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犬前肢手术中两种臂丛神经阻滞技术的临床比较。

Clinical comparison of two techniques of brachial plexus block for forelimb surgery in dogs.

作者信息

Benigni L, Lafuente P, Viscasillas J

机构信息

The Royal Veterinary College, North Mymms, Hartfield, Hertfordshire AL9 7TA, United Kingdom.

The Royal Veterinary College, North Mymms, Hartfield, Hertfordshire AL9 7TA, United Kingdom.

出版信息

Vet J. 2019 Feb;244:23-27. doi: 10.1016/j.tvjl.2018.12.001. Epub 2018 Dec 5.

Abstract

The objective of this study was to compare two different local anaesthesia techniques for intraoperative analgesia in dogs undergoing surgical procedures distal to the mid humeral diaphysis. Thirty-two dogs were divided into two groups: the US group received an ultrasound-guided brachial plexus block at the level of the first rib and the N group received a neurostimulation-guided paravertebral brachial plexus block. Ropivacaine 0.75% at 1.5mg/kg was injected in each case. Dogs were monitored during the surgical procedure, and rescue analgesia was administered whenever the heart rate, respiratory rate or blood pressure increased more than 20% from the basal values. Success rate was defined as no need for rescue analgesia during surgery and complete blockade of the operated leg evaluated just after anaesthesia recovery. Complications were also recorded. Data was analysed using Fisher exact and Mann/Whitney tests. Success rate was observed in 14/16 (87%) dogs and in 12/16 (75%) dogs in the US and N groups, respectively (P=0.65). Complications recorded were hypotension in three cases (US group, n=1; N group, n=2) and Horner's syndrome in three cases (US group, n=1; N group, n=2; P=0.65). Both techniques were found to provide good level of analgesia that allowed performing the orthopaedic procedures from the mid humeral diaphysis and distal in the limb, without the need for further analgesia.

摘要

本研究的目的是比较两种不同的局部麻醉技术,用于肱骨骨干中段远端接受外科手术的犬术中镇痛。32只犬被分为两组:超声组(US组)在第一肋水平接受超声引导下臂丛神经阻滞,神经刺激组(N组)接受神经刺激引导下椎旁臂丛神经阻滞。每组均注射1.5mg/kg的0.75%罗哌卡因。在手术过程中对犬进行监测,每当心率、呼吸频率或血压较基础值升高超过20%时,给予补救性镇痛。成功率定义为手术期间无需补救性镇痛,且在麻醉恢复后立即评估手术肢体的完全阻滞情况。同时记录并发症。使用Fisher精确检验和Mann/Whitney检验对数据进行分析。超声组16只犬中有14只(87%)、神经刺激组16只犬中有12只(75%)观察到成功率(P=0.65)。记录的并发症有3例低血压(超声组1例,神经刺激组2例)和3例霍纳综合征(超声组1例,神经刺激组2例;P=0.65)。发现两种技术均能提供良好的镇痛水平,使从肱骨骨干中段及肢体远端进行骨科手术成为可能,而无需进一步镇痛。

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