Floriano Dario, Sahagian Michael J, Chiavaccini Ludovica
Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Molecular and Biomedical Sciences, North Carolina State University, Raleigh, North Carolina.
Vet Surg. 2019 Oct;48(7):1330-1337. doi: 10.1111/vsu.13290. Epub 2019 Jul 21.
To compare perioperative opioid consumption and duration of hospitalization (DOH) in anesthetized dogs receiving opioid-based analgesia (OBA) vs those receiving bupivacaine epidural-based analgesia (EPID) during cystotomy.
Retrospective cross-sectional study.
Fifty-six client-owned dogs undergoing cystotomy.
Clinical records of dogs undergoing cystotomy between January 2015 and December 2017 were reviewed. Demographic data, duration of anesthesia and surgery, anesthetic management, perioperative opioid consumption expressed in morphine equivalents (ME), perioperative use of adjuvant analgesics, time to first micturition, time to eat, time to ambulate, and DOH were recorded. Opioid consumption and DOH were compared with a Wilcoxon rank-sum test, followed by linear regression analysis as appropriate. Time to first micturition, time to eat, and time to walk unassisted were modeled with Cox-proportional hazard models.
Dogs treated with EPID during surgery required 1.5 mg/kg ME less compared with those treated with OBA (P = .04) during surgery. Three of 19 dogs treated with EPID vs 15 of 37 dogs receiving OBA required intraoperative adjuvant analgesics (P = .06). Dogs treated with EPID regained motor function slower than dogs treated with OBA (P = .01); however, there was no difference in time to urinate, time to eat, or DOH between treatments.
Perioperative lumbosacral epidural with bupivacaine reduced intraoperative opioid consumption in dogs anesthetized for cystotomy.
The use of epidural bupivacaine in dogs undergoing cystotomy may reduce intraoperative opioid requirements without affecting return of bladder function or DOH.
比较膀胱切开术期间接受阿片类药物镇痛（OBA）的麻醉犬与接受布比卡因硬膜外镇痛（EPID）的麻醉犬的围手术期阿片类药物消耗量和住院时间（DOH）。
回顾性横断面研究。
56只接受膀胱切开术的客户拥有的犬。
回顾2015年1月至2017年12月期间接受膀胱切开术的犬的临床记录。记录人口统计学数据、麻醉和手术持续时间、麻醉管理、以吗啡当量（ME）表示的围手术期阿片类药物消耗量、围手术期辅助镇痛药的使用、首次排尿时间、进食时间、行走时间和住院时间。使用Wilcoxon秩和检验比较阿片类药物消耗量和住院时间，随后进行适当的线性回归分析。使用Cox比例风险模型对首次排尿时间、进食时间和独立行走时间进行建模。
与手术期间接受OBA治疗的犬相比，手术期间接受EPID治疗的犬所需的ME少1.5mg/kg（P = 0.04）。接受EPID治疗的19只犬中有3只与接受OBA治疗的37只犬中有15只需要术中辅助镇痛药（P = 0.06）。接受EPID治疗的犬恢复运动功能比接受OBA治疗的犬慢（P = 0.01）；然而，不同治疗之间在排尿时间、进食时间或住院时间方面没有差异。
围手术期腰荐硬膜外注射布比卡因可减少接受膀胱切开术麻醉的犬的术中阿片类药物消耗量。
在接受膀胱切开术的犬中使用硬膜外布比卡因可减少术中阿片类药物需求，而不影响膀胱功能恢复或住院时间。
