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在绵羊中使用多端口导管经腰骶部途径给予低浓度布比卡因和吗啡进行胸段硬膜外镇痛。

Thoracic epidural analgesia via the lumbosacral approach using multiport catheters with a low concentration of bupivacaine and morphine in sheep.

作者信息

DeRossi Rafael, Pagliosa Ronaldo, Módolo Tiago C, Maciel Felipe B, Macedo Gustavo G

机构信息

Department of Veterinary Medicine, Surgery and Anesthesiology, Faculty of Veterinary Medicine and Animal Science, Federal University of Mato Grosso do Sul, Campo Grande, Brazil.

出版信息

Vet Anaesth Analg. 2012 May;39(3):306-14. doi: 10.1111/j.1467-2995.2011.00689.x. Epub 2012 Mar 8.

Abstract

OBJECTIVE

To determine the analgesic and systemic effects of thoracic epidural administration of bupivacaine (BP) and morphine (MP) in conscious sheep.

STUDY DESIGN

Randomized, crossover, experimental study.

ANIMALS

Six healthy castrated sheep weighing between 40 and 50 kg.

METHODS

Each sheep received, via the lumbosacral approach, BP (0.5 mg kg(-1)), MP (0.1 mg kg(-1)), and BP plus MP (BPMP; 0.25 mg kg(-1) + 0.05 mg kg(-1)) in a randomized order. Heart rate, blood pressure, respiratory rate, blood gas analysis, skin temperature, rectal temperature, analgesia, sedation, and motor blockade were determined before treatment and at predetermined intervals until analgesia had disappeared.

RESULTS

The main areas of complete analgesia for the BP and BPMP treatments were the thorax and forelimb bilaterally. The median duration of analgesia was shorter with MP treatment (45 minutes; score 2) than with BP treatment (70 minutes) and BPMP treatment (140 minutes; p < 0.05). The BP and BPMP treatments caused motor block, and MP and BPMP treatments showed mild sedation. Significant decreases in systolic and diastolic arterial blood pressures were observed only with the BP treatment (p < 0.05). Epidural MP combined with the BP local anesthetic depressed ventilation but within acceptable limits in these clinically healthy sheep.

CONCLUSIONS

Thoracic epidural administration of BPMP to sheep resulted in longer duration of analgesia of the thorax and forelimbs bilaterally in conscious sheep than the administration of MP or BP alone. The incidence of complications was low, but side-effects such as depressed ventilation and muscle paralysis occurred and require appropriate management.

CLINICAL RELEVANCE

This technique should be considered as another method for the relief of postoperative pain after thoracic surgery in sheep.

摘要

目的

确定在清醒绵羊中经胸段硬膜外给予布比卡因(BP)和吗啡(MP)的镇痛及全身效应。

研究设计

随机、交叉、实验性研究。

动物

6只体重在40至50千克之间的健康去势绵羊。

方法

每只绵羊通过腰骶途径,按随机顺序接受BP(0.5毫克/千克)、MP(0.1毫克/千克)以及BP加MP(BPMP;0.25毫克/千克 + 0.05毫克/千克)。在治疗前及预定的时间间隔内测定心率、血压、呼吸频率、血气分析、皮肤温度、直肠温度、镇痛、镇静及运动阻滞情况,直至镇痛消失。

结果

BP和BPMP治疗的完全镇痛主要区域为双侧胸部和前肢。MP治疗的镇痛中位持续时间(45分钟;评分2)短于BP治疗(70分钟)和BPMP治疗(140分钟;p < 0.05)。BP和BPMP治疗引起运动阻滞,MP和BPMP治疗表现出轻度镇静。仅BP治疗时观察到收缩压和舒张压显著降低(p < 0.05)。硬膜外MP与BP局部麻醉药联合使用会抑制通气,但在这些临床健康的绵羊中处于可接受范围内。

结论

在清醒绵羊中,经胸段硬膜外给予BPMP比单独给予MP或BP能使双侧胸部和前肢的镇痛持续时间更长。并发症发生率低,但会出现如通气抑制和肌肉麻痹等副作用,需要适当处理。

临床意义

该技术应被视为绵羊胸段手术后缓解疼痛的另一种方法。

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