Department of Veterinary Medicine, University Center of Ourinhos, Ourinhos, SP, Brazil.
Department of Veterinary Medicine, Roque Quagliato Veterinary Teaching Hospital, University Center of Ourinhos, Ourinhos, SP, Brazil.
Top Companion Anim Med. 2023 Mar-Jun;53-54:100775. doi: 10.1016/j.tcam.2023.100775. Epub 2023 Mar 27.
The purpose of this study was to assess perioperative analgesia provided by the combination of epidural dexmedetomidine and morphine in bitches undergoing elective ovariohysterectomy. Twenty-four bitches were included in the study and allocated into 3 groups: GM, morphine 0.1 mg/kg; GD, dexmedetomidine 2 µg/kg; and GDM, dexmedetomidine and morphine at the same doses. All solutions were diluted in saline to a total of 0.36 mL/kg. Heart rate (HR), respiratory rate (FR) and systolic blood pressure (SAP) were recorded prior to epidural analgesia (TB), immediately following epidural analgesia (TEA), at surgical incision (TSI), at the first ovarian pedicle clamping (TOP1), at the second pedicle clamping (TOP2), at uterine stump clamping (TUC), at the start of abdominal cavity closure (TSC) and at the end of skin closure (TEC). Rescue analgesia with fentanyl was administered at 2 µg/kg IV if nociception corresponding to a 20% increase of any cardiorespiratory variables was noted. Postoperative pain assessment was performed using a modified composite Glasgow pain scale along the first 6 hours following the end of surgery. Numeric data were compared using ANOVA for repeated measures followed by Tukey test and ovarian ligament relaxation was analyzed using chi-square test under 5% significance. No differences were found on FR among times or groups, although HR showed significant differences between GM and GD at TSI, TOP1, TOP2, TSC and TEC and between GM and GDM at TEA and TSI (significantly lower HR values recorded in dexmedetomidine groups). Differences among time points were found on HR between TB and TEA in GD and on PAS between TOP1 and TSC in GM and between TOP1 and TUC in GDM (P < .05). Ovarian ligament relaxation was significantly more present in groups using dexmedetomidine, although the number of rescue analgesia administrations did not differ among groups. Kaplan-Meyer analysis failed to show significant differences on time of rescue analgesia administration among groups (P > .05). In conclusion, the combination of epidural dexmedetomidine and morphine is a more interesting choice for elective ovariohysterectomy in bitches for producing analgesia comparable to that of each drug alone, with noticeable relaxation of ovarian ligaments and lesser cardiovascular consequences.
本研究旨在评估硬膜外给予右美托咪定和吗啡联合用于行择期卵巢子宫切除术母犬的围手术期镇痛效果。24 只母犬纳入本研究,并分为 3 组:GM 组,吗啡 0.1mg/kg;GD 组,右美托咪定 2μg/kg;GDM 组,右美托咪定和吗啡剂量相同。所有溶液用生理盐水稀释至 0.36ml/kg。在硬膜外镇痛前(TB)、硬膜外镇痛后即刻(TEA)、手术切口时(TSI)、第一卵巢蒂夹闭时(TOP1)、第二卵巢蒂夹闭时(TOP2)、子宫残端夹闭时(TUC)、开始关闭腹腔时(TSC)和皮肤缝合结束时(TEC)记录心率(HR)、呼吸频率(FR)和收缩压(SAP)。如果任何心肺变量的痛觉增加 20%,则给予芬太尼 2μg/kg 静脉内解救镇痛。术后 6 小时内使用改良格拉斯哥复合疼痛量表评估术后疼痛。使用重复测量方差分析比较数值数据,然后进行 Tukey 检验,在 5%的显著水平下使用卡方检验分析卵巢韧带松弛情况。各组之间 FR 在各时间点均无差异,而 GM 组和 GD 组在 TSI、TOP1、TOP2、TSC 和 TEC 时 HR 有显著差异,GM 组和 GDM 组在 TEA 和 TSI 时 HR 有显著差异(记录的 HR 值在右美托咪定组中较低)。GD 组在 TEA 和 TB 之间 HR 有差异,GM 组在 TOP1 和 TSC 之间 PAS 有差异,GDM 组在 TOP1 和 TUC 之间 PAS 有差异(P<.05)。使用右美托咪定的组中卵巢韧带松弛更为明显,但各组之间解救镇痛的使用次数无差异。卡普兰-迈耶分析显示各组之间解救镇痛的使用时间无显著差异(P>.05)。结论:与单独使用每种药物相比,硬膜外给予右美托咪定和吗啡联合用于行择期卵巢子宫切除术母犬,产生的镇痛效果相似,且卵巢韧带松弛更明显,心血管不良后果更少。