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.
Vet Anaesth Analg. 2021 May;48(3):415-421. doi: 10.1016/j.vaa.2021.02.004. Epub 2021 Mar 4.
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.
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。
J Am Vet Med Assoc. 2014-5-1
BMC Vet Res. 2017-4-18
Vet Comp Orthop Traumatol. 2014
J Am Vet Med Assoc. 2014-5-1