Dick White Referrals, Station Farm, Six Mile Bottom, Cambridgeshire, UK.
Dick White Referrals, Station Farm, Six Mile Bottom, Cambridgeshire, UK.
Vet Anaesth Analg. 2024 Jul-Aug;51(4):362-371. doi: 10.1016/j.vaa.2024.03.007. Epub 2024 Mar 24.
To compare the analgesic effect of a bilateral ultrasound-guided erector spinae plane block (ESPB) in dogs undergoing hemilaminectomy using either a low-volume high-concentration (LV-HC) or a high-volume low-concentration (HV-LC) local anaesthetic solution.
Retrospective observational equivalence trial.
A total of 391 client-owned dogs undergoing hemilaminectomy.
Dogs were assigned to group LV-HC or HV-LC depending on whether 0.2-0.25% levobupivacaine (0.4-0.5 mL kg) or 0.125-0.15% levobupivacaine (0.8-1 mL kg) was used to perform the ESPB, respectively. The number of dogs in which intraoperative rescue fentanyl boluses were administered, the total dose of fentanyl administered, the overall methadone consumption during the first 24 hours postoperatively and anaesthetic complications were recorded. Univariate and multivariate statistical analyses were performed considering p < 0.05 significant.
A total of 248 and 143 dogs were assigned to groups LV-HC and HV-LC, respectively. In group HV-LC, the number of dogs requiring fentanyl intraoperatively (64.3%) was higher (p = 0.0001) than that in group LV-HC (43.5%). The overall intraoperative fentanyl consumption was higher in group HV-LC between the first skin incision and the end of the lamina drilling (p = 0.028). According to the regression analysis, the group allocation was the best variable to predict the intraoperative fentanyl consumption (p < 0.001). Antimuscarinic drugs were administered more frequently in group LV-HC (p < 0.02). However, the prevalence of hypotension and other pharmacological cardiovascular interventions did not differ between groups. No differences in methadone consumption during the first 24 hours postoperatively were found between the groups.
When performing a bilateral ESPB in dogs undergoing hemilaminectomy, compared with HV-LC, the use of LV-HC local anaesthetic solution reduces the intraoperative fentanyl consumption without affecting the postoperative methadone requirement.
比较在接受半椎板切除术的犬中使用低容量高浓度（LV-HC）或高容量低浓度（HV-LC）局部麻醉溶液行双侧超声引导竖脊肌平面阻滞（ESPB）的镇痛效果。
回顾性观察性等效试验。
共 391 只接受半椎板切除术的患犬。
根据术中是否给予 0.2-0.25%左布比卡因（0.4-0.5ml/kg）或 0.125-0.15%左布比卡因（0.8-1ml/kg）进行 ESPB，将犬分为 LV-HC 组或 HV-LC 组。记录术中给予芬太尼冲击剂量的犬数、给予的芬太尼总剂量、术后 24 小时内的总体美沙酮消耗量和麻醉并发症。进行单变量和多变量统计分析，考虑 p<0.05 为有统计学意义。
共有 248 只和 143 只犬分别被分配到 LV-HC 组和 HV-LC 组。在 HV-LC 组中，需要术中给予芬太尼的犬的数量（64.3%）高于 LV-HC 组（43.5%）（p=0.0001）。在 HV-LC 组中，从皮肤切口到最后钻孔结束时，术中芬太尼总消耗量较高（p=0.028）。根据回归分析，组分配是预测术中芬太尼消耗的最佳变量（p<0.001）。LV-HC 组更频繁地给予抗毒蕈碱药物（p<0.02）。然而，两组之间的低血压和其他药理学心血管干预的发生率没有差异。两组术后 24 小时内的美沙酮消耗量无差异。
在接受半椎板切除术的犬中行双侧 ESPB 时，与 HV-LC 相比，使用 LV-HC 局部麻醉溶液可减少术中芬太尼的消耗，而不影响术后美沙酮的需求。
