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在接受胫骨平台平整术的犬中,围手术期隐神经和坐骨神经阻滞、腰荐硬膜外或吗啡-利多卡因-氯胺酮输注对术后疼痛和镇静的影响。

Effects of perioperative saphenous and sciatic nerve blocks, lumbosacral epidural or morphine-lidocaine-ketamine infusion on postoperative pain and sedation in dogs undergoing tibial plateau leveling osteotomy.

机构信息

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

Department of Biomedical Informatics, Center for Biostatistics, College of Medicine, The Ohio State University, Columbus, OH, USA.

出版信息

Vet Anaesth Analg. 2021 May;48(3):415-421. doi: 10.1016/j.vaa.2021.02.004. Epub 2021 Mar 4.


DOI:10.1016/j.vaa.2021.02.004
PMID:33814330
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8107141/
Abstract

OBJECTIVE: To compare the quality of postoperative analgesia and sedation after preoperative saphenous and sciatic nerve blockade, preoperative lumbosacral epidural injection and perioperative intravenous (IV) morphine, lidocaine and ketamine infusions in dogs undergoing stifle arthroscopy and tibial plateau leveling osteotomy (TPLO) under general anesthesia. STUDY DESIGN: Prospective, blinded, randomized, clinical comparison study. ANIMALS: A total of 45 dogs weighing 33.9 (15.9-56.7) kg and aged 5.2 (1.0-12.0) years, mean (range), undergoing elective unilateral TPLO for spontaneous cranial cruciate ligament rupture. METHODS: Client-owned dogs were enrolled. Dogs were randomly assigned to one of three groups: group MLK, perioperative IV morphine, lidocaine and ketamine infusion; group EPID, lumbosacral epidural with ropivacaine and morphine; or group SSNB, saphenous and sciatic nerve blockade with ropivacaine. Routine stifle arthroscopy followed by TPLO surgery was performed. Sedation and pain scores were assessed at 0, 2, 4, 8 and 24 hours following extubation. Rescue analgesia was administered as prescribed by Glasgow composite pain score-short form score >5. RESULTS: Sedation scores for MLK were higher than EPID and SSNB. Pain scores for SSNB were lower than those for EPID and MLK. No significant differences were found in anesthesia duration or surgery duration among groups. No dogs required rescue analgesia. CONCLUSIONS AND CLINICAL RELEVANCE: Although analgesia was adequate in all groups, the best combination of analgesia without increased sedation was recorded for SSNB.

摘要

目的:比较术前隐神经和坐骨神经阻滞、术前腰荐硬膜外注射和围手术期静脉(IV)吗啡、利多卡因和氯胺酮输注与全身麻醉下膝关节镜检查和胫骨平台平整截骨术(TPLO)后犬的术后镇痛和镇静质量。

研究设计:前瞻性、盲法、随机、临床比较研究。

动物:共 45 只体重 33.9(15.9-56.7)kg、年龄 5.2(1.0-12.0)岁的犬,行择期单侧 TPLO 治疗自发性十字韧带断裂。

方法:纳入患犬。将犬随机分为三组:MLK 组,围手术期 IV 吗啡、利多卡因和氯胺酮输注;EPID 组,腰荐硬膜外罗哌卡因和吗啡;或 SSNB 组,隐神经和坐骨神经阻滞用罗哌卡因。常规行膝关节镜检查后行 TPLO 手术。拔管后 0、2、4、8 和 24 小时评估镇静和疼痛评分。根据格拉斯哥复合疼痛评分-短表评分>5 给予解救镇痛。

结果:MLK 组的镇静评分高于 EPID 组和 SSNB 组。SSNB 组的疼痛评分低于 EPID 组和 MLK 组。三组之间的麻醉持续时间和手术持续时间无显著差异。没有犬需要解救镇痛。

结论和临床相关性:虽然所有组的镇痛效果均充分,但 SSNB 组记录到的镇痛效果最佳,镇静作用最小。

相似文献

[1]
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[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[10]
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Vet Sci. 2025-6-19

[2]
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[3]
Ultrasound-Guided Greater Ischiatic Notch Plane Block Combined with the Caudal Quadratus Lumborum Block (GIN-TONIC Block) in Dogs Undergoing Pelvic Limb Surgery: Preliminary Results.

Animals (Basel). 2024-6-11

[4]
Saphenous and Sciatic Nerve Blockade with and without Obturator Nerve Block for Tibial Plateau Levelling Osteotomy Surgery in Dogs: A Randomized Controlled Trial.

Animals (Basel). 2023-12-8

[5]
A Randomized Double-Blind Prospective Study Comparing the Efficacy of Subperiosteal and Periarticular Injections of a Local Anesthetic for Postoperative Pain Management after Total Knee Arthroplasty.

Arch Bone Jt Surg. 2023

[6]
Incidence of postoperative administration of opioids in dogs undergoing a tibial plateau leveling osteotomy after intra-operative liposomal bupivacaine administration with or without morphine epidural.

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本文引用的文献

[1]
Peripheral nerve block versus systemic analgesia in dogs undergoing tibial plateau levelling osteotomy: Analgesic efficacy and pharmacoeconomics comparison.

Vet Anaesth Analg. 2020-1

[2]
Results of a survey of Veterinary Orthopedic Society members on the preferred method for treating cranial cruciate ligament rupture in dogs weighing more than 15 kilograms (33 pounds).

J Am Vet Med Assoc. 2018-9-1

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Regional anesthetic techniques for the pelvic limb and abdominal wall in small animals: A review of the literature and technique description.

Vet J. 2018-8

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Sedation levels in dogs: a validation study.

BMC Vet Res. 2017-4-18

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Evaluating Femoral-Sciatic Nerve Blocks, Epidural Analgesia, and No Use of Regional Analgesia in Dogs Undergoing Tibia-Plateau-Leveling-Osteotomy.

J Am Anim Hosp Assoc. 2016

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Comparison of bupivacaine and dexmedetomidine femoral and sciatic nerve blocks with bupivacaine and buprenorphine epidural injection for stifle arthroplasty in dogs.

Vet Anaesth Analg. 2016-7

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Comparison of Short-Term Postoperative Analgesia by Epidural, Femoral Nerve Block, or Combination Femoral and Sciatic Nerve Block in Dogs Undergoing Tibial Plateau Leveling Osteotomy.

Vet Surg. 2015-11

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Treatment of canine cranial cruciate ligament disease. A survey of ACVS Diplomates and primary care veterinarians.

Vet Comp Orthop Traumatol. 2014

[9]
Postoperative comparison of four perioperative analgesia protocols in dogs undergoing stifle joint surgery.

J Am Vet Med Assoc. 2014-5-1

[10]
Effect of dexmedetomidine, morphine-lidocaine-ketamine, and dexmedetomidine-morphine-lidocaine-ketamine constant rate infusions on the minimum alveolar concentration of isoflurane and bispectral index in dogs.

Am J Vet Res. 2013-7

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