Kalchofner Guerrero Karin S, Campagna Ivo, Bruhl-Day Rodolfo, Hegamin-Younger Cecilia, Guerrero Tomas G
Small Animal Medicine & Surgery Department, School of Veterinary Medicine, St George's University, St.George's, Grenada.
Equine Department, Section Anaesthesiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
Vet Anaesth Analg. 2016 Sep;43(5):571-8. doi: 10.1111/vaa.12348. Epub 2016 Feb 12.
Intraperitoneal (IP) bupivacaine provides postoperative analgesia in dogs undergoing ovariohysterectomy (OHE) alone or in combination with incisional (INC) bupivacaine. This study investigated whether the combination of INC and IP bupivacaine is superior to IP bupivacaine alone.
Prospective, randomized, blinded clinical study.
Thirty-nine privately owned dogs undergoing OHE, aged 25 ± 23 months and weighing 11.8 ± 5.7 kg.
Dogs were premedicated with acepromazine (0.05 mg kg(-1) ) and morphine (0.5 mg kg(-1) ) intramuscularly (IM); anaesthesia was induced with propofol and maintained with isoflurane in oxygen. Carprofen (4 mg kg(-1) ) was administered subcutaneously (SC) after intubation. Bupivacaine (3 mg kg(-1) ) IP was administered before complete closure of the linea alba to all dogs. Dogs were randomly assigned into two groups: group B received bupivacaine (n = 20; 1 mg kg(-1) ) and group S received saline (n = 19; 0.2 mL kg(-1) ) INC as a subcutaneous 'splash' before skin closure. Postoperative analgesia was assessed with a dynamic interactive visual analogue scale, the short form of the Glasgow Composite Pain Scale, and mechanical nociceptive threshold (MNT) measurement at 0.5, 1, 2, 4, 6, 8, 12 and 20 hours after surgery by one blinded observer. Parametric data were tested using t-test; nonparametric data were analysed using the two-sample Wilcoxon test (p < 0.05).
There was no significant difference between groups with regard to age, weight, surgical and anaesthetic duration, incision length, sedation and pain scores. MNT values decreased in both groups at all time points as compared with the baseline. No dog required rescue analgesia. No postoperative complications were observed.
Bupivacaine IP and carprofen SC after morphine IM did provide satisfactory postoperative analgesia in dogs undergoing OHE with the anaesthetic protocol used. There appears to be no clinical advantage to adding bupivacaine INC. Neither protocol could prevent the development of primary hyperalgesia.
腹腔内（IP）注射布比卡因可为单独接受卵巢子宫切除术（OHE）或联合切口（INC）注射布比卡因的犬只提供术后镇痛。本研究调查了INC和IP布比卡因联合使用是否优于单独使用IP布比卡因。
前瞻性、随机、盲法临床研究。
39只接受OHE的私人饲养犬只，年龄25±23个月，体重11.8±5.7千克。
犬只肌肉注射（IM）乙酰丙嗪（0.05毫克/千克）和吗啡（0.5毫克/千克）进行术前用药；用丙泊酚诱导麻醉，并用异氟醚和氧气维持麻醉。插管后皮下注射（SC）卡洛芬（4毫克/千克）。所有犬只在白线完全闭合前腹腔注射布比卡因（3毫克/千克）。犬只被随机分为两组：B组接受布比卡因（n = 20；1毫克/千克），S组接受生理盐水（n = 19；0.2毫升/千克）作为切口皮下“喷洒”，在皮肤闭合前使用。由一名盲法观察者在术后0.5、1、2、4、6、8、12和20小时，使用动态交互式视觉模拟评分法、格拉斯哥综合疼痛量表简表和机械伤害性感受阈值（MNT）测量来评估术后镇痛效果。参数数据使用t检验进行测试；非参数数据使用两样本Wilcoxon检验进行分析（p < 0.05）。
两组在年龄、体重、手术和麻醉持续时间、切口长度、镇静和疼痛评分方面无显著差异。与基线相比，两组在所有时间点的MNT值均下降。没有犬只需要急救镇痛。未观察到术后并发症。
按照所使用的麻醉方案，吗啡IM后腹腔注射布比卡因和皮下注射卡洛芬确实为接受OHE的犬只提供了满意的术后镇痛。添加切口布比卡因似乎没有临床优势。两种方案均无法预防原发性痛觉过敏的发生。
