Cremer Jeannette, Sum Steffen O, Braun Christina, Figueiredo Juliana, Rodriguez-Guarin Carolina
Animal Health Trust, Anaesthesia Department, Landwades Park, Kentford, Newmarket, UK.
Vet Anaesth Analg. 2013 Jul;40(4):432-9. doi: 10.1111/vaa.12032. Epub 2013 Mar 28.
To investigate the efficacy of maxillary and infraorbital nerve blocks for prevention of cardiovascular and qualitative responses to rhinoscopy, as well as response to skin clamping after assigned nerve block placement.
Randomized, blinded, placebo-controlled cross-over experimental study.
Eight random-source mixed breed dogs > 1 year old and weighing between 13 and 22 kg.
Within three anesthetic episodes, separated by at least 3 days, dogs were assigned to receive either 1 mL lidocaine 2% maxillary nerve block (ML); 0.5 mL lidocaine 2% infraorbital nerve block (IOL); or equal amounts of saline for maxillary or infraorbital nerve block combined as control treatment (S). Monitoring included temperature, respiratory rate, end-tidal CO2 , ECG, heart rate (HR), systolic, diastolic and mean arterial pressure (SAP, DAP, MAP). Posterior (pR) and anterior rhinoscopies (aR) were performed and scored. Differences from baseline for outcome parameters HR, SAP, DAP, MAP were analyzed using repeated-measures anova, and results reported as mean ± SD. Binary scores for rhinoscopy were analyzed using logistic regression, and odds ratio was reported.
Changes from baseline for HR and SAP were significant for all treatments, besides ML for pR. Difference in changes from baseline among treatments was statistically significant for HR during pR with ML < S, and for SAP, DAP and MAP in right and left aR with ML < S and IOL > ML, except for DAP in left aR with only IOL > ML. Analysis of the binary score showed that the probability of a response for S and IOL treatments was nearly triple that of the ML treatment. None of the dogs, regardless of the treatments applied, responded to skin clamping.
Cardiovascular parameters do not seem to reflect the occurrence of adverse reactions during rhinoscopy. The maxillary nerve block is superior to the infraorbital nerve block, as applied in this study, in preventing adverse reactions during posterior rhinoscopy.
探讨上颌神经阻滞和眶下神经阻滞对预防鼻镜检查时心血管及定性反应的效果，以及在指定神经阻滞放置后对皮肤夹捏的反应。
随机、双盲、安慰剂对照交叉实验研究。
8只随机来源的1岁以上、体重在13至22千克之间的杂种犬。
在至少间隔3天的3次麻醉过程中，犬被分配接受以下处理：1毫升2%利多卡因上颌神经阻滞（ML）；0.5毫升2%利多卡因眶下神经阻滞（IOL）；或等量生理盐水用于上颌或眶下神经阻滞联合作为对照处理（S）。监测包括体温、呼吸频率、呼气末二氧化碳分压、心电图、心率（HR）、收缩压、舒张压和平均动脉压（SAP、DAP、MAP）。进行后鼻镜检查（pR）和前鼻镜检查（aR）并评分。使用重复测量方差分析分析HR、SAP、DAP、MAP等结局参数与基线的差异，结果以平均值±标准差报告。使用逻辑回归分析鼻镜检查的二元评分，并报告比值比。
除pR时的ML外，所有处理的HR和SAP与基线相比均有显著变化。pR时ML组的HR在各处理间与基线变化的差异有统计学意义（ML < S），左右aR时ML组的SAP、DAP和MAP在各处理间与基线变化的差异有统计学意义（ML < S且IOL > ML），但左aR时DAP仅IOL > ML。二元评分分析表明，S组和IOL组出现反应的概率几乎是ML组的三倍。无论应用何种处理，均无犬对皮肤夹捏产生反应。
心血管参数似乎不能反映鼻镜检查期间不良反应的发生情况。在本研究中应用时，上颌神经阻滞在预防后鼻镜检查期间的不良反应方面优于眶下神经阻滞。
