Choquette Amélie, Del Castillo Jérôme R E, Moreau Maxim, Guillot Martin, Alexander Kate, Kona-Boun Jean-Jacques, Gauvin Dominique, Troncy Eric
Animal Pharmacology Research Group of Quebec (GREPAQ), Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada.
Animal Pharmacology Research Group of Quebec (GREPAQ), Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada.
Vet Anaesth Analg. 2017 Mar;44(2):317-328. doi: 10.1016/j.vaa.2016.08.002. Epub 2017 Jan 11.
To compare the motor and sensory block efficacy and duration of a modified paravertebral brachial plexus block (PBPB) after administration of lidocaine alone (LI) or combined with epinephrine (LE).
Prospective, randomized, blinded, crossover study.
A total of eight healthy female Beagle dogs.
Under general anesthesia, modified PBPB was performed on the left thoracic limb using neurostimulation and/or ultrasound guidance to administer lidocaine (2 mg kg; 0.2 mL kg) either alone (treatment LI, n = 10) or with epinephrine (1:100,000; treatment LE, n = 9). Sensory block was evaluated through reaction to a painful mechanical stimulus applied at five sites on the limb. Motor block effect was evaluated according to visual gait assessments and thoracic limb vertical force measurements under dynamic and static conditions. Data were analyzed using repeated-measures generalized estimating equations. All statistical tests were performed two-sided at the α = 0.05 significance threshold.
The duration of sensory block did not differ significantly between treatments. Visible gait impairment was more persistent in LE than in LI (118 ± 63 minutes for LI and 163 ± 23 minutes for LE; mean ± standard deviation) (p = 0.027). At nadir value, dynamic peak vertical force was lower in LE than in LI (p = 0.007). For both dynamic and static evaluations, the nadir and the return to baseline force were delayed in LE (return to normal at 180-200 minutes) when compared with LI (130-140 minutes) (p < 0.005).
The addition of epinephrine to lidocaine prolonged the duration and increased the intensity of the regional block, as verified by visual gait assessment and kinetic analysis. No significant difference was noted between treatments regarding sensory blockade. Kinetic analysis could be useful to evaluate regional anesthetic effect in dogs.
比较单独使用利多卡因（LI）或联合肾上腺素（LE）进行改良椎旁臂丛神经阻滞（PBPB）后的运动和感觉阻滞效果及持续时间。
前瞻性、随机、双盲、交叉研究。
总共8只健康雌性比格犬。
在全身麻醉下，使用神经刺激和/或超声引导对左前肢进行改良PBPB，单独给予利多卡因（2mg/kg；0.2mL/kg）（治疗组LI，n = 10）或联合肾上腺素（1:100,000；治疗组LE，n = 9）。通过对肢体五个部位施加疼痛性机械刺激的反应来评估感觉阻滞。根据动态和静态条件下的视觉步态评估和前肢垂直力测量来评估运动阻滞效果。使用重复测量广义估计方程分析数据。所有统计检验均在α = 0.05显著性阈值下进行双侧检验。
各治疗组之间感觉阻滞的持续时间无显著差异。LE组的可见步态障碍比LI组更持久（LI组为118±63分钟，LE组为163±23分钟；平均值±标准差）（p = 0.027）。在最低点时，LE组的动态峰值垂直力低于LI组（p = 0.007）。对于动态和静态评估，与LI组（130 - 140分钟）相比，LE组的最低点和恢复到基线力的时间延迟（180 - 200分钟恢复正常）（p < 0.005）。
利多卡因联合肾上腺素可延长区域阻滞的持续时间并增加其强度，这通过视觉步态评估和动力学分析得到验证。各治疗组在感觉阻滞方面未观察到显著差异。动力学分析可能有助于评估犬的区域麻醉效果。
