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对开胸犬经胸段或腰段硬膜外给予吗啡的镇痛及生理效应的评估。

Evaluation of analgesic and physiologic effects of epidural morphine administered at a thoracic or lumbar level in dogs undergoing thoracotomy.

作者信息

Carregaro Adriano B, Freitas Gabrielle C, Lopes Carlize, Lukarsewski Rafael, Tamiozzo Fernanda S, Santos Rogério R

出版信息

Vet Anaesth Analg. 2014 Mar;41(2):205-11. doi: 10.1111/vaa.12105.

Abstract

OBJECTIVE

To evaluate the analgesic and physiological effects of epidural morphine administered at the sixth and seventh lumbar or the fifth and sixth thoracic vertebrae in dogs undergoing thoracotomy.

STUDY DESIGN

Prospective, randomized, blinded trial.

ANIMALS

Fourteen mixed-breed dogs, weighing 8.6 ± 1.4 kg.

METHODS

The animals received acepromazine (0.1 mg kg⁻¹) IM and anesthesia was induced with propofol (4 mg kg)⁻¹ IV. The lumbosacral space was punctured and an epidural catheter was inserted up to the region between the sixth and seventh lumbar vertebrae (L, n = 6) or up to the fifth or sixth intercostal space (T, n = 8). The dogs were allowed to recover and after radiographic confirmation of correct catheter position, anesthesia was reinduced with propofol IV and maintained with 1.7% isoflurane. Following stabilization of monitored parameters, animals received morphine (0.1 mg kg⁻¹) diluted in 0.9% NaCl to a final volume of 0.25 mL kg⁻¹ via the epidural catheter, and after 40 minutes, thoracotomy was initiated. Heart rate and rhythm, systolic, mean and diastolic arterial pressures, respiratory rate, arterial hemoglobin oxygen saturation, partial pressure of expired CO₂ and body temperature were measured immediately before the epidural administration of morphine (0 minute) and every 10 minutes during the anesthetic period. The Melbourne pain scale and the visual analog scale were used to assess postoperative pain. The evaluation began 3 hours after the epidural administration of morphine and occurred each hour until rescue analgesia.

RESULTS

There were no important variations in the physiological parameters during the anesthetic period. The post-operative analgesic period differed between the groups, being longer in T (9.9 01.6 hours) compared with L (5.8 ± 0.8 hours).

CONCLUSIONS

The use of morphine, at a volume of 0.25 mL kg 0.1, administered epidurally over the thoracic vertebrae provided longer lasting analgesia than when deposited over the lumbar vertebrae.

摘要

目的

评估在接受开胸手术的犬只中,于第六和第七腰椎或第五和第六胸椎处硬膜外注射吗啡的镇痛和生理效果。

研究设计

前瞻性、随机、双盲试验。

动物

14只杂种犬,体重8.6±1.4千克。

方法

动物肌肉注射乙酰丙嗪(0.1毫克/千克),静脉注射丙泊酚(4毫克/千克)诱导麻醉。穿刺腰骶间隙,插入硬膜外导管至第六和第七腰椎之间区域(L组,n = 6)或至第五或第六肋间间隙(T组,n = 8)。犬只恢复后,经X线确认导管位置正确,静脉注射丙泊酚再次诱导麻醉,并使用1.7%异氟烷维持麻醉。监测参数稳定后,动物通过硬膜外导管接受用0.9%氯化钠稀释至最终体积为0.25毫升/千克的吗啡(0.1毫克/千克),40分钟后开始开胸手术。在硬膜外注射吗啡前即刻(0分钟)以及麻醉期间每10分钟测量心率和心律、收缩压、平均动脉压和舒张压、呼吸频率、动脉血红蛋白氧饱和度、呼出二氧化碳分压和体温。使用墨尔本疼痛量表和视觉模拟量表评估术后疼痛。评估在硬膜外注射吗啡后3小时开始,每小时进行一次,直至进行解救镇痛。

结果

麻醉期间生理参数无重要变化。两组术后镇痛期不同,T组(9.9±1.6小时)比L组(5.8±0.8小时)更长。

结论

以0.25毫升/千克、0.1毫克的剂量硬膜外注射于胸椎处的吗啡比注射于腰椎处提供的镇痛持续时间更长。

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