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经皮内镜下肾盂输尿管切开取石术治疗肾盂输尿管连接部梗阻

Short-term efficacy of epidural pain management in dogs undergoing cystoscopy.

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.

出版信息

J Vet Intern Med. 2021 Mar;35(2):980-986. doi: 10.1111/jvim.16055. Epub 2021 Feb 3.

Abstract

BACKGROUND

The effects of epidural anesthesia in dogs undergoing cystoscopy are unknown.

OBJECTIVE

To investigate the effect of epidural analgesia on postcystoscopy pain in dogs.

ANIMALS

Twenty-six dogs undergoing routine cystoscopy for lower urinary tract disease.

METHODS

Prospective, randomized, blinded observational study. Dogs were assigned either to a treatment group that received epidural anesthesia (preservative free morphine sulfate, 0.09 mg/kg; 1% ropivacaine, 0.2 mg/kg; total volume delivered, 1 mL/4.5 kg of body weight to a maximum of 10 mL; n = 9) or to a nonepidural control group (n = 13). Vital signs were monitored for 24 hours, and sedation and pain scores, behavioral assessments, and presence or absence of complications was evaluated for 5 days postprocedure.

RESULTS

All dogs tolerated the epidural without complications. Four dogs were removed from the study because of status unblinding, lack of patient cooperation, or incomplete follow-up. No significant differences were noted in postprocedural pain scores in dogs that received epidural analgesia. Significant differences in postprocedural pain scores were noted in the nonepidural control group. No significant differences were noted in vital signs, behavioral assessments, or the proportion of dogs with a 50% increase in pain scores between the epidural and nonepidural groups.

CONCLUSIONS AND CLINICAL IMPORTANCE

Epidural anesthesia was well-tolerated. Dogs not receiving the epidural had poor postprocedural pain control. A consistent benefit for the epidural vs nonepidural group could not be identified. Additional studies are required to better assess the impact and efficacy of epidural anesthesia for cystoscopic procedures.

摘要

背景

硬膜外麻醉对接受膀胱镜检查的犬的影响尚不清楚。

目的

研究硬膜外镇痛对犬膀胱镜检查后疼痛的影响。

动物

26 只因下尿路疾病接受常规膀胱镜检查的犬。

方法

前瞻性、随机、盲法观察性研究。将犬分为治疗组(接受硬膜外麻醉,即硫酸吗啡(无防腐剂)0.09mg/kg;罗哌卡因 1%,0.2mg/kg;总容量为 1mL/4.5kg 体重,最大 10mL;n=9)或非硬膜外对照组(n=13)。监测 24 小时的生命体征,并在术后 5 天评估镇静和疼痛评分、行为评估以及是否发生并发症。

结果

所有犬均耐受硬膜外麻醉,无并发症。由于失访、患者不配合或随访不完整,有 4 只犬被排除在研究之外。接受硬膜外镇痛的犬术后疼痛评分无显著差异。非硬膜外对照组犬术后疼痛评分有显著差异。硬膜外组和非硬膜外组之间的生命体征、行为评估或疼痛评分增加 50%的犬的比例无显著差异。

结论和临床意义

硬膜外麻醉耐受良好。未接受硬膜外麻醉的犬术后疼痛控制不佳。硬膜外组与非硬膜外组之间未发现一致的受益。需要进一步的研究来更好地评估硬膜外麻醉对膀胱镜检查的影响和疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0797/7995430/d0eeae31aa8a/JVIM-35-980-g001.jpg

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