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用于犬鼻镜检查及鼻腔活检的上颌神经阻滞改良眶下进路的评估。

Evaluation of a modified infraorbital approach for a maxillary nerve block for rhinoscopy with nasal biopsy of dogs.

作者信息

Fizzano Kristen M, Claude Andrew K, Kuo Lan-Hsin, Eells Jeffrey B, Hinz Simone B, Thames Brittany E, Ross Matthew K, Linford Robert L, Wills Robert W, Olivier Alicia K, Archer Todd M

出版信息

Am J Vet Res. 2017 Sep;78(9):1025-1035. doi: 10.2460/ajvr.78.9.1025.

DOI:10.2460/ajvr.78.9.1025
PMID:28836847
Abstract

OBJECTIVE To determine whether a maxillary nerve block via a modified infraorbital approach, applied before rhinoscopy and nasal biopsy of dogs, would decrease procedural nociception, minimize cardiorespiratory anesthetic effects, and improve recovery quality. ANIMALS 8 healthy adult hound-type dogs PROCEDURES In a crossover study, dogs received 0.5% bupivacaine (0.1 mL/kg) or an equivalent volume of saline (0.9% NaCl) solution as a maxillary nerve block via a modified infraorbital approach. A 5-cm, 20-gauge over-the-needle catheter was placed retrograde within each infraorbital canal, and bupivacaine or saline solution was administered into each pterygopalatine region. Rhinoscopy and nasal biopsy were performed. Variables monitored included heart rate, systolic arterial blood pressure (SAP), mean arterial blood pressure (MAP), diastolic arterial blood pressure (DAP), plasma cortisol and norepinephrine concentrations, purposeful movement, and pain scores. After a 14-day washout period, the other treatment was administered on the contralateral side, and rhinoscopy and nasal biopsy were repeated. RESULTS SAP, MAP, and DAP were significantly higher for the saline solution treatment than for the bupivacaine treatment, irrespective of the time point. Plasma cortisol concentrations after saline solution treatment were significantly higher 5 minutes after nasal biopsy than at biopsy. Heart rate, norepinephrine concentration, purposeful movement, and pain score were not significantly different between treatments. CONCLUSIONS AND CLINICAL RELEVANCE Maxillary nerve block via a modified infraorbital approach prior to rhinoscopy and nasal biopsy reduced procedural nociception as determined on the basis of blood pressures and plasma cortisol concentrations during anesthesia. These findings warrant further evaluation in dogs with nasal disease.

摘要

目的 确定在犬鼻内镜检查和鼻活检前,通过改良眶下途径进行上颌神经阻滞是否会降低手术伤害感受、将心肺麻醉效应降至最低并改善恢复质量。

动物 8只健康成年猎犬型犬

方法 在一项交叉研究中,犬通过改良眶下途径接受0.5%布比卡因(0.1 mL/kg)或等量的生理盐水(0.9%氯化钠)溶液作为上颌神经阻滞。将一根5 cm、20号的套管针逆行置入每个眶下管内,并将布比卡因或生理盐水注入每个翼腭区域。进行鼻内镜检查和鼻活检。监测的变量包括心率、收缩期动脉血压(SAP)、平均动脉血压(MAP)、舒张期动脉血压(DAP)、血浆皮质醇和去甲肾上腺素浓度、有目的的运动和疼痛评分。在14天的洗脱期后,在对侧给予另一种治疗,并重复鼻内镜检查和鼻活检。

结果 无论时间点如何,生理盐水治疗组的SAP、MAP和DAP均显著高于布比卡因治疗组。生理盐水治疗后,鼻活检后5分钟的血浆皮质醇浓度显著高于活检时。治疗之间的心率、去甲肾上腺素浓度、有目的的运动和疼痛评分无显著差异。

结论及临床意义 在鼻内镜检查和鼻活检前,通过改良眶下途径进行上颌神经阻滞可降低手术伤害感受,这是根据麻醉期间的血压和血浆皮质醇浓度确定的。这些发现值得在患有鼻腔疾病的犬中进一步评估。

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