Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Equine Vet J. 2023 Sep;55(5):755-764. doi: 10.1111/evj.13915. Epub 2023 Jan 9.
Liposomal local anaesthetic solutions may provide extended-duration analgesia postoperatively but have not been assessed following intra-peritoneal local infiltration in any species.
To evaluate two doses of 1.33% liposomal bupivacaine (LB) versus 0.75% bupivacaine HCL (BHCl) for analgesia following laparoscopic ovariectomy in mares.
Prospective cohort study.
Fifteen healthy Quarter Horse mares (age 2-20 years) with normal bilateral ovarian palpation and appearance were enrolled. Horses were restrained in standing stocks and administered an α-2 agonist, butorphanol, and flunixin meglumine, followed by a variable rate infusion of sedation with α-2 agonists. Bilateral paralumbar fossa ovariectomies were performed. Treatment with either 30 ml 0.75% BHCl followed by 20 or 40 ml LB 13.3% (LB20 and LB40) volume expanded with saline to 80 ml total (n = 6/group) or 80 ml BHCl alone (n = 3, BCHL) was infused around incision sites and each mesovarium (LB or BHCl) prior to ovariectomy. Horses were monitored for 72 h by physical examination, algometry, and pain scoring (composite pain scale by Bussieres et al., Horse Grimace Scale). Abdominocentesis with peritoneal fluid analysis was performed at 72 h.
Analgesia achieved with all treatment protocols allowed completion of ovariectomy procedures. Pressure algometry scores were lower in BHCl-treated horses versus both LB groups overall. Pain scores were improved with LB-treated horses in a dose-dependent fashion (Horse Grimace Scale scores LB40 < LB20 < BHCL; composite pain scale scores LB40 < BHCL, LB20 < BHCL, BHCL, and LB20 did not differ). Peritoneal fluid total protein was lower in LB40 versus LB20 and BHCL horses. No complications from LB administration were appreciated.
Small patient sample size, lack of follow-up past 72 h or histopathology.
Analgesia duration was extended and pain scores improved postoperatively with LB versus BHCl in a dose-dependent fashion. Further clinical evaluation of extended-duration local anaesthetics in horses for improved postoperative pain management is warranted.
脂质体局部麻醉剂解决方案可能在术后提供延长的镇痛作用，但尚未在任何物种中评估过腹腔内局部浸润后的效果。
评估两种剂量的 1.33%脂质体布比卡因（LB）与 0.75%布比卡因盐酸盐（BHCL）在马的腹腔镜卵巢切除术术后的镇痛效果。
前瞻性队列研究。
15 匹健康的夸特马（年龄 2-20 岁）双侧卵巢触诊和外观正常，被纳入研究。马被固定在站立架上，给予 α-2 激动剂，布托啡诺和氟尼辛葡甲胺，然后通过 α-2 激动剂的可变速率输注镇静。双侧腰旁窝卵巢切除术。使用 30ml 0.75% BHCL 加 20 或 40ml LB 13.3%（LB20 和 LB40），用生理盐水扩张至 80ml 总容量（每组 6 匹马）或单独使用 80ml BHCL（n=3，BHCL）在切口部位和每个卵巢系膜（LB 或 BHCL）周围输注，然后进行卵巢切除术。通过体格检查、压力测痛和疼痛评分（Bussieres 等人的综合疼痛评分，马面部痛苦量表）在 72 小时内对马进行监测。在 72 小时时进行腹腔穿刺和腹腔液分析。
所有治疗方案的镇痛效果均允许完成卵巢切除术。与 LB 组相比，BHCL 治疗的马在整体上压力测痛评分更低。LB 治疗的马的疼痛评分呈剂量依赖性改善（马面部痛苦量表评分 LB40<LB20<BHCL；综合疼痛评分 LB40<BHCL，LB20<BHCL，BHCL 和 LB20 之间无差异）。LB40 组的腹腔液总蛋白低于 LB20 组和 BHCL 组。未观察到 LB 给药的并发症。
患者样本量小，缺乏超过 72 小时的随访或组织病理学检查。
与 BHCL 相比，LB 在剂量依赖性方式下延长了术后镇痛时间并改善了术后疼痛评分。需要进一步评估延长时间的局部麻醉剂在马中的应用，以改善术后疼痛管理。
