Cerasoli Ilaria, Tutunaru Alexandru, Cenani Alessia, Ramirez Juan, Detilleux Johann, Balligand Marc, Sandersen Charlotte
Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.
Department of Quantitative Genetics, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.
Vet Anaesth Analg. 2017 Mar;44(2):337-345. doi: 10.1016/j.vaa.2016.01.001. Epub 2017 Jan 11.
To evaluate the efficacy, in terms of the amount of rescue analgesia required, and the clinical usefulness of epidural injection of morphine with bupivacaine or levobupivacaine for elective pelvic limb surgery in dogs during a 24-hour perioperative period.
Prospective, blinded, randomized clinical study.
A group of 26 dogs weighing 31.7 ± 14.2 (mean ± standard deviation) kg and aged 54 ± 36 months.
All dogs were premedicated with methadone intravenously (0.2 mg kg) and anaesthesia induced with diazepam (0.2 mg kg) and propofol intravenously to effect. After induction of anaesthesia, dogs randomly received a lumbosacral epidural injection of morphine 0.1 mg kg with either levobupivacaine 0.5% (1 mg kg; group LevoBM) or bupivacaine 0.5% (1 mg kg; group BM). Cardiovascular, respiratory and temperature values were recorded during the intra- and postoperative period. A visual analogue scale, subjective pain scale, sedation scale and the short form of the Glasgow pain scale were assessed every 6 hours after epidural injection during 24 hours. The ability to stand and walk, neurological deficits and other side effects were assessed at the same time points. The amount of rescue analgesia (sufentanil intraoperatively and methadone postoperatively) was recorded.
No statistically significant differences were found between groups for any of the recorded data, with the exception of the incidence of spontaneous urination and postoperative rescue analgesia requirement. In group LevoBM four dogs spontaneously urinated at recovery while none of the dogs in group BM did (p = 0.03) and seven dogs of group LevoBM required postoperative rescue analgesia versus none of the dogs in the BM group (p = 0.005).
and clinical relevance Epidural LevoBM is a suitable alternative to BM in healthy dogs during elective pelvic limb surgery. Epidural BM produced more urinary retention but better pain control compared to the same concentration and dose of LevoBM in dogs.
评估在24小时围手术期内,硬膜外注射吗啡联合布比卡因或左旋布比卡因用于犬择期骨盆四肢手术时,所需挽救性镇痛量方面的疗效以及临床实用性。
前瞻性、盲法、随机临床研究。
一组26只犬,体重31.7±14.2(均值±标准差)千克,年龄54±36个月。
所有犬均静脉注射美沙酮(0.2毫克/千克)进行术前用药,并静脉注射地西泮(0.2毫克/千克)和丙泊酚诱导麻醉至起效。麻醉诱导后,犬随机接受腰荐部硬膜外注射0.1毫克/千克吗啡联合0.5%左旋布比卡因(1毫克/千克;左旋布比卡因-吗啡组)或0.5%布比卡因(1毫克/千克;布比卡因-吗啡组)。在术中及术后记录心血管、呼吸和体温值。在硬膜外注射后24小时内,每6小时评估一次视觉模拟评分、主观疼痛评分、镇静评分以及格拉斯哥疼痛量表简表。在相同时间点评估站立和行走能力、神经功能缺损及其他副作用。记录挽救性镇痛量(术中舒芬太尼及术后美沙酮)。
除自主排尿发生率和术后挽救性镇痛需求外,两组间的任何记录数据均未发现统计学显著差异。左旋布比卡因-吗啡组有4只犬在恢复时自主排尿,而布比卡因-吗啡组无犬自主排尿(p = 0.03);左旋布比卡因-吗啡组有7只犬术后需要挽救性镇痛,而布比卡因-吗啡组无犬需要(p = 0.005)。
硬膜外注射左旋布比卡因-吗啡在健康犬择期骨盆四肢手术中是布比卡因-吗啡的合适替代方案。与相同浓度和剂量的左旋布比卡因相比,硬膜外注射布比卡因-吗啡在犬中产生更多尿潴留,但疼痛控制更好。