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关节内注射吗啡、布比卡因或不进行治疗用于单侧肘关节镜检查术后镇痛

Intra-articular morphine, bupivacaine or no treatment for postoperative analgesia following unilateral elbow joint arthroscopy.

作者信息

Gurney M A, Rysnik M, Comerford E J, Cripps P J, Iff I

机构信息

Northwest Surgeons, Delamere House, Ashville Point, Sutton Weaver, Cheshire, UK.

出版信息

J Small Anim Pract. 2012 Jul;53(7):387-92. doi: 10.1111/j.1748-5827.2012.01222.x. Epub 2012 Jun 19.


DOI:10.1111/j.1748-5827.2012.01222.x
PMID:22712686
Abstract

OBJECTIVES: To compare intra-articular morphine or bupivacaine against no treatment following unilateral elbow joint arthroscopy using force plate analysis and pain scoring. METHODS: Thirty-one dogs were randomly allocated to receive 0·1 mg/kg intra-articular morphine, 0·5 mg/kg bupivacaine or no treatment following elbow arthroscopy. Force plate analysis, pain scoring and kinematic evaluation were performed before anaesthesia, 4 and 24 hours after surgery. Peak vertical force index, symmetry index, rate of loading, rate of unloading, stance time and range of motion were obtained from gait analysis. Pain scoring was performed every 4 hours and interventional analgesia (0·3 mg/kg methadone) was administered if necessary. RESULTS: Of 29 dogs analysed, peak vertical force index (P<0·001), symmetry index (P=0·01) and rate of unloading (P=0·01) decreased significantly over time in each group; however, this was not affected by treatment. No significant differences were observed in stance time or rate of loading over time. Kinematic (range of motion) evaluation was not complete for all dogs. Pain scores increased significantly at both time points postoperatively in the no treatment group (P=0·007) and in morphine-treated dogs at 4 hours compared to baseline (P=0·03). For intra-articular bupivacaine significant increases in pain scores were not detected (P=0·28). CLINICAL SIGNIFICANCE: No benefit to intra-articular bupivacaine or morphine was detected using peak vertical force index from force plate analysis. Bupivacaine prevented increases in pain scores at both time points as did morphine at the 24-hour evaluation, compared to no treatment.

摘要

目的:使用测力板分析和疼痛评分,比较单侧肘关节镜检查后关节内注射吗啡或布比卡因与不治疗的效果。 方法:31只犬随机分为三组,分别在肘关节镜检查后接受0.1mg/kg关节内吗啡、0.5mg/kg布比卡因或不治疗。在麻醉前、术后4小时和24小时进行测力板分析、疼痛评分和运动学评估。从步态分析中获得垂直力峰值指数、对称指数、加载速率、卸载速率、站立时间和运动范围。每4小时进行一次疼痛评分,必要时给予介入性镇痛(0.3mg/kg美沙酮)。 结果:在分析的29只犬中,每组的垂直力峰值指数(P<0.001)、对称指数(P=0.01)和卸载速率(P=0.01)均随时间显著下降;然而,这不受治疗的影响。在站立时间或加载速率随时间变化方面未观察到显著差异。并非所有犬的运动学(运动范围)评估都完成。与基线相比,未治疗组术后两个时间点的疼痛评分均显著增加(P=0.007),吗啡治疗组在4小时时疼痛评分也显著增加(P=0.03)。关节内注射布比卡因未检测到疼痛评分显著增加(P=0.28)。 临床意义:使用测力板分析的垂直力峰值指数未检测到关节内注射布比卡因或吗啡有任何益处。与不治疗相比,布比卡因在两个时间点均防止了疼痛评分增加,吗啡在24小时评估时也有此效果。

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引用本文的文献

[1]
Effect of analgesic therapy on clinical outcome measures in a randomized controlled trial using client-owned dogs with hip osteoarthritis.

BMC Vet Res. 2012-10-4

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