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腹横肌平面阻滞和肋间神经阻滞在接受腹腔镜卵巢切除术母犬中的应用:一项随机对照试验

Use of Transversus Abdominis Plane and Intercostal Blocks in Bitches Undergoing Laparoscopic Ovariectomy: A Randomized Controlled Trial.

作者信息

Paolini Andrea, Santoro Francesco, Bianchi Amanda, Collivignarelli Francesco, Vignoli Massimo, Scialanca Silvia, Parrillo Salvatore, Falerno Ilaria, De Bonis Andrea, Rosto Martina, Tamburro Roberto

机构信息

Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy.

Department of Clinical Sciences and Services, The Royal Veterinary College, Hatfield AL9 7TA, UK.

出版信息

Vet Sci. 2022 Oct 31;9(11):604. doi: 10.3390/vetsci9110604.

Abstract

In humans and dogs, loco-regional anesthesia is associated with lower peri-operative opioid consumption and less related side effects. The combination of transversus abdominis plane (TAP) and intercostal blocks can be used to desensitize the entire abdominal wall in dogs. The aim of this study was to evaluate the effectiveness of TAP and intercostal blocks in bitches undergoing laparoscopic ovariectomy. Twenty client-owned bitches were enrolled in this double-blinded randomized controlled trial. After premedication with dexmedetomidine, methadone and ketamine, the animals were randomized into two groups. Dogs in the TAP group received intercostal blocks from T8 to T10 and a TAP block with ropivacaine. Dogs in the FEN group received a fentanyl bolus and a constant rate infusion for the entire duration of the procedure. Intra-operative cardiovascular stability, post-operative pain scores, rescue opioid requirement, dysphoria during recovery, time to attain sternal recumbency and interest in food at 6 h post-extubation were compared. Bitches in the TAP group received a statistically significant lower amount of rescue fentanyl intra-operatively and methadone post-operatively. Pain scores were lower in the TAP group until 6 h post-extubation. No difference was found for dysphoric recoveries, time to attain sternal recumbency and appetite at 6 h post-extubation. No adverse event was recorded for any of the dogs. The combination of TAP and intercostal blocks can be part of an effective multi-modal analgesic strategy in bitches undergoing laparoscopic ovariectomy.

摘要

在人类和犬类中,区域麻醉与围手术期较低的阿片类药物消耗量及较少的相关副作用有关。腹横肌平面(TAP)阻滞和肋间神经阻滞联合使用可使犬类的整个腹壁脱敏。本研究的目的是评估TAP阻滞和肋间神经阻滞在接受腹腔镜卵巢切除术的母犬中的有效性。二十只客户拥有的母犬被纳入这项双盲随机对照试验。在使用右美托咪定、美沙酮和氯胺酮进行预处理后,将动物随机分为两组。TAP组的犬接受T8至T10肋间神经阻滞及罗哌卡因TAP阻滞。芬太尼组的犬在整个手术过程中接受一次芬太尼推注和持续输注。比较术中心血管稳定性、术后疼痛评分、挽救性阿片类药物需求量、恢复期间的烦躁不安、达到胸卧姿势的时间以及拔管后6小时的食欲。TAP组的母犬术中挽救性芬太尼用量和术后美沙酮用量在统计学上显著较低。TAP组在拔管后6小时内的疼痛评分较低。在烦躁不安的恢复、达到胸卧姿势的时间以及拔管后6小时的食欲方面未发现差异。未记录到任何一只犬出现不良事件。TAP阻滞和肋间神经阻滞联合使用可以成为接受腹腔镜卵巢切除术的母犬有效多模式镇痛策略的一部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6083/9694432/9fa4a96cf690/vetsci-09-00604-g001.jpg

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