Krohm Patricia, Levionnois Olivier, Ganster Murielle, Zilberstein Luca, Spadavecchia Claudia
Anaesthesia Section, Department for Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Switzerland Allevia AG, The Bone CRO, Bern, Switzerland.
Vet Anaesth Analg. 2011 Jul;38(4):363-73. doi: 10.1111/j.1467-2995.2011.00623.x. Epub 2011 Jun 6.
To evaluate the peri-operative analgesic efficacy of intra-articular bupivacaine administered before or after stifle arthrotomy.
Prospective, randomized, blind, placebo-controlled experimental trial.
Thirty-nine healthy goats.
The goats were allocated randomly to one of three intra-articular treatment groups: group PRE (bupivacaine before and saline after surgery), group POST (saline before and bupivacaine after surgery) and group CON (saline before and after surgery). Anaesthesia was maintained with a constant end-tidal sevoflurane of 2.5%. Intra-operatively heart rate (HR), respiratory rate and mean arterial blood pressure (MAP) after critical surgical events (CSE) were recorded and compared with pre-incision values. Propofol requirements to maintain surgical anaesthesia were recorded. Flunixin was administered for 5 days. Post-operative pain assessment at 20 minutes, 2 hours, 4 hours after recovery and on day 2 and 3 included a multidimensional pain score (MPS), a lameness score and mechanical nociceptive threshold (MNT) testing. Rescue analgesia consisted of systemic opioids. Data were analysed using Kruskal-Wallis, Mann-Whitney, Friedman or chi-square tests as appropriate.
Intra-operatively, group PRE had lower HR and MAP at several CSEs than groups POST/CON and required less propofol [0 mg kg(-1) (0-0 mg kg(-1))] than group POST/CON [0.3 mg kg(-1) (0-0.6 mg kg(-1))]. Post-operatively, group POST had significantly higher peri-articular MNTs than groups PRE and CON up to 4 hours after recovery. No treatment effect was detected for MPS, lameness scores and rescue analgesic consumption at any time point.
Pre-operative intra-articular bupivacaine provided notable intra-operative analgesia in goats undergoing stifle arthrotomy but did not reduce post-operative pain. Post-operative intra-articular bupivacaine provided a short lasting reduction of peri-articular hyperalgesia without affecting the requirements for systemic analgesia. Multimodal perioperative pain therapy is recommended to provide adequate analgesia for stifle arthrotomy in goats.
评估在膝关节切开术前或术后给予关节腔内布比卡因的围手术期镇痛效果。
前瞻性、随机、盲法、安慰剂对照试验。
39只健康山羊。
将山羊随机分配到三个关节腔内治疗组之一：PRE组（术前给予布比卡因，术后给予生理盐水）、POST组（术前给予生理盐水，术后给予布比卡因）和CON组（术前和术后均给予生理盐水）。使用2.5%的持续呼气末七氟醚维持麻醉。记录关键手术事件（CSE）后术中的心率（HR）、呼吸频率和平均动脉血压（MAP），并与切口前值进行比较。记录维持手术麻醉所需的丙泊酚用量。氟尼辛给药5天。术后恢复20分钟、2小时、4小时以及术后第2天和第3天的疼痛评估包括多维疼痛评分（MPS）、跛行评分和机械性伤害性感受阈值（MNT）测试。补救性镇痛采用全身性阿片类药物。根据情况使用Kruskal-Wallis、Mann-Whitney、Friedman或卡方检验分析数据。
术中，PRE组在几个CSE时的HR和MAP低于POST/CON组，且所需丙泊酚[0 mg·kg⁻¹（0 - 0 mg·kg⁻¹）]少于POST/CON组[0.3 mg·kg⁻¹（0 - 0.6 mg·kg⁻¹）]。术后，POST组在恢复后长达4小时的关节周围MNT显著高于PRE组和CON组。在任何时间点，未检测到MPS、跛行评分和补救性镇痛药物用量的治疗效果。
术前关节腔内注射布比卡因可为接受膝关节切开术的山羊提供显著的术中镇痛，但不能减轻术后疼痛。术后关节腔内注射布比卡因可短暂减轻关节周围痛觉过敏，且不影响全身性镇痛的需求。建议采用多模式围手术期疼痛治疗，为山羊膝关节切开术提供充分的镇痛。
