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睾丸切除术后犬硬膜外注射利多卡因、利多卡因-吗啡或利多卡因-曲马多的镇痛效果比较。

Comparison of analgesia provided by lidocaine, lidocaine-morphine or lidocaine-tramadol delivered epidurally in dogs following orchiectomy.

作者信息

Almeida Ricardo M, Escobar André, Maguilnik Samara

机构信息

School of Agriculture and Veterinary Medicine, Universidade de Brasília, Brasília, DF, Brazil.

出版信息

Vet Anaesth Analg. 2010 Nov;37(6):542-9. doi: 10.1111/j.1467-2995.2010.00563.x.

Abstract

OBJECTIVE

To evaluate and compare the postoperative analgesia provided by epidural lidocaine, lidocaine/morphine or lidocaine/tramadol in dogs following elective orchiectomy.

STUDY DESIGN

Prospective experimental trial.

ANIMALS

Thirty-six mongrel dogs aged 2-8 years old, weighing 6.6-22 kg.

METHODS

The dogs received 6.0 mg kg(-1) of lidocaine combined with 1.0 mg kg(-1) of tramadol, 0.1 mg kg(-1) of morphine or 0.01 mL kg(-1) of 0.9% NaCl epidurally. Analgesia was assessed at 4, 8, 12, 18 and 24 hours (T4, T8, T12 and T24) after the offset of lidocaine using a scale composed of physiologic and behavioral parameters. Rescue analgesia with morphine (0.2 mg kg(-1) , IM) was performed if the evaluation score exceeded 10 during the postoperative period. The scores over time were analyzed using the Friedman's two-way analysis of variance and the comparison between groups was made by the Kruskal-Wallis test with statistical significances accepted if p ≤ 0.05.

RESULTS

There were no differences in the pain scores between the morphine and tramadol groups over time and no rescue analgesia was administered. In the NaCl group, rescue analgesia was needed at T4, T8 and T12. Within this group, the final evaluation times (T18 and T24) had lower pain scores than at T4, T8 and T12.

CONCLUSIONS AND CLINICAL RELEVANCE

Epidural lidocaine/tramadol provided an analgesic effect comparable to that of epidural lidocaine/morphine during the first 12 hours after surgical castration without substantial side effects, suggesting that tramadol may be an effective postoperative analgesic in dogs submitted to this surgical procedure.

摘要

目的

评估并比较利多卡因、利多卡因/吗啡或利多卡因/曲马多硬膜外给药用于犬择期睾丸切除术后的镇痛效果。

研究设计

前瞻性实验性试验。

动物

36只2至8岁、体重6.6至22千克的杂种犬。

方法

犬硬膜外给予6.0毫克/千克的利多卡因,分别联合1.0毫克/千克的曲马多、0.1毫克/千克的吗啡或0.01毫升/千克的0.9%氯化钠溶液。在利多卡因作用消失后的4、8、12、18和24小时(T4、T8、T12和T24),使用由生理和行为参数组成的评分量表评估镇痛效果。如果术后评估分数超过10分,则给予吗啡(0.2毫克/千克,肌肉注射)进行补救镇痛。使用Friedman双向方差分析对随时间变化的分数进行分析,并通过Kruskal-Wallis检验进行组间比较,若p≤0.05,则认为具有统计学意义。

结果

吗啡组和曲马多组随时间变化的疼痛评分无差异,且未给予补救镇痛。在氯化钠组中,T4、T8和T12时需要进行补救镇痛。在该组中,最终评估时间(T18和T24)的疼痛评分低于T4、T8和T12时。

结论及临床意义

在手术去势后的前12小时内,硬膜外利多卡因/曲马多的镇痛效果与硬膜外利多卡因/吗啡相当,且无明显副作用,这表明曲马多可能是接受该手术的犬有效的术后镇痛药。

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