Lardone E, Crasta M, Ostan P C, Gherlinzoni P, Landi A, Franci P
Department of Veterinary Science, University of Turin, Grugliasco, Italy.
AniCura VisionVet, Bologna, Italy.
J Small Anim Pract. 2025 May;66(5):328-334. doi: 10.1111/jsap.13829. Epub 2025 Jan 12.
To evaluate the perioperative efficacy of a modified supratemporal retrobulbar block in dogs undergoing ocular surgery.
In this prospective randomised clinical trial, dogs were premedicated with dexmedetomidine (1 mcg/kg im) and methadone (0.1 mg/kg im), induced with propofol to effect and maintained with isoflurane (FE'Iso 1.1%). In the retrobulbar group a mixture of lidocaine 2% (5.5 mL) and ropivacaine 0.75% (2 mL) was administered at 0.1 mL/kg, via a modified supratemporal technique using a Tuohy needle. No block was performed in the controls. When heart rate or mean arterial pressure increased above 30% of the pre-incisional values, fentanyl (1 mcg/kg iv) was administered. Propofol (1 mg/kg iv) was injected when anaesthesia was deemed too light. After a total of three administrations regardless of the type of drugs (fentanyl/propofol), a constant rate infusion of fentanyl (5 mcg/kg/h iv) was started. Quality of recovery (blindly assessed using a descriptive score scale), postoperative eye rubbing and complications were studied.
Eighteen dogs were included. The retrobulbar group (nine) dogs had significantly less risk of receiving fentanyl than controls (nine) (Relative risk: 0.142, 95% CI: 0.021 to 0.936) and a recovery score > 2 (RR: 0.058, 95% CI: 0.003 to 0.887). The median amount of fentanyl (mcg/kg) was statistically lower in the retrobulbar group than in the controls: 0 mcg/kg (range, 0 to 1) versus 2 mcg/kg (range, 0 to 8.49), respectively. Only controls showed eye rubbing.
The modified supratemporal retrobulbar block reduced the intraoperative rescue analgesia and improved the quality of recovery.
评估改良颞上球后阻滞在眼科手术犬中的围手术期疗效。
在这项前瞻性随机临床试验中，犬只术前使用右美托咪定（1微克/千克，肌肉注射）和美沙酮（0.1毫克/千克，肌肉注射）进行预处理，用丙泊酚诱导麻醉至起效，并使用异氟烷维持麻醉（呼气末异氟烷浓度为1.1%）。在球后阻滞组，通过改良颞上技术使用Tuohy针，以0.1毫升/千克的剂量注射2%利多卡因（5.5毫升）和0.75%罗哌卡因（2毫升）的混合液。对照组不进行阻滞。当心率或平均动脉压升高超过切口前值的30%时，静脉注射芬太尼（1微克/千克）。当麻醉深度不够时，静脉注射丙泊酚（1毫克/千克）。在总共三次给药后，无论使用何种药物（芬太尼/丙泊酚），开始以5微克/千克/小时的速度静脉输注芬太尼。研究恢复质量（使用描述性评分量表进行盲法评估）、术后揉眼情况和并发症。
纳入18只犬。球后阻滞组（9只）犬接受芬太尼的风险显著低于对照组（9只）（相对风险：0.142，95%置信区间：0.021至0.936），且恢复评分>2（相对风险：0.058，95%置信区间：0.003至0.887）。球后阻滞组芬太尼的中位数剂量（微克/千克）在统计学上低于对照组：分别为0微克/千克（范围，0至1）和2微克/千克（范围，0至8.49）。只有对照组出现揉眼情况。
改良颞上球后阻滞减少了术中补救性镇痛，并改善了恢复质量。
