Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantation, Aldo Moro University, Bari, Italy; PhD Course in Organs and Tissues Transplantation and Celluar Therapies, Department of Emergency and Organ Transplantations, Aldo Moro University, Bari, Italy.
Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantation, Aldo Moro University, Bari, Italy.
Vet Anaesth Analg. 2021 Nov;48(6):962-971. doi: 10.1016/j.vaa.2021.05.006. Epub 2021 Aug 30.
To evaluate the effects of dexmedetomidine administered perineurally or intramuscularly (IM) on sensory, motor function and postoperative analgesia produced by lidocaine for sciatic and femoral nerve blocks in dogs undergoing unilateral tibial tuberosity advancement surgery.
Prospective, blinded, clinical study.
A group of 30 dogs.
Dogs were anaesthetized with acepromazine, propofol and isoflurane in oxygen/air. Electrolocation-guided femoral and sciatic nerve blocks were performed: group L, 0.15 mL kg 2% lidocaine (n = 10); group LD, lidocaine and 0.15 μg kg dexmedetomidine perineurally (n = 10); group LD, lidocaine and 0.3 μg kg dexmedetomidine IM (n = 10). After anaesthesia, sensory blockade was evaluated by response to forceps pinch on skin innervated by the saphenous/femoral, common fibular and tibial nerves. Motor blockade was evaluated by observing the ability to walk and proprioception. Analgesia was monitored with Short Form of Glasgow Composite Pain Scale for up to 4 hours after extubation. Methadone IM was administered as rescue analgesia. Data were analysed by linear mixed effect models and Kaplan-Meier test (p < 0.05).
Median duration of the sensory blockade for all nerves was longer (p < 0.001) for group LD than for groups L and LD and was longer (p = 0.0011) for group LD than for group L. Proprioception returned later (p < 0.001) for group LD [285 (221-328) minutes] compared with group L [160 (134-179) minutes] or LD [195 (162-257) minutes]. Return of the ability to walk was similar among all groups. Dogs in group LD required postoperative rescue analgesia later (p = 0.001) than dogs in groups LD and L.
Dexmedetomidine administered perineurally with lidocaine prolonged sensory blockade and analgesia during the immediate postoperative period. Systemic dexmedetomidine also prolonged the sensory blockade of perineural lidocaine.
评估在接受单侧胫骨结节推进手术的犬中，鞘内或肌肉内（IM）给予右美托咪定对利多卡因用于坐骨神经和股神经阻滞产生的感觉、运动功能和术后镇痛的影响。
前瞻性、盲法、临床研究。
一组 30 只狗。
狗在氧气/空气中接受乙酰丙嗪、异丙酚和异氟烷麻醉。进行电定位引导的股神经和坐骨神经阻滞：L 组，0.15 mL kg 2%利多卡因（n=10）；LD 组，利多卡因和 0.15 μg kg 鞘内右美托咪定（n=10）；LD 组，利多卡因和 0.3 μg kg IM 右美托咪定（n=10）。麻醉后，通过股神经、腓总神经和胫神经支配皮肤的镊子夹反应评估感觉阻滞。通过观察行走能力和本体感觉评估运动阻滞。术后拔管后 4 小时内使用简短格拉斯哥复合疼痛量表监测镇痛。肌肉内给予美沙酮作为解救镇痛。使用线性混合效应模型和 Kaplan-Meier 检验分析数据（p<0.05）。
所有神经的感觉阻滞中位持续时间均长于 LD 组（p<0.001），LD 组也长于 L 组（p=0.0011）。LD 组本体感觉恢复时间较 L 组[285（221-328）分钟]和 LD 组[195（162-257）分钟]更晚（p<0.001）。所有组的行走能力恢复时间相似。LD 组术后需要解救镇痛的时间较 L 组和 LD 组更晚（p=0.001）。
鞘内给予右美托咪定与利多卡因联合使用可延长术后即刻的感觉阻滞和镇痛。全身给予右美托咪定也延长了鞘内利多卡因的感觉阻滞。
