Steiner A, Ossent P, Mathis G A
Veterinär-Chirurgischen Klinik.
Schweiz Arch Tierheilkd. 1990;132(5):227-37.
We present a literature review on current techniques of intravenous regional anesthesia and intravenous regional antibiosis of the distal limb in cattle. Our own experiences performing a combined procedure of intravenous anesthesia and antibiosis (10 million I.U. benzylpenicillin sodium dissolved in 15-20 ml 2%-lidocaine hydrochloride) are discussed in detail. Complete anesthesia of the treated limb was achieved in 22 out of 23 cases (96%). The successfully treated animals did not express any symptoms of pain for the entire surgical procedure. In 2 out of 15 patients (13%) we observed serious post-surgical complications. The reason of which was extensive thrombosis of all veins distal of the tourniquet. The age of the clots at the time of slaughtering of the cows was determined histologically. A direct cause effect relationship between intravenous anesthesia/antibiosis and complication is indicated. We conclude that direct toxicity of the 2000-fold overdose of benzylpenicillin (as compared to generally accepted therapeutic levels) most likely caused the problem. We recommend to reduce the dose of penicillin in regional intravenous antibiosis to maximally 100,000 I.U., even in the case of local sepsis.
我们对牛远端肢体静脉区域麻醉和静脉区域抗菌的当前技术进行了文献综述。详细讨论了我们自己进行静脉麻醉和抗菌联合操作(将1000万国际单位苄青霉素钠溶解于15 - 20毫升2%盐酸利多卡因中)的经验。23例中有22例(96%)实现了治疗肢体的完全麻醉。成功治疗的动物在整个手术过程中未表现出任何疼痛症状。15例中有2例(13%)出现了严重的术后并发症。原因是止血带远端所有静脉广泛血栓形成。通过组织学确定了母牛屠宰时血栓的形成时间。表明了静脉麻醉/抗菌与并发症之间存在直接的因果关系。我们得出结论,苄青霉素过量2000倍(与普遍接受的治疗水平相比)的直接毒性很可能导致了该问题。我们建议即使在局部脓毒症的情况下,区域静脉抗菌中青霉素的剂量最多减少至100,000国际单位。