Alza Salvatierra D N, Motta L, Redondo J I, du Toit M, Pompermaier E, Martinez M
Northwest Veterinary Specialists, Linnaeus Veterinary Limited, United Kingdom.
Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, Spain.
J S Afr Vet Assoc. 2024 Jun 27. doi: 10.36303/JSAVA.600.
Veterinary medicine has seen significant advancements in locoregional anaesthesia and pain management, including the emergence of the erector spinae plane (ESP) block. However, limited clinical evidence exists on its efficacy and safety.
This study compares ultrasound-guided ESP block (ESP group) with an intraoperative intravenous ketamine infusion analgesic protocol (CRI group) in dogs undergoing thoracolumbar mini-hemilaminectomy, focusing on intraoperative opioid consumption, cardiovascular response to surgical stimulation (CR), postoperative pain scores (PS), and postoperative opioid consumption.
Retrospective, case-control, non-inferiority study conducted in a single centre. Data collected included demographics, bupivacaine dose, ESP block operator, intraoperative recorded variables (haemodynamic variables, CR, complications, rescue analgesia), pre- and postoperative analgesia, 24-hour PS and opioid administration, first food intake post-extubation and postoperative complications. Univariate and multiple regression analyses were applied.
One-hundred dogs were included, 75 in the ESP group and 25 in the CRI group. Univariate analysis revealed no significant differences between treatment groups in terms of CR, PS, postoperative rescue analgesia, intraoperative and postoperative opioid consumption, or time to first meal intake. However, the multivariate regression analysis indicated that dogs receiving ketamine infusion had higher CR suspected to be nociception-related ( = 0.036), and higher postoperative opioid consumption ( = 0.013).
Our study suggests that ultrasound-guided ESP block is as effective as intraoperative ketamine infusion providing perioperative analgesia in dogs undergoing thoracolumbar mini-hemilaminectomy for intervertebral disc disease. ESP group showed significantly lower CR suspected to be nociception-related intraoperatively and lower postoperative opioid consumption within the initial 24 hours.
兽医学在局部区域麻醉和疼痛管理方面取得了显著进展,包括竖脊肌平面(ESP)阻滞的出现。然而,关于其有效性和安全性的临床证据有限。
本研究比较了超声引导下的ESP阻滞(ESP组)与术中静脉输注氯胺酮镇痛方案(持续输注组,CRI组)对接受胸腰椎半椎板切除术的犬的影响,重点关注术中阿片类药物的消耗量、对手术刺激的心血管反应(CR)、术后疼痛评分(PS)和术后阿片类药物的消耗量。
在单一中心进行回顾性、病例对照、非劣效性研究。收集的数据包括人口统计学资料、布比卡因剂量、ESP阻滞操作者、术中记录的变量(血流动力学变量、CR、并发症、补救性镇痛)、术前和术后镇痛、24小时PS和阿片类药物给药、拔管后首次进食时间和术后并发症。应用单因素和多因素回归分析。
共纳入100只犬,ESP组75只,CRI组25只。单因素分析显示,治疗组在CR、PS、术后补救性镇痛、术中和术后阿片类药物消耗量或首次进食时间方面无显著差异。然而,多因素回归分析表明,接受氯胺酮输注的犬有更高的疑似与伤害感受相关的CR(P = 0.036),以及更高的术后阿片类药物消耗量(P = 0.013)。
我们的研究表明,超声引导下的ESP阻滞与术中输注氯胺酮在为因椎间盘疾病接受胸腰椎半椎板切除术的犬提供围手术期镇痛方面效果相当。ESP组在术中显示出显著更低的疑似与伤害感受相关的CR,以及术后24小时内更低的阿片类药物消耗量。