Nuss K, Eiberle B J, Sauter-Louis C
Departement für Nutztiere, Vetsuisse-Fakultät der Universität Zürich, Winterthurerstrasse 260, 8057 Zürich, Schweiz.
Tierarztl Prax Ausg G Grosstiere Nutztiere. 2012;40(3):141-9.
To compare the feasibility and efficacy of two methods of local anaesthesia with procaine 2% for flank laparotomy in cattle. MATERIAL UND METHODS: A total of 100 cattle undergoing laparotomy were divided into two groups of 50: one group underwent a modified infiltration anaesthesia (MIA) technique consisting of an incisional line block combined with an inverted L-block, and the other group underwent proximal paravertebral anaesthesia (PPVA). Indications for laparotomy were displaced abomasum, caecal disorders, rumenotomy and exploratory laparotomy. The two methods were compared with regard to the reaction of the cows to the application of anaesthesia, the degree of difficulty and the amount of time and anaesthetic agent required. The reactions of the cattle to incision of the various layers of the abdominal wall, abdominal exploration and surgical closure of the abdomen were assessed.
Both techniques required a mean of 8 minutes to complete but the MIA method was considered more difficult than the PPVA (p=0.13). The PPVA required significantly (p<0.001) less procaine than the MIA (144 vs. 195ml). Comparison of the two techniques with respect to different types of pain reactions (no reaction, non-specific reaction, specific reaction) during cutting of the different layers of the abdominal wall revealed that PPVA provided significantly (p=0.01) better analgesia than the MIA. After PPVA, pain reactions to incision of the external oblique abdominal muscle were more severe, but reactions to abdominal exploration and to suturing the two oblique abdominal muscles were significantly (p<0.05) milder than after MIA.
Neither technique resulted in consistent and complete elimination of pain reactions in every patient, but overall PPVA had better results than the MIA. The analgesic effect of both techniques could be improved by repeated administration of procaine and mild tranquillization (Xylazine; 0.01mg/kg i.v.) before laparotomy. For PPVA, a combination of procaine and epinephrine should be used. It would be advantageous to have anaesthetic agents, e.g. lidocaine, that are more potent than procaine 2% for local analgesia in cattle.
比较两种2%普鲁卡因局部麻醉方法用于牛侧腹剖腹术的可行性和效果。材料与方法：总共100头接受剖腹术的牛被分为两组，每组50头：一组采用改良浸润麻醉（MIA）技术，包括切口线阻滞联合倒L形阻滞，另一组采用近端椎旁麻醉（PPVA）。剖腹术的指征为皱胃移位、盲肠疾病、瘤胃切开术和 exploratory laparotomy（此处可能有误，推测为探查性剖腹术）。比较两种方法在奶牛对麻醉应用的反应、操作难度以及所需时间和麻醉剂用量方面的差异。评估牛对腹壁各层切开、腹腔探查和腹部手术缝合的反应。
两种技术平均都需要8分钟完成，但MIA方法被认为比PPVA更困难（p = 0.13）。PPVA所需的普鲁卡因明显（p < 0.001）少于MIA（144毫升对195毫升）。比较两种技术在腹壁不同层切开时不同类型疼痛反应（无反应、非特异性反应、特异性反应）发现，PPVA提供的镇痛效果明显（p = 0.01）优于MIA。PPVA后，对腹外斜肌切开的疼痛反应更严重，但对腹腔探查和缝合两条腹斜肌的反应明显（p < 0.05）比MIA后更轻。
两种技术都不能使每个患者的疼痛反应持续且完全消除，但总体而言PPVA的效果优于MIA。在剖腹术前重复给予普鲁卡因和轻度镇静（赛拉嗪；0.01毫克/千克静脉注射）可改善两种技术的镇痛效果。对于PPVA，应使用普鲁卡因和肾上腺素的组合。拥有比2%普鲁卡因在牛局部镇痛中更有效的麻醉剂，如利多卡因，将是有利的。
