Fernandez-Parra Rocio, Zilberstein Luca, Fontaine Cyril, Adami Chiara
Department of Veterinary Anesthesiology and Critical Care, Ecole Nationale Vétérinaire d'Alfort, Paris, France.
Department of Veterinary Anesthesiology and Critical Care, Ecole Nationale Vétérinaire d'Alfort, Paris, France.
Vet Anaesth Analg. 2017 Mar;44(2):356-363. doi: 10.1016/j.vaa.2016.03.010. Epub 2017 Mar 1.
The objective of this study was to compare three analgesic protocols for feline castration.
Prospective, randomized clinical study.
Forty-nine client-owned cats.
Cats were injected with intramuscular (IM) dexmedetomidine (15 μg kg) and alfaxalone (3 mg kg) and assigned randomly to one of three treatment groups. Group ITL (n = 15) were administered intratesticular 2% lidocaine (0.05 mL each testicle), group SCL (n = 15) a sacrococcygeal epidural injection of 2% lidocaine (0.1 mL kg) and group IVM (n = 19) intravenous (IV) methadone (0.3 mg kg), before surgery. Cardiorespiratory variables were recorded. In case of autonomic nociceptive response, IV fentanyl (2 μg kg) was administered. During recovery, time from IM atipamezole (75 μg kg, administered at the end of surgery) to sternal recumbency and to active interaction was recorded. Quality of recovery was assessed using a simple descriptive scale. Postoperative analgesia was evaluated using a visual analogue scale and the UNESP-Botucatu multidimensional composite pain scale (MCPS) at return of active interaction and then 1, 2 and 3 hours later.
The three analgesic protocols were comparable in terms of intraoperative fentanyl and propofol requirement. Cardiorespiratory variables stayed within normal ranges in the majority of the cases, although group IVM had the lowest intraoperative respiratory rate (p = 0.0009). No differences were detected between groups in UNESP-Botucatu MCPS scores (p = 0.21). However, group ITL showed higher visual analogue scale score than group IVM (p = 0.001). Four cats enrolled in group ITL, as well as three of group SCL and one of group IVM, required rescue analgesics before the completion of pain assessment.
Intratesticular and sacrococcygeal epidural lidocaine injections could be regarded as good alternatives to systemic opioids in cats undergoing castration, although the benefits of these techniques seem to be of shorter duration than IV methadone.
本研究的目的是比较三种用于猫去势手术的镇痛方案。
前瞻性、随机临床研究。
49只客户拥有的猫。
给猫肌肉注射（IM）右美托咪定（15μg/kg）和阿法沙龙（3mg/kg），并随机分配到三个治疗组之一。ITL组（n = 15）在每个睾丸内注射2%利多卡因（0.05mL），SCL组（n = 15）在骶尾硬膜外注射2%利多卡因（0.1mL/kg），IVM组（n = 19）在手术前静脉注射（IV）美沙酮（0.3mg/kg）。记录心肺变量。如有自主伤害性反应，则静脉注射芬太尼（2μg/kg）。在恢复期间，记录从肌肉注射阿替美唑（75μg/kg，在手术结束时给药）到胸骨卧位和主动互动的时间。使用简单的描述性量表评估恢复质量。在主动互动恢复时以及随后1、2和3小时，使用视觉模拟量表和UNESP - 博图卡图多维复合疼痛量表（MCPS）评估术后镇痛效果。
三种镇痛方案在术中芬太尼和丙泊酚需求量方面具有可比性。大多数情况下，心肺变量保持在正常范围内，尽管IVM组术中呼吸频率最低（p = 0.0009）。在UNESP - 博图卡图MCPS评分方面，各组之间未检测到差异（p = 0.21）。然而，ITL组的视觉模拟量表评分高于IVM组（p = 0.001）。ITL组的4只猫以及SCL组的3只猫和IVM组的1只猫在疼痛评估完成前需要急救镇痛药。
对于接受去势手术的猫，睾丸内和骶尾硬膜外注射利多卡因可被视为全身用阿片类药物的良好替代方案，尽管这些技术的益处似乎比静脉注射美沙酮的持续时间短。
