Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
Vet Anaesth Analg. 2023 Mar;50(2):188-196. doi: 10.1016/j.vaa.2023.01.003. Epub 2023 Jan 23.
To describe an ultrasound-guided lateral pre-iliac (LPI) and parasacral (PS) approach in feline cadavers (phase I) and compare the perioperative analgesic use and complications in cats administered LPI and PS blocks (group PNB) or epidural anesthesia (group EPI) for pelvic limb surgery (phase II).
Experimental uncontrolled, anatomic and retrospective cohort study.
A group of eight feline cadavers and 52 medical records.
Bilateral LPI and PS approaches with 0.1 mL kg of dye to stain the femoral and obturator nerves and the lumbosacral trunk, respectively, were performed on each cadaver. Nerve staining effect was evaluated upon dissections (phase I). Perioperative analgesics use, and complication rates were retrospectively compared between groups PNB and EPI (phase II). Continuous data were compared using the Mann-Whitney U test and the prevalence of events with Fisher's exact test. Differences were considered significant when p < 0.05.
Dissections revealed that the LPI approach stained 94% and 75% of the femoral and obturator nerves, respectively. The PS approach stained 100% of the lumbosacral trunks. Cats enrolled in group PNB (n = 23) were administered lower doses of intraoperative opioids than those in group EPI (n = 25) (p = 0.006). Intraoperative rescue analgesia was required in 60% and 17.4% of cats enrolled in groups EPI and PNB, respectively (p = 0.003). Group PNB required more intraoperative anticholinergics than group EPI (p = 0.02). There were no differences in postoperative pain scores, analgesic use and complication rates.
The ultrasound-guided LPI and PS approach stained the femoral/obturator nerves and the lumbosacral trunk, respectively, in feline cadavers. Furthermore, PNB was associated with lower intraoperative opioid use and similar postoperative pain and analgesic use compared with epidural anesthesia in a cohort of cats undergoing surgery of the pelvic limb.
描述一种在猫尸体上进行的超声引导下外侧髂前（LPI）和骶旁（PS）入路（第 I 阶段），并比较接受 LPI 和 PS 阻滞（PNB 组）或硬膜外麻醉（EPI 组）进行骨盆肢体手术的猫的围手术期镇痛使用和并发症（第 II 阶段）。
实验性、非对照、解剖学和回顾性队列研究。
一组 8 只猫尸体和 52 份病历。
在每只尸体上进行双侧 LPI 和 PS 入路，分别用 0.1 mL kg 的染料染色股神经和闭孔神经以及腰荐干。在解剖时评估神经染色效果（第 I 阶段）。回顾性比较 PNB 组和 EPI 组之间的围手术期镇痛药物使用和并发症发生率（第 II 阶段）。使用 Mann-Whitney U 检验比较连续数据，使用 Fisher 精确检验比较事件的发生率。当 p < 0.05 时，认为差异具有统计学意义。
解剖显示，LPI 入路分别染色了 94%和 75%的股神经和闭孔神经。PS 入路染色了 100%的腰荐干。接受 PNB 组（n = 23）的猫术中阿片类药物用量低于接受 EPI 组（n = 25）（p = 0.006）。EPI 组和 PNB 组分别有 60%和 17.4%的猫需要术中解救镇痛（p = 0.003）。PNB 组比 EPI 组需要更多的术中抗胆碱能药物（p = 0.02）。两组术后疼痛评分、镇痛使用和并发症发生率无差异。
在猫尸体上进行的超声引导下 LPI 和 PS 入路分别染色了股神经/闭孔神经和腰荐干。此外，与硬膜外麻醉相比，PNB 组在接受骨盆肢体手术的猫中，术中阿片类药物使用量较低，术后疼痛和镇痛使用相似。
