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鼻内镜检查中筛前神经和上颌神经阻滞与全身阿片类药物给药在犬中的比较:一项非随机临床试验。

Ethmoidal and maxillary nerve block versus systemic opioid administration during rhinoscopy in dogs: a non-randomised clinical trial.

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, 08826, South Korea.

出版信息

J Small Anim Pract. 2022 Nov;63(11):816-820. doi: 10.1111/jsap.13537. Epub 2022 Jul 20.

DOI:10.1111/jsap.13537
PMID:35859528
Abstract

OBJECTIVES

This study aimed to evaluate the clinical effects of ethmoidal and maxillary nerve blocks during rhinoscopy in dogs.

MATERIALS AND METHODS

Fourteen dogs underwent rhinoscopy. Under general anaesthesia with isoflurane, ethmoidal and maxillary nerve blocks were applied bilaterally using 2% lidocaine before rhinoscopy in eight dogs (EM group). Six dogs were premedicated with hydromorphone (0.05 mg/kg) as a substitute for local nerve block (H group). During rhinoscopy, the heart rate, arterial blood pressure and end-tidal isoflurane concentration were recorded. The vaporizer setting was adjusted to increase the end-tidal isoflurane concentration when reflex movement was caused by nasal stimulation.

RESULTS

The H group, compared to the EM group, had an increase in HR that was 18 beats/minute (95% CI: 11 to 26) higher, an increase in SAP that was 22 mmHg (12 to 31) higher, an increase in MAP that was 15 mmHg (7 to 23) higher, an increase in DAP that was 12 mmHg (5 to 19) higher, and an increase in end-tidal isoflurane concentration that was 0.4% (0.3 to 0.5) higher. Head movement due to endoscope insertion was observed in 5/6 dogs (83.3%) in the H group and 1/8 dogs (12.5%) in the EM group (odds ratio, 0.029; ra95% CI, 0.001-0.574).

CLINICAL SIGNIFICANCE

Compared with administration of 0.05 mg/kg hydromorphone, concurrent block of the ethmoidal and maxillary nerves can reduce the cardiovascular response, reflex movement and anaesthetic requirement during rhinoscopy in dogs.

摘要

目的

本研究旨在评估犬鼻内窥镜检查中筛前神经和上颌神经阻滞的临床效果。

材料和方法

14 只狗接受了鼻内窥镜检查。在异氟醚全身麻醉下,8 只狗(EM 组)在鼻内窥镜检查前双侧行 2%利多卡因筛前神经和上颌神经阻滞。6 只狗用氢吗啡酮(0.05mg/kg)行预处理,作为局部神经阻滞的替代(H 组)。在鼻内窥镜检查过程中,记录心率、动脉血压和呼气末异氟醚浓度。当鼻腔刺激引起反射运动时,调整蒸发器设置以增加呼气末异氟醚浓度。

结果

与 EM 组相比,H 组的 HR 增加了 18 次/分钟(95%CI:11 至 26),SAP 增加了 22mmHg(12 至 31),MAP 增加了 15mmHg(7 至 23),DAP 增加了 12mmHg(5 至 19),呼气末异氟醚浓度增加了 0.4%(0.3 至 0.5)。H 组 6 只狗中有 5 只(83.3%)在插入内窥镜时出现头部运动,EM 组 8 只狗中有 1 只(12.5%)(比值比,0.029;95%CI,0.001-0.574)。

临床意义

与给予 0.05mg/kg 氢吗啡酮相比,同时阻滞筛前神经和上颌神经可以减少犬鼻内窥镜检查时的心血管反应、反射运动和麻醉需求。

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