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评价腰方肌阻滞作为犬卵巢子宫切除术非阿片类麻醉一部分的效果。

Evaluation of Quadratus Lumborum Block as Part of an Opioid-Free Anaesthesia for Canine Ovariohysterectomy.

作者信息

Viscasillas Jaime, Sanchis-Mora Sandra, Burillo Paula, Esteve Vicente, Del Romero Ayla, Lafuente Pilar, Redondo Jose Ignacio

机构信息

Departamento Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain.

The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK.

出版信息

Animals (Basel). 2021 Dec 1;11(12):3424. doi: 10.3390/ani11123424.

Abstract

Quadratus lumborum block (QLB) is used to provide analgesia for abdominal surgery in humans. The aim of this study was to assess an anaesthetic protocol involving the QLB for canine ovariohysterectomy. Ten dogs were included. Anaesthetic protocol consisted of premedication with IM medetomidine (20 μg kg) and SC meloxicam (0.1 mg kg), induction with propofol to effect, and maintenance with sevoflurane in oxygen/medical air. QLB was performed injecting 0.4 mL kg of 0.25% bupivacaine/iohexol per side. Computed Tomography (CT) was performed before and after surgery. Fentanyl was administered as rescue analgesia during surgery. The Short Form of The Glasgow Composite Pain Scale and thermal threshold (TT) at the level of the elbow, T, T and L were assessed before premedication and every hour postoperatively. Methadone was given as rescue analgesia postoperatively when pain score was >3. A Yuen's test on trimmed means for dependent samples was used to analyse the data ( < 0.05). CT images showed spreading of the contrast/block for a median (range) of 3 (2-5) vertebrae, without differences between preoperative and postoperative images. One dog needed rescue analgesia during surgery. Pain score was less than 4/24 in all the animals during the first 4 h after surgery. TT showed a significant increased signal in all the areas tested, apart from the humerus, 30 min after surgery. The QLB may provide additional analgesia for canine ovariohysterectomy. Further studies are needed to assess the specific contribution of the QLB in abdominal analgesia.

摘要

腰方肌阻滞(QLB)用于为人类腹部手术提供镇痛。本研究的目的是评估一种涉及QLB的犬卵巢子宫切除术麻醉方案。纳入了10只犬。麻醉方案包括肌肉注射美托咪定(20μg/kg)和皮下注射美洛昔康(0.1mg/kg)进行术前用药,丙泊酚诱导至起效,以及在氧气/医用空气中用七氟醚维持麻醉。每侧注射0.4mL/kg的0.25%布比卡因/碘海醇进行QLB。手术前后进行计算机断层扫描(CT)。手术期间给予芬太尼作为补救性镇痛。在术前用药前以及术后每小时评估格拉斯哥综合疼痛量表简表和肘部、T、T和L水平的热阈值(TT)。术后疼痛评分>3时给予美沙酮作为补救性镇痛。采用对相关样本截尾均值的Yuen检验分析数据(P<0.05)。CT图像显示造影剂/阻滞剂在中位数(范围)为3(2 - 5)个椎体的范围内扩散,术前和术后图像之间无差异。1只犬在手术期间需要补救性镇痛。术后前4小时所有动物的疼痛评分均低于4/24。术后30分钟,除肱骨外,所有测试区域的TT均显示信号显著增加。QLB可为犬卵巢子宫切除术提供额外的镇痛作用。需要进一步研究来评估QLB在腹部镇痛中的具体作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff02/8697988/5a3d5e0a3ab2/animals-11-03424-g001.jpg

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