Smith Lesley J, Yu Jeff Kwang-An
Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI, USA.
Vet Anaesth Analg. 2001 Apr;28(2):87-96. doi: 10.1046/j.1467-2987.2000.00038.x. Epub 2016 Nov 15.
Objective To compare the efficacy of epidural buprenorphine with epidural morphine for post-operative pain relief in dogs undergoing cranial cruciate ligament rupture repair. Study design A randomized, double blind clinical trial. Animals Twenty client-owned dogs with cranial cruciate ligament rupture. Methods Dogs were randomly assigned to receive either epidural buprenorphine (4 µg kg) or epidural morphine (0.1 mg kg) in a total volume of 0.2 mL kg. Epidural injections were performed immediately after induction of anesthesia. End-tidal halothane and CO were recorded every 15 minutes from the time of epidural administration of drug to extubation. A numerical rating pain score system was used by a blinded observer to evaluate analgesia beginning at extubation and continuing at specific intervals for 24 hours after surgery. Heart rate, respiratory rate, and blood pressure were recorded noninvasively at the same times. If pain score indicated moderate discomfort, rescue morphine at 1.0 mg kg was administered intramuscularly. Results There were no significant differences between groups with respect to pain score, heart rate, respiratory rate, indirect blood pressure, end-tidal halothane or end-tidal CO at any time point. Fifty percent of dogs in the buprenorphine group and 50% of dogs in the morphine group required rescue analgesic medication. Time of systemic rescue morphine administration did not differ significantly between the two groups. There were no clinically observable side-effects from epidural administration of either drug in any of the dogs of this study. Conclusions Epidural buprenorphine is as effective as epidural morphine for the relief of postoperative hindlimb orthopedic pain in dogs. Clinical relevance Buprenorphine appears to be an effective opioid for epidural use in healthy dogs. Buprenorphine may offer certain advantages over morphine for epidural use, such as lower abuse potential and, in some clinics, reduced cost and less wastage of drug.
目的 比较硬膜外注射丁丙诺啡与吗啡对犬颅交叉韧带断裂修复术后疼痛缓解的效果。研究设计 一项随机、双盲临床试验。动物 20只患颅交叉韧带断裂的客户自养犬。方法 将犬随机分为两组，分别接受总量为0.2 mL/kg的硬膜外丁丙诺啡（4 μg/kg）或硬膜外吗啡（0.1 mg/kg）。在麻醉诱导后立即进行硬膜外注射。从硬膜外给药至拔管期间，每15分钟记录一次呼气末氟烷和二氧化碳浓度。由一位不知情的观察者使用数字评分疼痛评分系统，从拔管时开始评估镇痛效果，并在术后24小时内按特定间隔持续评估。同时无创记录心率、呼吸频率和血压。如果疼痛评分显示中度不适，则肌肉注射1.0 mg/kg的解救吗啡。结果 在任何时间点，两组在疼痛评分、心率、呼吸频率、间接血压、呼气末氟烷或呼气末二氧化碳方面均无显著差异。丁丙诺啡组50%的犬和吗啡组50%的犬需要解救镇痛药物。两组全身使用解救吗啡的时间无显著差异。在本研究的任何犬中，硬膜外注射这两种药物均未观察到临床可见的副作用。结论 硬膜外注射丁丙诺啡在缓解犬术后后肢骨科疼痛方面与硬膜外注射吗啡效果相同。临床意义 丁丙诺啡似乎是一种用于健康犬硬膜外给药的有效阿片类药物。与吗啡相比，丁丙诺啡在硬膜外使用时可能具有某些优势，如滥用可能性较低，在一些诊所还具有成本降低和药物浪费减少的优点。
