Moldal Elena R, Eriksen Thomas, Kirpensteijn Jolle, Nødtvedt Ane, Kristensen Annemarie T, Sparta Fiorella M, Haga H Andreas
Department of Small Animal Clinical Sciences, Faculty of Life Sciences, University of Copenhagen, Frederiksberg C, Denmark.
Vet Anaesth Analg. 2013 Jan;40(1):63-73. doi: 10.1111/j.1467-2995.2012.00773.x. Epub 2012 Oct 4.
To evaluate the usefulness of intratesticular and subcutaneous lidocaine in alleviating the intraoperative nociceptive response to castration, measured by pulse rate (PR) and mean arterial pressure (MAP), and to test the applicability of heart rate variability (HRV) analysis in assessing this response.
Randomized, controlled, observer-blinded experimental trial.
Thirty-nine healthy male cats admitted for castration.
One group received general anaesthesia and served as control group (GA), while the treatment group (LA) additionally received local anaesthesia (lidocaine 2 mg kg(-1)) intratesticularly and subcutaneously. PR and MAP were recorded at anaesthesia baseline (T0), treatment (T1), incision left testicle (T2), traction on spermatic cord (T3), tightening of the autoligature and resection of the cord (T4), incision on the right side (T5), traction on spermatic cord (T6), and tightening of the autoligature and resection of cord (T7). HRV analysis was divided into three 5-minute intervals: baseline (H0), treatment (H1), and surgery (H2).
There were significant increases in PR and MAP for both groups during surgery from T3 onwards; however, the increase in the treatment group (LA) was significantly lower than for the control group (GA). For HRV analysis, significant differences were found between groups in the following parameters during surgery: TP (total power), VLF (very low frequency), SDNN (standard deviation of NN intervals [= the interval between two consecutive R-waves in the ECG]), and TI (triangular index), which were lower in the LA group. Mean NN was significantly lower in the GA group, whereas LF (low frequency) and LFn (low frequency, normalized value) were lower in the LA group. HF (high frequency) and HFn (high frequency, normalized value) decreased significantly from H1 to H2 in both groups.
The study showed that the nociceptive response to surgery was alleviated by the use of intratesticular and subcutaneous lidocaine and that HRV analysis is a promising research tool to estimate intraoperative nociception in cats during general anaesthesia.
通过脉搏率（PR）和平均动脉压（MAP）评估睾丸内及皮下注射利多卡因在减轻去势术中伤害性反应方面的有效性，并测试心率变异性（HRV）分析在评估该反应中的适用性。
随机、对照、观察者盲法实验性试验。
39只因去势而入院的健康雄性猫。
一组接受全身麻醉作为对照组（GA），而治疗组（LA）额外接受睾丸内及皮下局部麻醉（利多卡因2 mg·kg⁻¹）。在麻醉基线（T0）、治疗时（T1）、切开左侧睾丸时（T2）、牵拉精索时（T3）、收紧自动结扎线并切除精索时（T4）、切开右侧时（T5）、牵拉精索时（T6）以及收紧自动结扎线并切除精索时（T7）记录PR和MAP。HRV分析分为三个5分钟时间段：基线（H0）、治疗（H1）和手术（H2）。
两组在手术期间从T3开始PR和MAP均显著升高；然而，治疗组（LA）的升高显著低于对照组（GA）。对于HRV分析，手术期间两组在以下参数上存在显著差异：总功率（TP）、极低频（VLF）、NN间期标准差（SDNN [=心电图中两个连续R波之间的间期]）和三角指数（TI），LA组这些参数较低。GA组平均NN显著较低，而LA组低频（LF）和低频标准化值（LFn）较低。两组高频（HF）和高频标准化值（HFn）从H1到H2均显著下降。
该研究表明，睾丸内及皮下注射利多卡因可减轻手术的伤害性反应，且HRV分析是评估猫在全身麻醉期间术中伤害感受的一种有前景的研究工具。
