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布比卡因和罗哌卡因在清醒犬硬膜外腔的镇痛及心肺效应比较

Comparative analgesic and cardiopulmonary effects of bupivacaine and ropivacaine in the epidural space of the conscious dog.

作者信息

Duke Tanya, Caulkett Nigel A, Ball Stephanie D, Remedios Audrey M

机构信息

Department of Veterinary Anesthesiology, Surgery and Radiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatchewan, Canada.

出版信息

Vet Anaesth Analg. 2000 Jan;27(1):13-21. doi: 10.1046/j.1467-2995.2000.00001.x. Epub 2016 Nov 15.

Abstract

OBJECTIVE

To compare the cardiopulmonary effects and sensory blockade of epidural bupivacaine and ropivacaine.

STUDY DESIGN

Prospective randomized study.

ANIMALS

Six young adult medium-sized crossbred dogs weighing 25.7 ± 7.1 kg.

METHOD

Dogs were chronically implanted with a lumbosacral epidural catheter. Acepromazine sedated dogs received all treatments: 0.5% bupivacaine at 0.14 mL kg (LB5) or 0.22 mL kg (HB5); 0.5% ropivacaine at 0.14 mL kg (LR5) or 0.22 mL kg (HR5); 0.75% bupivacaine at 0.22 mL kg (HB7.5) or 0.75% ropivacaine at 0.22 mL kg (HR7.5). Loss of sensation was tested at the level of the perineum, hind toe webs, flank, and caudodorsal rib areas before injection, and post-injection (PI) up to 150 minutes PI. Systemic arterial blood pressure and heart rate were recorded before injection, and every 10 minutes PI until 150 minutes PI. Arterial blood gas analyses were performed prior to injection, and at 30, 60 and 150 minutes PI.

RESULTS

No statistical differences existed between groups for the cardiopulmonary data or time to onset of block. Group HR7.5 had lower systolic (10-70 minutes PI) and diastolic (10-70 minutes PI) blood pressures and group HR5 had lower mean (10-90 minutes PI) and diastolic (10-90 minutes PI) blood pressures compared to baseline. Heart rate was lower compared to baseline in groups LR5 and HB7.5. A significant, but mild metabolic acidosis developed in groups LR5 and HB7.5 (150 minutes PI). No differences were present for the duration of block between groups, but duration of block in the dorsocaudal rib area was shorter in group HR5 compared to HR7.5.

CONCLUSION

Epidural ropivacaine and bupivacaine at the doses used have mild effects on the cardiopulmonary system, and extent of block are similar.

CLINICAL RELEVANCE

The 0.75% concentration of bupivacaine and ropivacaine at 0.22 mL kg appeared to contribute to greater success of block (>80%) at dermatomes L-L.

摘要

目的

比较布比卡因和罗哌卡因硬膜外给药对心肺功能的影响及感觉阻滞情况。

研究设计

前瞻性随机研究。

动物

6只体重为25.7±7.1千克的成年杂种犬。

方法

给犬长期植入腰骶部硬膜外导管。用乙酰丙嗪镇静后,犬接受所有治疗:0.5%布比卡因,剂量为0.14毫升/千克(LB5)或0.22毫升/千克(HB5);0.5%罗哌卡因,剂量为0.14毫升/千克(LR5)或0.22毫升/千克(HR5);0.75%布比卡因,剂量为0.22毫升/千克(HB7.5)或0.75%罗哌卡因,剂量为0.22毫升/千克(HR7.5)。在注射前、注射后(PI)直至150分钟PI时,测试会阴部、后趾蹼、胁腹和尾背肋骨区域的感觉丧失情况。在注射前、注射后每隔10分钟直至150分钟PI时记录体循环动脉血压和心率。在注射前、注射后30、60和150分钟PI时进行动脉血气分析。

结果

各治疗组间心肺数据或阻滞起效时间无统计学差异。与基线相比,HR7.5组的收缩压(注射后10 - 70分钟)和舒张压(注射后10 - 70分钟)较低,HR5组的平均动脉压(注射后10 - 90分钟)和舒张压(注射后10 - 90分钟)较低。LR5组和HB7.5组的心率低于基线。LR5组和HB7.5组出现显著但轻度的代谢性酸中毒(注射后150分钟)。各治疗组间阻滞持续时间无差异,但HR5组尾背肋骨区域的阻滞持续时间比HR7.5组短。

结论

所用剂量的硬膜外罗哌卡因和布比卡因对心肺系统影响轻微,阻滞范围相似。

临床意义

0.75%浓度的布比卡因和罗哌卡因,剂量为0.22毫升/千克,似乎有助于在L - L皮节获得更高的阻滞成功率(>80%)。

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