Warrit Kanawee, Griffenhagen Gregg, Goh Clara, Boscan Pedro
Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, CO, USA.
Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, CO, USA.
Vet Anaesth Analg. 2019 Sep;46(5):673-681. doi: 10.1016/j.vaa.2019.05.010. Epub 2019 Jun 12.
To assess the effects of ultrasound-guided lumbar plexus and sciatic nerve blocks on perianesthetic analgesia and recovery quality in dogs undergoing tibial plateau leveling osteotomy (TPLO).
A group of twenty 20 dogs.
Prospective, randomized, blinded, clinical study.
Dogs were administered lumbar plexus and sciatic nerve blocks with ropivacaine (1.5 mg kg; group RA) or sham blocks with saline (group CON). Dogs were administered hydromorphone (0.2 mg kg) and atropine (0.02 mg kg) subcutaneously before anesthesia was induced with intravenous propofol and maintained with isoflurane. Variables included duration to perform nerve blocks, intraoperative rescue analgesia, recovery score, postoperative pain scores (modified University of Melbourne, Colorado State University and visual analog pain scales), postoperative rescue analgesia-sedation and complications observed. Two-tailed Student t test, Mann-Whitney test, repeated measures analysis of variance, Friedman test and Fisher exact test were used for comparison. Significance was p < 0.05.
Time to perform nerve blocks was [median (range)] 4.3 (2.6-6.1) minutes after aseptic skin preparation. Total fentanyl requirements were 14.2 ± 9 μg kg and 25.4 ± 10 μg kg (p = 0.02) and incidence of hypotension (mean arterial pressure < 60 mmHg) was 40% and 80% (p = 0.16) for groups RA and CON, respectively. Six of eight group CON dogs required more intensive treatment for hypotension than group RA dogs. Recovery scores were 1 (1-4) and 2.5 (1-4) for groups RA and CON, respectively (p = 0.04). RA dogs were less likely to require fentanyl rescue analgesia during the postoperative period (p = 0.04).
As part of a multimodal analgesia regimen, ultrasound-guided lumbar plexus and sciatic nerve blocks provided greater analgesia and improved recovery quality in dogs during TPLO surgery.
评估超声引导下腰丛神经和坐骨神经阻滞对接受胫骨平台水平截骨术（TPLO）的犬围麻醉期镇痛及恢复质量的影响。
一组20只犬。
前瞻性、随机、盲法临床研究。
给犬使用罗哌卡因（1.5毫克/千克；RA组）进行腰丛神经和坐骨神经阻滞，或使用生理盐水进行假阻滞（CON组）。在静脉注射丙泊酚诱导麻醉并用异氟醚维持麻醉前，给犬皮下注射氢吗啡酮（0.2毫克/千克）和阿托品（0.02毫克/千克）。观察指标包括进行神经阻滞的时间、术中补救性镇痛、恢复评分、术后疼痛评分（改良墨尔本大学、科罗拉多州立大学和视觉模拟疼痛量表）、术后补救性镇痛-镇静及观察到的并发症。采用双尾学生t检验、曼-惠特尼检验、重复测量方差分析、弗里德曼检验和费舍尔精确检验进行比较。显著性水平为p < 0.05。
无菌皮肤准备后，进行神经阻滞的时间为[中位数（范围）]4.3（2.6 - 6.1）分钟。RA组和CON组的总芬太尼需求量分别为14.2±9微克/千克和25.4±10微克/千克（p = 0.02），低血压（平均动脉压<60毫米汞柱）发生率分别为40%和80%（p = 0.16）。CON组8只犬中有6只比RA组犬需要更强化的低血压治疗。RA组和CON组的恢复评分分别为1（1 - 4）和2.5（1 - 4）（p = 0.04）。RA组犬术后更不太可能需要芬太尼补救性镇痛（p = 0.04）。
作为多模式镇痛方案的一部分，超声引导下腰丛神经和坐骨神经阻滞在TPLO手术期间为犬提供了更强的镇痛效果并改善了恢复质量。
