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罗哌卡因经神经周围给药联合右美托咪定经神经周围或静脉给药对犬坐骨神经和隐神经阻滞的影响。

Effects of perineural administration of ropivacaine combined with perineural or intravenous administration of dexmedetomidine for sciatic and saphenous nerve blocks in dogs.

出版信息

Am J Vet Res. 2021 Jun;82(6):449-458. doi: 10.2460/ajvr.82.6.449.

Abstract

OBJECTIVE

To evaluate the effects of using ropivacaine combined with dexmedetomidine for sciatic and saphenous nerve blocks in dogs.

ANIMALS

7 healthy adult Beagles.

PROCEDURES

In phase 1, dogs received each of the following 3 treatments in random order: perineural sciatic and saphenous nerve injections of 0.5% ropivacaine (0.4 mL/kg) mixed with saline (0.9% NaCl) solution (0.04 mL/kg; DEX0PN), 0.5% ropivacaine mixed with dexmedetomidine (1 μg/kg; DEX1PN), and 0.5% ropivacaine mixed with dexmedetomidine (2 μg/kg; DEX2PN). In phase 2, dogs received perineural sciatic and saphenous nerve injections of 0.5% ropivacaine and an IV injection of diluted dexmedetomidine (1 μg/kg; DEX1IV). For perineural injections, the dose was divided equally between the 2 sites. Duration of sensory blockade was evaluated, and plasma dexmedetomidine concentrations were measured.

RESULTS

Duration of sensory blockade was significantly longer with DEX1PN and DEX2PN, compared with DEX0PN; DEX1IV did not prolong duration of sensory blockade, compared with DEX0PN. Peak plasma dexmedetomidine concentrations were reached after 15 minutes with DEX1PN (mean ± SD, 348 ± 200 pg/mL) and after 30 minutes DEX2PN (816 ± 607 pg/mL), and bioavailability was 54 ± 40% and 73 ± 43%, respectively. The highest plasma dexmedetomidine concentration was measured with DEX1IV (1,032 ± 415 pg/mL) 5 minutes after injection.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that perineural injection of 0.5% ropivacaine in combination with dexmedetomidine (1 μg/kg) for locoregional anesthesia in dogs seemed to balance the benefit of prolonging sensory nerve blockade while minimizing adverse effects.

摘要

目的

评估罗哌卡因联合右美托咪定用于犬坐骨神经和隐神经阻滞的效果。

动物

7 只健康成年比格犬。

操作步骤

在第 1 阶段,犬随机接受以下 3 种治疗方法中的 1 种:周围神经坐骨神经和隐神经注射 0.5%罗哌卡因(0.4 mL/kg)与生理盐水(0.9%NaCl)溶液(0.04 mL/kg;DEX0PN)、0.5%罗哌卡因与右美托咪定(1μg/kg;DEX1PN)混合,以及 0.5%罗哌卡因与右美托咪定(2μg/kg;DEX2PN)混合。在第 2 阶段,犬接受周围神经坐骨神经和隐神经注射 0.5%罗哌卡因和静脉注射稀释的右美托咪定(1μg/kg;DEX1IV)。对于周围神经注射,剂量在 2 个部位平均分配。评估感觉阻滞的持续时间,并测量血浆右美托咪定浓度。

结果

与 DEX0PN 相比,DEX1PN 和 DEX2PN 的感觉阻滞持续时间明显更长;DEX1IV 与 DEX0PN 相比,并未延长感觉阻滞的持续时间。DEX1PN 组在 15 分钟时达到最高血浆右美托咪定浓度(均值±SD,348±200pg/mL),DEX2PN 组在 30 分钟时达到最高血浆右美托咪定浓度(816±607pg/mL),生物利用度分别为 54%±40%和 73%±43%。DEX1IV 组在注射后 5 分钟时测量到最高血浆右美托咪定浓度(1032±415pg/mL)。

结论和临床相关性

结果表明,犬局部麻醉中周围神经注射 0.5%罗哌卡因联合右美托咪定(1μg/kg)似乎平衡了延长感觉神经阻滞的益处,同时最小化了不良反应。

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