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. 2024 Nov-Dec;51(6):686-694. doi: 10.1016/j.vaa.2024.07.008. Epub 2024 Jul 18.
To compare perioperative opioid consumption in dogs undergoing pelvic limb surgeries and receiving a lumbosacral plexus block by combining a lumbar [lateral pre-iliac (LPI)] block with a lumbosacral trunk [i.e. parasacral (PS group) or greater ischiatic notch plane (GIN group)] block. Study design Retrospective, descriptive, exploratory, noninferiority cohort study.
Medical records of 37 client-owned dogs were analyzed. Intraoperative (primary outcome) and postoperative (24 hours) opioid use, 24 hour cumulative pain scores and prevalence of complications were compared between the two groups. Opioid use was quantified in morphine equivalents (ME, mg kg ). The noninferiority limit for intraoperative opioid consumption was set at 0.05 ME kg hour. Demographic data, procedure duration, surgery type and perioperative dexmedetomidine and ketamine use were also collected. A t-test or Wilcoxon rank-sum test, a Fisher's exact test and multivariable linear regression were used. Significance was set at p < 0.05.
The GIN and PS groups comprised 17 and 20 dogs, respectively. Total intraoperative ME consumption was 0.17 (0.11-0.21) and 0.22 (0.16-0.30) mg kg hour for the GIN and PS groups, respectively (p = 0.077). The noninferiority analysis adjusted by surgery type and body mass revealed that the mean difference between the groups (GIN - PS) was -0.039 (95% CI -0.11-0.03, p = 0.247) ME mg kg hour, indicating that the GIN group was not inferior to the PS group regarding intraoperative ME consumption. Dexmedetomidine and ketamine use, postoperative ME consumption and pain scores were similar between groups.
This retrospective study and preliminary observations support the clinical use of the GIN plane block, demonstrating its noninferiority to the PS block when combined with the LPI block for multimodal perioperative analgesia in dogs undergoing pelvic limb surgeries.
比较在接受腰椎-荐骨丛阻滞时，将腰旁（LPI）阻滞与腰椎干[即荐旁（PS 组）或坐骨大切迹平面（GIN 组）]阻滞联合应用，对行后肢手术的犬围手术期阿片类药物消耗的影响。研究设计：回顾性、描述性、探索性、非劣效性队列研究。
分析了 37 例患犬的病历。比较了两组犬的术中（主要结局）和术后（24 小时）阿片类药物使用、24 小时累积疼痛评分和并发症发生率。用吗啡等效剂量（ME，mg/kg）来量化阿片类药物的使用。术中阿片类药物消耗的非劣效性界值设定为 0.05 ME kg·h。还收集了人口统计学数据、手术时间、手术类型以及围手术期使用右美托咪定和氯胺酮的数据。使用 t 检验或 Wilcoxon 秩和检验、Fisher 确切概率检验和多变量线性回归。p<0.05 为有统计学意义。
GIN 组和 PS 组分别有 17 只和 20 只犬。GIN 组和 PS 组的总术中 ME 消耗量分别为 0.17（0.11-0.21）和 0.22（0.16-0.30）mg/kg·h（p=0.077）。通过手术类型和体重进行调整的非劣效性分析显示，两组间的平均差值（GIN-PS）为-0.039（95%CI-0.11-0.03，p=0.247）ME mg/kg·h，表明 GIN 组在术中 ME 消耗方面不劣于 PS 组。两组的右美托咪定和氯胺酮使用、术后 ME 消耗量和疼痛评分均相似。
本回顾性研究和初步观察结果支持在犬后肢手术中使用 GIN 平面阻滞，当与 LPI 阻滞联合应用于多模式围手术期镇痛时，其可作为 PS 阻滞的一种非劣效选择。
