Soto Natalia, Fauber Amy E, Ko Jeff C H, Moore George E, Lambrechts Nicolaas E
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.
J Am Vet Med Assoc. 2014 Jun 1;244(11):1291-7. doi: 10.2460/javma.244.11.1291.
To compare the analgesic effects of intra-articularly administered saline (0.9% NaCl) solution, morphine, dexmedetomidine, and a morphine-dexmedetomidine combination in dogs undergoing stifle joint surgery for cranial cruciate ligament rupture.
Randomized, controlled, clinical trial.
44 dogs with cranial cruciate ligament rupture that underwent tibial tuberosity advancement (TTA) or tibial plateau leveling osteotomy (TPLO).
Dogs received intra-articular injections of saline solution (0.2 mL/kg [0.09 mL/lb]), morphine (0.1 mg/kg [0.045 mg/lb]), dexmedetomidine (2.5 μg/kg [1.14 μg/lb]), or a combination of morphine (0.1 mg/kg) and dexmedetomidine (2.5 μg/kg). Intra-articular injections of the stifle joint were performed after completion of the corrective osteotomy procedure, just prior to skin closure. Signs of pain were assessed every 2 hours thereafter on the basis of mean behavioral and objective pain scores. Dogs with pain scores exceeding predetermined thresholds were given hydromorphone (0.05 mg/kg [0.023 mg/lb], SC) as rescue analgesia.
Time to rescue analgesia did not significantly differ between dogs that underwent TTA versus TPLO. No significant difference in time to rescue analgesia was found among dogs receiving intra-articular injections of dexmedetomidine (median, 6 hours; range, 2 to 10 hours), morphine (median, 7 hours; range, 4 to 10 hours), or saline solution (median, 5 hours; range, 4 to 10 hours). However, time to rescue analgesia for dogs receiving intra-articular injection of the morphine-dexmedetomidine combination (median, 10 hours; range, 6 to 14 hours) was significantly longer than the time to rescue analgesia for other treatment groups.
Intra-articular administration of the morphine-dexmedetomidine combination provided longer-lasting postoperative analgesia, compared with either morphine or dexmedetomidine alone, in dogs undergoing TTA or TPLO.
比较关节内注射生理盐水（0.9%氯化钠）溶液、吗啡、右美托咪定以及吗啡 - 右美托咪定联合用药对因颅交叉韧带断裂而接受 stifle 关节手术的犬的镇痛效果。
随机对照临床试验。
44 只因颅交叉韧带断裂而接受胫骨结节前移术（TTA）或胫骨平台水平截骨术（TPLO）的犬。
犬接受关节内注射生理盐水溶液（0.2 mL/kg [0.09 mL/lb]）、吗啡（0.1 mg/kg [0.045 mg/lb]）、右美托咪定（2.5 μg/kg [1.14 μg/lb]）或吗啡（0.1 mg/kg）与右美托咪定（2.5 μg/kg）的联合用药。在矫正截骨手术完成后、即将关闭皮肤前，对 stifle 关节进行关节内注射。此后每 2 小时根据平均行为和客观疼痛评分评估疼痛体征。疼痛评分超过预定阈值的犬给予氢吗啡酮（0.05 mg/kg [0.023 mg/lb]，皮下注射）作为解救镇痛。
接受 TTA 与 TPLO 的犬在解救镇痛时间上无显著差异。接受关节内注射右美托咪定（中位数，6 小时；范围，2 至 10 小时）、吗啡（中位数，7 小时；范围，4 至 10 小时）或生理盐水溶液（中位数，5 小时；范围，4 至 10 小时）的犬在解救镇痛时间上未发现显著差异。然而，接受关节内注射吗啡 - 右美托咪定联合用药的犬的解救镇痛时间（中位数，10 小时；范围，6 至 14 小时）显著长于其他治疗组的解救镇痛时间。
在接受 TTA 或 TPLO 的犬中，与单独使用吗啡或右美托咪定相比，关节内注射吗啡 - 右美托咪定联合用药提供了更持久的术后镇痛效果。
