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对接受盆腔肢体骨科手术的犬进行两种外周腰骶丛阻滞的回顾性比较。

Retrospective comparison of two peripheral lumbosacral plexus blocks in dogs undergoing pelvic limb orthopaedic surgery.

作者信息

Vettorato E, De Gennaro C, Okushima S, Corletto F

机构信息

Dick White Referrals, Station Farm - London Road, Six Mile Bottom, Cambridgeshire, CB80UH.

出版信息

J Small Anim Pract. 2013 Dec;54(12):630-7. doi: 10.1111/jsap.12146. Epub 2013 Oct 24.

Abstract

OBJECTIVES

To compare the lateral pre-iliac approach to the lumbar plexus combined with lumbar paravertebral sciatic nerve block, and the dorsal paravertebral approach to the lumbar plexus combined with sciatic nerve block in dogs.

METHODS

Retrospective examination of case records of dogs that received the blocks and underwent pelvic limb orthopaedic surgery between 2010 and 2012. Success rate (intraoperative fentanyl consumption <2·1 µg/kg/hour), type and dose of local anaesthetic used, multiple of minimum alveolar concentration of volatile anaesthetic agent administered, incidence of intraoperative hypotension, postoperative methadone administration, postoperative contralateral limb paralysis and neurological complication at 6 weeks re-examination were analysed.

RESULTS

Ninety-six and 95 records were retrieved in which lateral pre-iliac - lumbar paravertebral sciatic nerve and dorsal paravertebral - sciatic nerve were used, respectively. Success rates were 82·3% in lateral pre-iliac - lumbar paravertebral sciatic nerve and 74·7% in dorsal paravertebral - sciatic nerve groups. Bupivacaine, levobupivacaine and ropivacaine were used. Total local anaesthetic doses, intraoperative hypotension and postoperative methadone administered were similar between groups; minimum alveolar concentration multiple was significantly (P<0·001) lower in lateral pre-iliac - lumbar paravertebral sciatic nerve group. No neurological complications were noted.

CLINICAL SIGNIFICANCE

Although success rates and perioperative analgesic requirements were not significantly different, the different exposure to anaesthetic agents suggests that the two techniques may not be equivalent.

摘要

目的

比较犬髂前外侧入路腰丛联合腰旁坐骨神经阻滞与椎旁背侧入路腰丛联合坐骨神经阻滞。

方法

回顾性检查2010年至2012年间接受阻滞并接受骨盆肢体骨科手术的犬的病例记录。分析成功率(术中芬太尼消耗量<2·1μg/kg/小时)、所用局部麻醉药的类型和剂量、挥发性麻醉药最低肺泡浓度倍数、术中低血压发生率、术后美沙酮给药情况、术后对侧肢体麻痹以及6周复查时的神经并发症。

结果

分别检索到96份和95份使用髂前外侧 - 腰旁坐骨神经和椎旁背侧 - 坐骨神经阻滞的记录。髂前外侧 - 腰旁坐骨神经组成功率为82·3%,椎旁背侧 - 坐骨神经组为74·7%。使用了布比卡因、左旋布比卡因和罗哌卡因。两组间局部麻醉药总剂量、术中低血压及术后美沙酮给药情况相似;髂前外侧 - 腰旁坐骨神经组最低肺泡浓度倍数显著更低(P<0·001)。未观察到神经并发症。

临床意义

尽管成功率和围手术期镇痛需求无显著差异,但不同的麻醉药暴露表明这两种技术可能不等同。

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