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在一项接受择期卵巢子宫切除术的狗的对照、随机试验中,布比卡因联合右美托咪定或布比卡因脂质体悬液的腹横肌平面注射可降低疼痛评分和需要抢救性镇痛的需求。

Transverse abdominis plane injection of bupivacaine with dexmedetomidine or a bupivacaine liposomal suspension yielded lower pain scores and requirement for rescue analgesia in a controlled, randomized trial in dogs undergoing elective ovariohysterectomy.

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY.

College of Veterinary Medicine, Cornell University, Ithaca, NY.

出版信息

Am J Vet Res. 2022 Jul 22;83(9):ajvr.22.03.0037. doi: 10.2460/ajvr.22.03.0037.

Abstract

OBJECTIVE

To evaluate the duration and analgesic quality of bupivacaine mixed with dexmedetomidine (BUP-DEX) or bupivacaine liposome suspension (BLS) administered as a transverse abdominis plane (TAP) block, compared with a negative control (no TAP block; CTRL) in dogs.

ANIMALS

26 mixed-breed shelter dogs undergoing elective ovariohysterectomy between January 28 and December 8, 2020.

PROCEDURES

Each dog was randomly assigned to receive either an ultrasound-guided TAP block with either BUP-DEX or BLS or to receive no TAP block at time 0 after induction of general anesthesia. Superficial and abdominal wall pain scores were evaluated before time 0 and at 4, 6, 12, 24, 48, 72, and 96 hours later. Additionally, sedation scores and time to return of various behaviors, such as eating or drinking, were compared.

RESULTS

The CTRL group had significantly greater pain scores than the BUP-DEX and BLS groups, but no differences were found between the BUP-DEX and BLS groups. Postoperatively, significantly more dogs needed rescue analgesia and the time to need it was shorter for the CTRL group, compared with the BUP-DEX or BLS groups. Additionally, the CTRL group had greater sedation scores than the other 2 groups. No significant differences were observed in any of the evaluated outcome variables such as eating or drinking.

CLINICAL RELEVANCE

A TAP block appeared to provide adequate postoperative analgesia for abdominal surgery in the dogs of the present study undergoing elective ovariohysterectomy. The BLS TAP block did not appear to provide any extra benefit beyond what BUP-DEX TAP block added under these specific conditions.

摘要

目的

评估布比卡因与右美托咪定(BUP-DEX)或布比卡因脂质体混悬液(BLS)混合用于横腹平面(TAP)阻滞时的持续时间和镇痛质量,并与狗的阴性对照(无 TAP 阻滞;CTRL)进行比较。

动物

2020 年 1 月 28 日至 12 月 8 日期间接受择期卵巢子宫切除术的 26 只杂种收容所犬。

程序

每只狗在全身麻醉诱导后 0 时随机分配接受超声引导的 TAP 阻滞,用 BUP-DEX 或 BLS 阻滞,或不接受 TAP 阻滞。在 0 时之前和 4、6、12、24、48、72 和 96 小时后评估浅表和腹壁疼痛评分。此外,比较镇静评分和恢复各种行为(如进食或饮水)的时间。

结果

CTRL 组的疼痛评分明显高于 BUP-DEX 和 BLS 组,但 BUP-DEX 和 BLS 组之间无差异。与 BUP-DEX 或 BLS 组相比,CTRL 组术后需要更多的解救性镇痛,需要的时间更短。此外,CTRL 组的镇静评分高于其他 2 组。在评估的变量中,如进食或饮水,未观察到任何有意义的差异。

临床意义

在接受择期卵巢子宫切除术的本研究犬中,TAP 阻滞似乎为腹部手术提供了足够的术后镇痛。在这些特定条件下,BLS TAP 阻滞似乎没有比 BUP-DEX TAP 阻滞增加任何额外的益处。

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