Cima Daniela Santilli, Credie Leonardo de Freitas Guimarães Arcoverde, Futema Fábio, Luna Stelio Pacca Loureiro
Department of Anesthesiology, Medical School, São Paulo State University (Unesp), Botucatu, Brazil.
School of Veterinary Medicine, São Judas Tadeu University, Santos, Brazil.
Front Vet Sci. 2020 Nov 3;7:527812. doi: 10.3389/fvets.2020.527812. eCollection 2020.
Epidural anesthesia minimizes perioperative pain in dogs. It is considered that epidural solution dispersion in cadavers is similar to alive dogs. The objective of the anatomical study was to compare the dispersion of 0.2 mL/kg 0.25% bupivacaine and iohexol via lumbar epidural (L1-L2) under fluoroscopic guidance in 10 thawed cadavers (GC) and 13 female dogs (G0.25) (5-15 kg; body score 4/5). The objective of the clinical study was to evaluate postoperative analgesic consumption and sedation for 6 h after extubation of dogs submitted to ovariohysterectomy when using 0.25% (G0.25; = 10) bupivacaine with the intraoperative use of fentanyl (GF; = 10). Parametric data were compared by the -test and non-parametric data by the Mann Whitney test. Pain and sedation scores were evaluated over time by the Friedman test, followed by the Dunn test. Alive dogs presented greater epidural dispersion (17 ± 3 vertebrae) than thawed cadavers (11 ± 4 vertebrae; = 0.002). All dogs treated with fentanyl and only one dog treated with 0.25% epidural bupivacaine presented pain scores above the cut-off point of the Glasgow Composite Measure Pain Scale Short-Form (GCMPS-SF) and required postoperative rescue analgesia up to 6 h after extubation. The sedation score was higher at all postoperative moments compared to preoperative moments in the G0.25 and GF, except for evaluations performed at 5 and 6 h after extubation in the GF. Greater sedation was observed immediately after extubation in the GF compared to the G0.25, and there was greater sedation in the G0.25 compared to the GF from 3 to 6 h after extubation. The conclusion of the anatomical study was that L1-L2 epidural bupivacaine dispersion is lower in canine thawed cadavers than in alive dogs. Conclusion of the clinical study was that lumbar epidural anesthesia improved postoperative analgesia and produced longer postoperative sedation when compared to fentanyl.
硬膜外麻醉可将犬围手术期疼痛降至最低。据认为，硬膜外溶液在尸体中的扩散情况与活体犬相似。解剖学研究的目的是比较在荧光镜引导下，10只解冻尸体（GC组）和13只雌性犬（G0.25组，体重5 - 15 kg；体况评分4/5）经腰段硬膜外（L1 - L2）给予0.2 mL/kg 0.25%布比卡因和碘海醇后的扩散情况。临床研究的目的是评估接受卵巢子宫切除术的犬在拔管后6小时内，使用0.25%布比卡因（G0.25组，n = 10）并在术中使用芬太尼（GF组，n = 10）时的术后镇痛药物消耗量和镇静情况。参数数据采用t检验进行比较，非参数数据采用曼 - 惠特尼检验进行比较。疼痛和镇静评分随时间通过弗里德曼检验进行评估，随后进行邓恩检验。活体犬的硬膜外扩散范围（17 ± 3个椎体）大于解冻尸体（11 ± 4个椎体；P = 0.002）。所有接受芬太尼治疗的犬以及仅一只接受0.25%硬膜外布比卡因治疗的犬，其疼痛评分高于格拉斯哥综合疼痛量表简表（GCMPS - SF）的临界值，并且在拔管后6小时内需要术后补救镇痛。与术前相比，G0.25组和GF组在所有术后时间点的镇静评分均较高，但GF组在拔管后5小时和6小时的评估除外。与G0.25组相比，GF组在拔管后立即观察到更强的镇静作用，而在拔管后3至6小时，G0.25组的镇静作用比GF组更强。解剖学研究的结论是，犬解冻尸体中L1 - L2硬膜外布比卡因的扩散低于活体犬。临床研究的结论是，与芬太尼相比，腰段硬膜外麻醉改善了术后镇痛效果并产生了更长时间的术后镇静作用。
