Gray Travis R, Dzikiti Brighton T, Zeiler Gareth E
Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa.
Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa; Clinical Sciences Department, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies.
Vet Anaesth Analg. 2019 Mar;46(2):214-225. doi: 10.1016/j.vaa.2018.09.041. Epub 2018 Sep 28.
To determine the effect of hyaluronidase on time to onset and offset of anaesthesia in ropivacaine or bupivacaine femoral-ischiatic nerve blocks.
Blinded randomized crossover trial.
Eight dogs.
Each dog underwent four treatments separated into two blocks - initially, the ropivacaine treatment block: RS (ropivacaine 0.5% plus saline 0.9%) and RH (ropivacaine 0.5% plus hyaluronidase 100 IU mL), followed 3 weeks later by the bupivacaine treatment block: BS (bupivacaine 0.5% plus saline) and BH (bupivacaine 0.5% plus hyaluronidase). The local anaesthetics were administered at 0.1 mL kg per site. Hyaluronidase and saline were administered at 0.02 mL kg per site. Performance of femoral-ischiatic blocks was aided by a combined ultrasound-electrolocation technique. The mechanical nociceptive threshold was measured, until offset or 360 minutes, using an algometer to ascertain baseline, onset and offset of anaesthesia. Onset and offset of anaesthesia were defined as a 25% increase above and as a return to <25% above baseline nociceptive threshold readings, respectively.
The median (range) onset of anaesthesia for RS and RH was 21 (3-60) and 12 (3-21) minutes, respectively (p = 0.141), and offset was 270 (90-360) and 180 (30-300) minutes, respectively (p = 0.361). By contrast, the median (range) onset of anaesthesia for BS and BH was 24 (3-60) and 9 (3-27) minutes, respectively (p = 0.394), and offset was 360 (240-360) and 330 (210-360) minutes, respectively (p = 0.456).
Hyaluronidase had no effect on the onset and offset times of ropivacaine and bupivacaine femoral-ischiatic nerve blocks in dogs compared with saline. The onset and offset times were highly variable in all treatments. Clinically, the high variability of the onset and offset times of the regional anaesthesia of these local anaesthetic drugs means that clinicians must monitor the animal's response and, if required, provide additional analgesic drugs.
确定透明质酸酶对罗哌卡因或布比卡因股坐骨神经阻滞麻醉起效时间和消退时间的影响。
双盲随机交叉试验。
8只犬。
每只犬接受4种治疗,分为两个阶段——最初是罗哌卡因治疗阶段:RS(0.5%罗哌卡因加0.9%生理盐水)和RH(0.5%罗哌卡因加100 IU/mL透明质酸酶),3周后是布比卡因治疗阶段:BS(0.5%布比卡因加生理盐水)和BH(0.5%布比卡因加透明质酸酶)。局部麻醉药按每部位0.1 mL/kg给药。透明质酸酶和生理盐水按每部位0.02 mL/kg给药。采用超声-电定位联合技术辅助进行股坐骨神经阻滞。使用痛觉计测量机械性伤害性感受阈值,直至麻醉消退或360分钟,以确定麻醉的基线、起效和消退情况。麻醉起效和消退分别定义为高于基线伤害性感受阈值读数增加25%以上和恢复到低于基线25%以上。
RS和RH的麻醉中位(范围)起效时间分别为21(3 - 60)分钟和12(3 - 21)分钟(p = 0.141),消退时间分别为270(90 - 360)分钟和180(30 - 300)分钟(p = 0.361)。相比之下,BS和BH的麻醉中位(范围)起效时间分别为24(3 - 60)分钟和9(3 - 27)分钟(p = 0.394),消退时间分别为360(240 - 360)分钟和330(210 - 360)分钟(p = 0.456)。
与生理盐水相比,透明质酸酶对犬罗哌卡因和布比卡因股坐骨神经阻滞的起效和消退时间无影响。所有治疗中起效和消退时间的变异性都很高。临床上,这些局部麻醉药区域麻醉起效和消退时间的高度变异性意味着临床医生必须监测动物的反应,并在需要时提供额外的镇痛药。