Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, Hatfield AL7 9TA, UK.
Can Vet J. 2024 May;65(5):473-480.
To compare the perioperative opioid requirements among dogs receiving an erector spinae plane (ESP) block with bupivacaine, with or without dexmedetomidine, and a control group.
Thirty client-owned, healthy adult dogs undergoing hemilaminectomy were included in this randomized, prospective, blinded clinical study. Dogs were randomly assigned to 1 of 3 treatment groups: Group B, ESP block with bupivacaine; Group BD, ESP block with bupivacaine and dexmedetomidine; and Group C, control. Rescue intra- and postoperative analgesia consisted of fentanyl and methadone, respectively. Postoperative pain was evaluated using the short form of the Glasgow Composite Measure Pain Scale (CMPS-SF).
In Group BD, 0/10 dogs required intraoperative fentanyl, compared to 9/10 in Group C ( < 0.001), whereas 1/10 required postoperative methadone, compared to 9/10 in Group B ( = 0.003) and 10/10 in Group C ( < 0.001). The total amount of intraoperative fentanyl (μg/kg) was 0 (0 to 4) in Group B and 0 (0 to 0) in BD, compared to 6 (0 to 8) in C ( = 0.004 and < 0.001, respectively). Postoperative methadone (mg/kg) required during the first 12 h was 0.5 (0 to 1.4) in Group B ( = 0.003) and 0 (0 to 0) in BD ( < 0.001), compared to C ( = 0.003 and < 0.001, respectively).
An ESP block with bupivacaine, with or without dexmedetomidine, was associated with a reduction in perioperative opioid consumption and provided effective acute pain control.
比较接受布比卡因竖脊肌平面阻滞(ESP 阻滞)的狗与接受布比卡因加右美托咪定或单纯布比卡因 ESP 阻滞的狗及对照组狗围术期阿片类药物需求的差异。
本随机、前瞻性、双盲临床研究纳入 30 只接受半椎板切除术的有主人的健康成年犬。狗被随机分配到 3 个治疗组之一:B 组,布比卡因 ESP 阻滞;BD 组,布比卡因加右美托咪定 ESP 阻滞;C 组,对照组。术中及术后补救镇痛分别使用芬太尼和美沙酮。使用格拉斯哥复合疼痛量表(CMPS-SF)的短表评估术后疼痛。
BD 组 0/10 只狗需要术中使用芬太尼,而 C 组为 9/10 只(<0.001);BD 组 1/10 只狗需要术后使用美沙酮,而 B 组为 9/10 只(=0.003)和 C 组为 10/10 只(<0.001)。B 组术中芬太尼总用量(μg/kg)为 0(0 至 4),BD 组为 0(0 至 0),而 C 组为 6(0 至 8)(=0.004 和<0.001)。B 组术后 12 h 内需要美沙酮(mg/kg)0.5(0 至 1.4),BD 组为 0(0 至 0)(<0.001),而 C 组为 0(0 至 0)(=0.003 和<0.001)。
布比卡因加或不加右美托咪定的 ESP 阻滞可减少围术期阿片类药物的使用,并提供有效的急性疼痛控制。