUSIONS AND CLINICAL RELEVANCE

Epidurally administered neostigmine reduced the use of supplemental analgesia after ovariohysterectomy in dogs. However, analgesic effects were less pronounced than for epidurally administered morphine or morphine-neostigmine. Adding neostigmine to epidurally administered morphine did not potentiate opioid-induced analgesia.

摘要

目的

评估硬膜外注射新斯的明单独使用或与吗啡联合使用对犬卵巢子宫切除术后的镇痛效果。动物——40只健康母犬。

步骤

在使用乙酰丙嗪进行术前用药后,诱导麻醉。在卵巢子宫切除术前30分钟,犬随机接受以下4种硬膜外治疗中的1种(每组n = 10):生理盐水(0.9%氯化钠)溶液(对照组)、吗啡(0.1 mg/kg)、新斯的明(10μg/kg)或吗啡 - 新斯的明(分别为0.1 mg/kg和10μg/kg)。术后24小时通过视觉模拟评分法(VAS;0至10分)或数字描述评分法(NDS;0至24分)以及补充镇痛的需求(当VAS≥4或NDS≥8时肌肉注射吗啡[0.5 mg/kg])来评估镇痛效果。

结果

与新斯的明治疗组的犬只数量(1只)相比,显著更多的对照组犬只(n = 8)接受了补充镇痛;其余组中没有犬只接受补充镇痛。与对照组犬只的值相比,吗啡 - 新斯的明治疗组犬只(2至6小时及12小时时)和吗啡治疗组犬只(所有时间点)的NDS评分较低。与新斯的明治疗组犬只的值相比,吗啡治疗组犬只在3、12和24小时时的NDS评分较低。VAS在检测组间差异方面不如NDS敏感。

结论及临床意义

硬膜外注射新斯的明减少了犬卵巢子宫切除术后补充镇痛的使用。然而,镇痛效果不如硬膜外注射吗啡或吗啡 - 新斯的明显著。向硬膜外注射的吗啡中添加新斯的明并未增强阿片类药物诱导的镇痛作用。

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