布比卡因与利多卡因混合液超声引导下猫卵巢切除术中腹横肌平面阻滞的围手术期镇痛效果
Perioperative analgesic effects of an ultrasound-guided transversus abdominis plane block with a mixture of bupivacaine and lidocaine in cats undergoing ovariectomy.
作者信息
Skouropoulou Despoina, Lacitignola Luca, Centonze Paola, Simone Angela, Crovace Alberto M, Staffieri Francesco
机构信息
Transplants of Organs and Tissues and Cellular Therapies, D.E.O.T., University of Bari, Italy; Department of Emergency and Organ Transplantation, Section of Veterinary Clinics and Animal Production, "Aldo Moro" University of Bari, Bari, Italy.
Department of Emergency and Organ Transplantation, Section of Veterinary Clinics and Animal Production, "Aldo Moro" University of Bari, Bari, Italy.
出版信息
Vet Anaesth Analg. 2018 May;45(3):374-383. doi: 10.1016/j.vaa.2018.01.005. Epub 2018 Feb 3.
OBJECTIVE
To evaluate the perioperative analgesic effects of a transversus abdominis plane (TAP) block with a mixture of lidocaine and bupivacaine administered to cats undergoing ovariectomy.
STUDY DESIGN
Controlled, randomized, prospective, blinded clinical study.
ANIMALS
A group of 20 healthy cats.
METHODS
Robenacoxib (2 mg kg) was administered subcutaneously 0.5 hour before intramuscular (IM) administration of ketamine (5 mg kg), methadone (0.1 mg kg) and dexmedetomidine (0.01 mg kg). General anesthesia was induced with intravenous (IV) propofol and maintained with isoflurane. An ultrasound-guided TAP block was performed by injecting 0.5% bupivacaine (0.2 mL kg) diluted in a total volume of 1.5 mL 2% lidocaine bilaterally (TAP group, n = 10) or the same volume of saline solution bilaterally in controls (CTR group, n = 10). During surgery, a 20% increase in heart rate and respiratory frequency was treated with IV fentanyl (0.001 mg kg). Before premedication and at 1, 2, 3, 4, 6, 8, 12, 16, 20 and 24 hours after extubation, pain was assessed with a simple descriptive pain scale, that ranged from 0 (no pain) to 4 (intense pain). For pain scores ≥3, IM methadone (0.1 mg kg) was administered. Data were analyzed with the Friedman or the analysis of variance (anova) test, and p < 0.05 was considered statistically significant.
RESULTS
Only two cats in the CTR group were administered one dose of fentanyl during surgery. At 2, 6, 8, 12, 16, 20 and 24 hours after surgery, the pain score was higher in the CTR group. A mean dose of 0.5 ± 0.2 mg kg methadone was administered to all cats in the CTR groups within 24 hours. Methadone was not administered to the TAP group (pain score < 3).
CONCLUSIONS AND CLINICAL RELEVANCE
Ultrasound-guided TAP block can be a reliable adjunctive technique, providing analgesia for up to 24 hours in cats undergoing ovariectomy.
目的
评估对接受卵巢切除术的猫使用利多卡因和布比卡因混合液进行腹横肌平面（TAP）阻滞的围手术期镇痛效果。
研究设计
对照、随机、前瞻性、盲法临床研究。
动物
一组20只健康猫。
方法
在肌肉注射（IM）氯胺酮（5mg/kg）、美沙酮（0.1mg/kg）和右美托咪定（0.01mg/kg）前0.5小时皮下注射罗贝考昔（2mg/kg）。静脉注射（IV）丙泊酚诱导全身麻醉，异氟醚维持麻醉。通过双侧注射稀释于总量1.5mL 2%利多卡因中的0.5%布比卡因（0.2mL/kg）进行超声引导下TAP阻滞（TAP组，n = 10），对照组（CTR组，n = 10）双侧注射相同体积的生理盐水。手术期间，心率和呼吸频率增加20%时静脉注射芬太尼（0.001mg/kg）进行处理。在术前用药前以及拔管后1、2、3、4、6、8、12、16、20和24小时，使用简单描述性疼痛量表评估疼痛，量表范围为0（无疼痛）至4（剧烈疼痛）。对于疼痛评分≥3的情况，肌肉注射美沙酮（0.1mg/kg）。数据采用Friedman检验或方差分析（anova）进行分析，p < 0.05被认为具有统计学意义。
结果
CTR组仅2只猫在手术期间接受了一剂芬太尼。术后2、6、8、12、16、20和24小时，CTR组的疼痛评分更高。CTR组所有猫在24小时内平均接受了0.5±0.2mg/kg的美沙酮。TAP组未使用美沙酮（疼痛评分<3）。
结论及临床意义
超声引导下TAP阻滞可作为一种可靠的辅助技术，为接受卵巢切除术猫提供长达24小时的镇痛。
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