Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
Vet Anaesth Analg. 2021 Jan;48(1):116-124. doi: 10.1016/j.vaa.2020.10.005. Epub 2020 Nov 2.
To compare the perioperative use of analgesics and complication rates in dogs administered an erector spinae plane (ESP) block or a traditional opioid-based (OP) treatment as part of analgesic management during hemilaminectomy.
Retrospective cohort study.
Medical records of 114 client-owned dogs.
General data included demographics, duration of procedure, number of laminae fenestrated, perioperative use of steroid and non-steroidal anti-inflammatory drugs. Intra- and postoperative analgesics used in 48 hours and complications rates were compared between groups. Opioid use was expressed in morphine equivalents [ME (mg kg)]. Continuous data were compared using the Mann-Whitney U test and incidence of events with a Fisher's exact tests. Multiple linear regression was used to evaluate association between perioperative ME consumption (dependent variable) with other independent variables. Data are presented as median (range). Differences were considered significant when p < 0.05.
Group ESP comprised 42 dogs and group OP 72 dogs. No differences were observed in the general data. Intraoperative ME was 0.65 (0.20-3.74) and 0.79 (0.19-5.60) mg kg in groups ESP and OP, respectively (p = 0.03). Intraoperative infusion of lidocaine was administered intravenously (IV) to 23.8% and 68% of groups ESP and OP, respectively (p < 0.0001). Intraoperative infusion of ketamine was administered IV to 21% and 40% of groups ESP and OP, respectively (p = 0.04). Regression analysis revealed the ESP block as the only independent variable affecting the perioperative ME consumption. Pharmacological intervention to treat cardiovascular complications was administered to 21.4% and 47.2% of dogs in groups ESP and OP, respectively (p = 0.008). There were no differences in postoperative complication rates.
ESP block was associated with reduced perioperative opioid consumption, intraoperative adjuvant analgesic use and incidence of pharmacological interventions to treat cardiovascular complications in dogs undergoing hemilaminectomy.
比较接受竖脊肌平面(ESP)阻滞或传统阿片类药物(OP)治疗的犬在接受半椎板切除术时围手术期镇痛药使用和并发症发生率,评估这两种镇痛管理方法的效果。
回顾性队列研究。
114 只患犬的病历。
一般资料包括人口统计学、手术时间、开窗的椎板数、围手术期使用类固醇和非甾体抗炎药。比较两组犬在术后 48 小时内使用的镇痛药和并发症发生率。用吗啡当量(ME,mg/kg)表示阿片类药物的使用。连续数据采用 Mann-Whitney U 检验比较,事件发生率采用 Fisher 确切概率法比较。采用多元线性回归分析评估围手术期 ME 消耗(因变量)与其他自变量之间的关系。数据表示为中位数(范围)。p<0.05 认为差异有统计学意义。
ESP 组包括 42 只犬,OP 组包括 72 只犬。两组一般资料无差异。ESP 组和 OP 组术中 ME 分别为 0.65(0.20-3.74)和 0.79(0.19-5.60)mg/kg(p=0.03)。ESP 组和 OP 组分别有 23.8%和 68%的犬静脉内(IV)输注利多卡因(p<0.0001)。ESP 组和 OP 组分别有 21%和 40%的犬 IV 输注氯胺酮(p=0.04)。回归分析显示,ESP 阻滞是影响围手术期 ME 消耗的唯一独立变量。ESP 组和 OP 组分别有 21.4%和 47.2%的犬接受了治疗心血管并发症的药物干预(p=0.008)。两组术后并发症发生率无差异。
与 OP 治疗相比,ESP 阻滞可减少犬接受半椎板切除术时的围手术期阿片类药物使用、术中辅助镇痛药使用和治疗心血管并发症的药物干预发生率。