犬眼球摘除术后球后间隙注射局部麻醉药用于术后镇痛的效果
Effectiveness of injection of local anesthetic into the retrobulbar space for postoperative analgesia following eye enucleation in dogs.
作者信息
Myrna Kathern E, Bentley Ellison, Smith Lesley J
机构信息
Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA.
出版信息
J Am Vet Med Assoc. 2010 Jul 15;237(2):174-7. doi: 10.2460/javma.237.2.174.
OBJECTIVE
To assess the efficacy of a retrobulbar bupivacaine nerve block for postoperative analgesia following eye enucleation in dogs.
DESIGN
Randomized controlled trial.
ANIMALS
22 dogs.
PROCEDURES
Client-owned dogs admitted to the hospital for routine eye enucleation were enrolled with owner consent and randomly assigned to a treatment (bupivacaine hydrochloride) or control (saline [0.9% NaCl] solution) group. Baseline subjective pain scores were recorded. Anesthesia consisted of hydromorphone and midazolam preoperatively, thiopental or propofol for induction, and isoflurane in oxygen for maintenance. An inferior-temporal palpebral retrobulbar injection of either saline solution or bupivacaine was administered. Transpalpebral eye enucleation was performed. Pain scores were recorded at 0.25, 0.5, 1, 2, 4, 6, 8, and 24 hours after extubation (time 0) by observers masked to treatment groups. Dogs were given hydromorphone (0.2 mg/kg [0.09 mg/lb], IM or IV) as a rescue analgesic if the subjective pain score totaled >or= 9 (out of a maximum total score of 18) or >or= 3 in any 1 category.
RESULTS
9 of 11 control dogs required a rescue dose of hydromorphone, but only 2 of 11 dogs in the bupivacaine treatment group required rescue analgesia. Mean time to treatment failure (ie, administration of rescue analgesia following extubation) was 0.56 hours (95% confidence interval, 0.029 to 1.095 hours) for the 11 dogs that received hydromorphone.
CONCLUSIONS AND CLINICAL RELEVANCE
Retrobulbar administration of bupivacaine in dogs in conjunction with traditional premedication prior to eye enucleation was an effective form of adjunctive analgesia and reduced the need for additional postoperative analgesics.
目的
评估球后布比卡因神经阻滞对犬眼球摘除术后镇痛的效果。
设计
随机对照试验。
动物
22只犬。
步骤
经主人同意后,将因常规眼球摘除术入院的客户拥有的犬纳入研究,并随机分为治疗组(盐酸布比卡因)或对照组(生理盐水[0.9%氯化钠]溶液)。记录基线主观疼痛评分。麻醉包括术前使用氢吗啡酮和咪达唑仑,诱导使用硫喷妥钠或丙泊酚,维持使用氧气中的异氟醚。经睑下向球后注射生理盐水溶液或布比卡因。进行经睑眼球摘除术。由对治疗组不知情的观察者在拔管后0.25、0.5、1、2、4、6、8和24小时记录疼痛评分。如果主观疼痛评分总分≥9(满分18分)或任何一项≥3,犬将接受氢吗啡酮(0.2mg/kg[0.09mg/lb],肌肉注射或静脉注射)作为解救镇痛药。
结果
11只对照犬中有9只需要氢吗啡酮解救剂量,但布比卡因治疗组的11只犬中只有2只需要解救镇痛。接受氢吗啡酮的11只犬的平均治疗失败时间(即拔管后给予解救镇痛)为0.56小时(95%置信区间,0.029至1.095小时)。
结论及临床意义
犬眼球摘除术前球后注射布比卡因并联合传统术前用药是一种有效的辅助镇痛方式,减少了术后额外镇痛药物的需求。