Stabile Marzia, Lacitignola Luca, Acquafredda Claudia, Scardia Annalaura, Crovace Antonio, Staffieri Francesco
Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy.
Front Vet Sci. 2023 Jan 13;9:1061605. doi: 10.3389/fvets.2022.1061605. eCollection 2022.
This study investigated the effects of 1 μg/kg/h intravenous constant rate infusion (CRI) of dexmedetomidine on the sensory and motor blockade for femoral and sciatic nerve blocks in dogs undergoing stifle surgery.
Client-owned dogs referred for stifle surgery were enrolled in this prospective, randomized, blinded study. Dogs were pre-medicated with acepromazine (0.005-0.01 mg/kg intramuscularly, IM); anesthesia was induced with propofol intravenously and maintained with isoflurane in a mixture of air and oxygen. Electrolocation-guided sciatic and femoral nerve blocks with lidocaine 2% (0.15 mL/kg) were performed using the parasacral and lateral pre-iliac approaches, respectively. After performing local block, a systemic infusion of saline solution (group C) or dexmedetomidine (group D) was started at a CRI at 1 ml/kg/h and continued until the end of surgery. Dexmedetomidine was infused at a dose of 1 μg/kg/h. Respiratory and hemodynamic variables were recorded during surgery. Sensory and motor blockade was evaluated by response to pinching the skin innervated by the sciatic/femoral nerves, with forceps and by observing the dogs' ability to walk and testing proprioception at 30, 60, 120, 180, and 240 min after extubation. Analgesia was monitored with SF-GCPS. Methadone IM was administered as rescue analgesia. Intraoperative data were analyzed by analysis of variance, while postoperative data were analyzed by the independent two-tailed -test and a Kaplan-Meier test ( < 0.05).
Twenty dogs were included in this study (10/group). A significant difference in the recovery of sensory nerve function was observed between the groups. The mean durations of the sensory blockade for femoral and sciatic nerves, respectively, was longer ( < 0.001) for group D [168 (146-191, 95% CI), 161 (143-179, 95% CI) min] than in group C [120 (96.1-144, 95% CI), 116 (90.9-142, 95% CI]. No differences in the recovery of patellar and tibial reflexes, proprioceptive function, and ability to walk were found among groups. The overall postoperative rescue analgesia requirement was significantly different ( = 0.019) between groups, with an incidence of 5/10 (50%) dogs in group D and 10/10 (100%) dogs in group C.
Dexmedetomidine administered as a CRI (1 μg/kg/h) combined with local lidocaine increases the duration of the sensory component of the sciatic and femoral nerve blocks and reduces the requirement for additional analgesia during the immediate postoperative hours.
本研究探讨了以1μg/kg/h的速率静脉持续输注右美托咪定对接受膝关节手术的犬股神经和坐骨神经阻滞的感觉和运动阻滞效果。
将因膝关节手术前来就诊的客户拥有的犬纳入本前瞻性、随机、双盲研究。犬术前肌肉注射乙酰丙嗪(0.005 - 0.01mg/kg);静脉注射丙泊酚诱导麻醉,并用异氟醚在空气和氧气混合气体中维持麻醉。分别采用骶旁和髂前外侧入路,用2%利多卡因(0.15mL/kg)进行电定位引导下的坐骨神经和股神经阻滞。进行局部阻滞之后,以1ml/kg/h的速率持续静脉输注生理盐水(C组)或右美托咪定(D组),直至手术结束。右美托咪定的输注剂量为1μg/kg/h。手术期间记录呼吸和血流动力学变量。通过用镊子夹捏由坐骨神经/股神经支配的皮肤的反应,以及在拔管后30、60、120、180和240分钟观察犬行走能力和测试本体感觉来评估感觉和运动阻滞。用SF - GCPS监测镇痛效果。肌肉注射美沙酮作为补救镇痛。术中数据采用方差分析,术后数据采用独立双尾检验和Kaplan - Meier检验(P < 0.05)。
本研究纳入了20只犬(每组10只)。两组间感觉神经功能恢复存在显著差异。D组股神经和坐骨神经感觉阻滞的平均持续时间分别长于C组(P < 0.001)[D组为168(146 - 191,95%CI)、161(143 - 179,95%CI)分钟,C组为120(96.1 - 144,95%CI)、116(90.9 - 142,95%CI)]。各组间髌反射和胫反射恢复、本体感觉功能及行走能力方面未发现差异。两组术后总体补救镇痛需求有显著差异(P = 0.019),D组5/10(50%)的犬有需求,C组10/10(100%)的犬有需求。
以1μg/kg/h的速率持续静脉输注右美托咪定联合局部注射利多卡因可延长坐骨神经和股神经阻滞感觉成分的持续时间,并减少术后即刻额外镇痛的需求。