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低剂量腰荐硬膜外罗哌卡因在健康小马中的镇痛效果。

Antinociceptive effects of low dose lumbosacral epidural ropivacaine in healthy ponies.

机构信息

Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, NL-3584 CM Utrecht, The Netherlands.

出版信息

Vet J. 2012 Jul;193(1):240-5. doi: 10.1016/j.tvjl.2011.11.004. Epub 2012 Mar 6.

Abstract

The objective of this study was to evaluate the safety and efficacy of low dose lumbosacral epidural ropivacaine in ponies. Antinociceptive effects of epidural ropivacaine were evaluated by means of mechanical nociceptive thresholds (MNTs) at several spinal levels in conscious ponies. The effects of ropivacaine on nociceptive afferent transmission to the spinal cord were also assessed by measuring spinal cord somatosensory evoked potentials (SSEPs) in anaesthetised ponies. Ataxia scores were determined in conscious ponies to assess the effects on motor function. A randomised, placebo controlled, double blind cross-over design was used. Low dose lumbosacral epidural ropivacaine led to increases in MNTs at various anatomical locations with a maximum effect at the lumbosacral and sacrococcygeal regions, both with respect to increase in threshold and duration of effect. Analysis of SSEPs showed that epidural ropivacaine influenced both Aβ- and Aδ-mediated afferent transmission to the spinal cord at the level of the lumbosacral junction. Ponies showed mild ataxia after low dose lumbosacral epidural ropivacaine, but all ponies remained standing. Application of low dose lumbosacral epidural ropivacaine provided safe and efficacious antinociceptive effects in conscious and anaesthetised ponies, and could therefore be a valuable addition to multimodal analgesic protocols in Equidae.

摘要

本研究旨在评估低剂量腰骶部硬膜外罗哌卡因在小马中的安全性和有效性。通过在清醒小马的几个脊柱水平上测量机械痛觉阈值 (MNTs) 来评估硬膜外罗哌卡因的镇痛效果。还通过测量麻醉小马的脊髓体感诱发电位 (SSEP) 来评估罗哌卡因对疼痛传入纤维向脊髓传递的影响。在清醒小马中确定共济失调评分以评估对运动功能的影响。采用随机、安慰剂对照、双盲交叉设计。低剂量腰骶部硬膜外罗哌卡因导致在不同解剖部位的 MNTs 增加,在腰骶部和尾骨区域的效果最大,无论是在阈值增加还是作用持续时间方面。SSEP 分析表明,硬膜外罗哌卡因影响腰骶连接水平脊髓的 Aβ-和 Aδ-介导的传入纤维传递。小马在接受低剂量腰骶部硬膜外罗哌卡因后出现轻度共济失调,但所有小马仍能站立。低剂量腰骶部硬膜外罗哌卡因的应用在清醒和麻醉小马中提供了安全有效的镇痛效果,因此可能是马科动物多模式镇痛方案的有益补充。

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