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利多卡因-布比卡因注入式可吸收明胶止血海绵与利多卡因-布比卡因球后注射用于犬眼球摘除术后镇痛的比较

Use of lidocaine-bupivacaine-infused absorbable gelatin hemostatic sponges versus lidocaine-bupivacaine retrobulbar injections for postoperative analgesia following eye enucleation in dogs.

作者信息

Ploog Christina L, Swinger Robert L, Spade Julia, Quandt Kimberly M, Mitchell Mark A

机构信息

Department of Ophthalmology, VCA Animal Hospital, Aurora, IL 60506.

出版信息

J Am Vet Med Assoc. 2014 Jan 1;244(1):57-62. doi: 10.2460/javma.244.1.57.

Abstract

OBJECTIVE

To compare use of lidocaine-bupivacaine-infused absorbable gelatin hemostatic sponges versus lidocaine-bupivacaine retrobulbar injections for postoperative analgesia in dogs following eye enucleation.

DESIGN

Randomized case-control study.

ANIMALS

19 dogs that underwent eye enucleation.

PROCEDURES

19 client-owned dogs admitted to a referral hospital for routine eye enucleation were enrolled with owner consent and randomly assigned to receive an orbital absorbable gelatin hemostatic sponge infused with lidocaine and bupivacaine after globe removal (n = 8) or retrobulbar injection of lidocaine and bupivacaine before globe removal (11). Baseline pain scores were recorded on the basis of an ordinal pain scale. Anesthetic premedication consisted of hydromorphone, midazolam, and glycopyrrolate. Propofol was used for anesthetic induction and isoflurane for maintenance. A transpalpebral eye enucleation was performed by a board-certified ophthalmologist. Pain scores and heart rate were again recorded 15 and 30 minutes and 1, 2, 4, 6, 8, and 24 hours after extubation by trained observers masked to treatment groups. Dogs were given hydromorphone as rescue analgesia if the total pain score was ≥ 9 of 18 or any categorical pain score was ≥ 3 (on a scale from 0 to 3 or 0 to 4).

RESULTS

There were significant differences over time for comfort level, response to touch, behavior, heart rate, and total pain score; however, there was no difference between treatment groups. One dog in the absorbable gelatin hemostatic sponge group required rescue hydromorphone 4 hours after surgery.

CONCLUSIONS AND CLINICAL RELEVANCE

The absorbable gelatin hemostatic sponge proved to be as effective in providing local analgesia for eye enucleation in dogs as the retrobulbar injections.

摘要

目的

比较利多卡因 - 布比卡因注入式可吸收明胶止血海绵与利多卡因 - 布比卡因球后注射用于犬眼球摘除术后镇痛的效果。

设计

随机病例对照研究。

动物

19只接受眼球摘除术的犬。

步骤

19只因常规眼球摘除术入住转诊医院的客户拥有的犬,经主人同意后入组,并随机分配,在眼球摘除后接受注入利多卡因和布比卡因的眼眶可吸收明胶止血海绵(n = 8),或在眼球摘除前接受利多卡因和布比卡因球后注射(n = 11)。根据序贯疼痛量表记录基线疼痛评分。麻醉前用药包括氢吗啡酮、咪达唑仑和格隆溴铵。丙泊酚用于麻醉诱导,异氟烷用于维持麻醉。由一名获得委员会认证的眼科医生进行经睑裂眼球摘除术。由对治疗组不知情的训练有素的观察者在拔管后15分钟、30分钟以及1、2、4、6、8和24小时再次记录疼痛评分和心率。如果总疼痛评分≥18分中的9分或任何分类疼痛评分≥3分(范围为0至3或0至4),则给犬使用氢吗啡酮作为解救镇痛药。

结果

舒适度、对触摸的反应、行为、心率和总疼痛评分随时间有显著差异;然而,治疗组之间没有差异。可吸收明胶止血海绵组中有1只犬在术后4小时需要使用氢吗啡酮进行解救镇痛。

结论及临床意义

可吸收明胶止血海绵在为犬眼球摘除术提供局部镇痛方面与球后注射同样有效。

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