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超声引导下股神经和坐骨神经阻滞在犬体内的布比卡因血药浓度和感觉及运动阻滞时间。

Blood concentration of bupivacaine and duration of sensory and motor block following ultrasound-guided femoral and sciatic nerve blocks in dogs.

机构信息

Faculty of Veterinary Medicine, University of Calgary, Calgary, Canada.

出版信息

PLoS One. 2018 Mar 5;13(3):e0193400. doi: 10.1371/journal.pone.0193400. eCollection 2018.

Abstract

Peripheral nerve blocks are becoming increasingly popular for perioperative use as anesthetics and analgesics in small animals. This prospective study was performed to investigate the duration of motor and sensory blockade following use of bupivacaine for ultrasound-guided femoral and sciatic nerve blocks in dogs and to measure the plasma concentrations of bupivacaine that result from these procedures. Six dogs were anesthetized twice using a randomized cross-over design. At the first anesthetic, dogs were assigned to receive either an ultrasound-guided femoral nerve block or sciatic nerve block with 0.15 mL kg-1 of bupivacaine 0.5%. Two months later, the other nerve block was performed during a second anesthetic. At 5, 10, 15, 20, 30 and 60 minutes after injection, arterial blood samples were collected for laboratory measurement of bupivacaine. After 60 minutes, dogs were recovered from anesthesia. Starting at two hours post-injection, video-recordings of the dogs were made every two hours for 24 hours. The videos were randomized and the degree of motor and sensory blockade was evaluated using a three-point scoring system (0 = no effect, 1 = mild effect, 2 = complete blockade) by two blinded assessors. The median (range) times to full recovery from motor blockade were 11 (6-14) hours (femoral) and 12 (4-18) hours (sciatic), and 15 (10-18) hours (femoral) and 10 (4-12) hours (sciatic) for sensory blockade. There were no differences in the median times to functional recovery for the two techniques. Plasma concentrations of bupivacaine were no different following the blocks and were less than 0.78 μg mL-1 at all times. These results suggest that these ultrasound-guided nerve blocks do not result in potentially toxic systemic levels of local anesthetic and that their duration of action is useful for providing anesthesia and analgesia for pelvic limb procedures.

摘要

周围神经阻滞在小动物围手术期作为麻醉剂和镇痛剂越来越受欢迎。本前瞻性研究旨在探讨布比卡因用于超声引导股神经和坐骨神经阻滞时,犬的运动和感觉阻滞持续时间,并测量这些操作产生的布比卡因血浆浓度。

6 只犬采用随机交叉设计进行了 2 次麻醉。在第一次麻醉时,犬被分配接受超声引导的股神经阻滞或坐骨神经阻滞,剂量为 0.15ml/kg 的 0.5%布比卡因。2 个月后,在第二次麻醉时进行另一种神经阻滞。注射后 5、10、15、20、30 和 60 分钟时采集动脉血样,用于实验室测量布比卡因。60 分钟后,犬从麻醉中恢复。注射后 2 小时开始,每 2 小时对犬进行一次视频记录,持续 24 小时。视频是随机的,由两名盲法评估员使用三点评分系统(0 = 无影响,1 = 轻度影响,2 = 完全阻滞)评估运动和感觉阻滞的程度。从运动阻滞完全恢复的中位数(范围)时间为 11(6-14)小时(股神经)和 12(4-18)小时(坐骨神经),感觉阻滞的中位数(范围)时间为 15(10-18)小时(股神经)和 10(4-12)小时(坐骨神经)。两种技术的功能恢复中位数时间无差异。阻滞后布比卡因的血浆浓度没有差异,所有时间点均小于 0.78μg/ml。

这些结果表明,这些超声引导的神经阻滞不会导致局部麻醉剂产生潜在毒性的全身水平,其作用持续时间可用于提供骨盆肢体手术的麻醉和镇痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70ad/5837095/771bc402bc4f/pone.0193400.g001.jpg

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