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脾切除术后犬硬膜外注射吗啡与低剂量布比卡因联合应用与单独硬膜外注射吗啡对运动和呼吸功能影响的比较。

A comparison of epidural morphine with low dose bupivacaine versus epidural morphine alone on motor and respiratory function in dogs following splenectomy.

作者信息

Abelson Amanda L, Armitage-Chan Elizabeth, Lindsey Jane C, Wetmore Lois A

机构信息

Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA, USA.

出版信息

Vet Anaesth Analg. 2011 May;38(3):213-23. doi: 10.1111/j.1467-2995.2011.00601.x.

Abstract

OBJECTIVE

To compare post-operative motor function in dogs that received epidural morphine and low dose bupivacaine versus epidural morphine alone following splenectomy.

STUDY DESIGN

Prospective, randomized study.

ANIMALS

16 client owned dogs undergoing routine splenectomy.

METHODS

Following splenectomy dogs were randomly allocated into one of two groups. The morphine group (MOR) was administered epidural morphine (0.1 mg kg(-1)); the morphine-bupivacaine group (MORB) received epidural morphine (0.1 mg kg(-1)) and low dose bupivacaine [0.25 mg kg(-1), (0.167%)]. The adjusted final volume was 0.15 mL kg(-1) in both groups. Motor function and pain assessment were performed at pre-determined times using a simple numerical motor score and the University of Melbourne Pain Scale (UMPS) respectively. An arterial blood gas was performed 2 hours following epidural administration to check for respiratory compromise. If patients scored >7 on the UMPS or were deemed painful by the observer they were administered hydromorphone intravenously and dose and time of rescue analgesia were recorded.

RESULTS

There were no statistically significant differences in motor scores, pain scores, amount of rescue analgesia administered or PaCO2 between treatment groups. No dogs demonstrated respiratory depression or profound motor dysfunction at any time point during the study. 9/16 (56%) dogs did not require rescue analgesia during the first 18 hours following splenectomy.

CONCLUSIONS AND CLINICAL RELEVANCE

The combination of low dose bupivacaine (0.25 mg kg(-1)) and morphine (0.1 mg kg(-1)) when administered epidurally has little effect on post-operative motor function. This combination can be used without concern of motor paralysis in healthy animals.

摘要

目的

比较脾切除术后接受硬膜外吗啡和低剂量布比卡因的犬与仅接受硬膜外吗啡的犬的术后运动功能。

研究设计

前瞻性随机研究。

动物

16只接受常规脾切除术的客户拥有的犬。

方法

脾切除术后,犬被随机分为两组。吗啡组(MOR)给予硬膜外吗啡(0.1 mg kg⁻¹);吗啡-布比卡因组(MORB)接受硬膜外吗啡(0.1 mg kg⁻¹)和低剂量布比卡因[0.25 mg kg⁻¹,(0.167%)]。两组的调整后最终体积均为0.15 mL kg⁻¹。分别在预定时间使用简单的数字运动评分和墨尔本大学疼痛量表(UMPS)进行运动功能和疼痛评估。硬膜外给药2小时后进行动脉血气分析以检查呼吸功能不全情况。如果患者在UMPS上得分>7或被观察者认为疼痛,则静脉给予氢吗啡酮,并记录救援镇痛的剂量和时间。

结果

治疗组之间在运动评分、疼痛评分、给予的救援镇痛量或PaCO₂方面无统计学显著差异。在研究期间的任何时间点,没有犬表现出呼吸抑制或严重运动功能障碍。9/16(56%)的犬在脾切除术后的前18小时内不需要救援镇痛。

结论及临床意义

硬膜外给予低剂量布比卡因(0.25 mg kg⁻¹)和吗啡(0.1 mg kg⁻¹)的组合对术后运动功能影响很小。这种组合可用于健康动物而无需担心运动麻痹。

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