Vullo Cecilia, Tambella Adolfo Maria, Falcone Annastella, Marino Gabriele, Catone Giuseppe
Department of ChiBioFarm, University of Messina, 98168 Messina, Italy.
School of Bioscience and Veterinary Medicine, University of Camerino, 62024 Matelica, MC, Italy.
Animals (Basel). 2021 Apr 29;11(5):1280. doi: 10.3390/ani11051280.
Tumescent anesthesia (TUM) is a technique that was initially used to perform liposuction under local anesthesia, which consists of the injection of such large volumes of local anesthetic until to produce swelling and firmness (tumescence) of the surgical area. The aim of this study was to compare the intraoperative analgesic efficacy of lidocaine (LID) constant rate infusion (CRI), of TUM, or their combination (LID/TUM) and the postoperative pain and analgesic requirement in dogs undergoing unilateral mastectomy. Twenty-four dogs were premedicated with dexmedetomidine (3 μg/kg) and methadone (0.2 mg/kg) intravenously (IV). After induction with propofol IV to effect, dogs were randomly allocated to receive a loading dose of lidocaine (2 mg/kg) followed by a CRI of 100 μg/kg/min (Group LID) in addition to an equivalent volume of lactated Ringer's solution instead of local TUM; a loading dose of lactated Ringer's solution followed by a CRI of Ringer's solution in addition to TUM (Group TUM); a loading dose of lidocaine (2 mg/kg) followed by a CRI of 100 μg/kg/min in addition to TUM (Group LID/TUM). Anesthesia was maintained with isoflurane in oxygen. Postoperative pain scores were assessed once the dogs had fully recovered from the sedative effects, and following 15, 30, 45 and 60 min. The results of the current study allow us to assert that all three treatments provided satisfactory intraoperative antinociceptive effects but administration of LID/TUM induced greater inhibition on sympathetic stimulating effect up to 60 min from recovery, thus, providing better early postoperative pain relief in dogs undergoing mastectomy.
肿胀麻醉（TUM）是一种最初用于在局部麻醉下进行吸脂手术的技术，该技术包括注射大量局部麻醉剂直至手术区域产生肿胀和坚实感（肿胀）。本研究的目的是比较利多卡因（LID）持续输注（CRI）、肿胀麻醉（TUM）或它们的联合应用（LID/TUM）在单侧乳房切除术犬中的术中镇痛效果以及术后疼痛和镇痛需求。24只犬静脉注射右美托咪定（3μg/kg）和美沙酮（0.2mg/kg）进行预处理。静脉注射丙泊酚诱导起效后，犬被随机分配接受利多卡因负荷剂量（2mg/kg），随后以100μg/kg/min的速度持续输注（LID组），同时输注等量的乳酸林格氏液而非局部肿胀麻醉；先输注乳酸林格氏液负荷剂量，随后输注林格氏液持续输注并联合肿胀麻醉（TUM组）；先输注利多卡因负荷剂量（2mg/kg），随后以100μg/kg/min的速度持续输注并联合肿胀麻醉（LID/TUM组）。用异氟醚在氧气中维持麻醉。犬从镇静作用中完全恢复后，以及在15、30、45和60分钟后评估术后疼痛评分。本研究结果使我们能够断言，所有三种治疗方法均提供了令人满意的术中抗伤害感受效果，但LID/TUM联合应用在恢复后长达60分钟内对交感神经刺激作用的抑制作用更强，因此，为接受乳房切除术的犬提供了更好的早期术后疼痛缓解。
