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布比卡因或布比卡因-右美托咪定竖脊肌平面阻滞在犬施行半椎板切除术的围手术期镇痛效果:一项随机对照试验。

Perioperative analgesic effects of the erector spinae plane block with bupivacaine or bupivacaine-dexmedetomidine in dogs undergoing hemilaminectomy: A randomized controlled trial.

机构信息

Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, Hatfield AL7 9TA, UK.

出版信息

Can Vet J. 2024 May;65(5):473-480.

Abstract

OBJECTIVE

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.

ANIMALS AND PROCEDURE

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).

RESULTS

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).

CONCLUSION

An ESP block with bupivacaine, with or without dexmedetomidine, was associated with a reduction in perioperative opioid consumption and provided effective acute pain control.

摘要

目的

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。

动物和程序

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。

结果

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)。

结论

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。

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本文引用的文献

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