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在接受站立位皱胃移位手术的奶牛中,在利多卡因椎旁麻醉中添加右美托咪定的术中和术后效果。

Intra and postoperative effects of adding detomidine to a lidocaine paravertebral anaesthesia in cows undergoing standing abomasum displacement surgery.

作者信息

d'Anselme O, Hartnack A, Bühlmann O, Torgerson P R, Kolp E, Ringer S K

机构信息

Department of Clinical Diagnostics and Services, Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

Department of Farm Animals, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

出版信息

Vet J. 2025 Jun;311:106364. doi: 10.1016/j.tvjl.2025.106364. Epub 2025 Apr 30.

Abstract

This study investigated the benefits of adding detomidine to a lidocaine proximal paravertebral nerve block (PPNB) for standing laparotomy in cattle. Forty adult cows undergoing surgery for abomasal displacement were randomly assigned to receive a PPNB with lidocaine (LIDO: 40 ml 2 % lidocaine per injection site) or lidocaine-detomidine (LIDO-DETO: lidocaine + 5 μg/kg detomidine equally distributed to the lidocaine syringes). The PPNB was done at T13, L1 and L2 vertebra, always by the same investigator using a blind technique. Intraoperative sedation score, pain score, heart (HR) and respiratory rate (RR) were recorded before PPNB and repeatedly after (5, 10, 15 min, then every 15 min) by a blinded observer (ODA). Rescue analgesia (local lidocaine infiltration) was applied based on the blinded surgeon's decision. Quality of anaesthesia was also assessed by the surgeons using a visual analogue scale (VAS) at the end of the intervention. Postoperative pain was evaluated (ODA) using the Zürich Composite Measure Pain Scale (ZCMPS) and mechanical nociceptive threshold (MNT) testing at 0, 2, 6, 12, and 24 hours. Surgery was completed in all cows, though two (LIDO-DETO) went into sternal recumbency. LIDO-DETO resulted in superior VAS (P < 0.001), higher sedation (P < 0.001), lower pain scores (P = 0.001), and reduced RR (P = 0.015). Postoperatively, LIDO-DETO cows showed significantly lower ZCMPS (P = 0.048) and higher MNT on the wound's left side (P = 0.026). Adding detomidine to lidocaine PPNB improved intraoperative anaesthesia quality with potential postoperative analgesic benefits.

摘要

本研究调查了在牛站立式剖腹手术中,在利多卡因椎旁神经阻滞(PPNB)近端加入右美托咪定的益处。40头接受皱胃移位手术的成年母牛被随机分配接受含利多卡因的PPNB(利多卡因组:每个注射部位注射40毫升2%利多卡因)或利多卡因-右美托咪定(利多卡因-右美托咪定组:利多卡因+5μg/kg右美托咪定,均匀分配到利多卡因注射器中)。PPNB在第13胸椎、第1腰椎和第2腰椎处进行,始终由同一名研究者采用盲法技术操作。在PPNB前记录术中镇静评分、疼痛评分、心率(HR)和呼吸频率(RR),并由一名盲法观察者(ODA)在术后反复记录(5、10、15分钟,然后每15分钟记录一次)。根据盲法外科医生的决定应用补救性镇痛(局部利多卡因浸润)。干预结束时,外科医生还使用视觉模拟量表(VAS)评估麻醉质量。术后通过ODA使用苏黎世综合疼痛测量量表(ZCMPS)和在0、2、6、12和24小时进行机械性伤害感受阈值(MNT)测试来评估疼痛。所有母牛的手术均完成,不过有两头(利多卡因-右美托咪定组)进入了胸卧式。利多卡因-右美托咪定组的VAS评分更高(P<0.001)、镇静程度更高(P<0.001)、疼痛评分更低(P=0.001)且RR降低(P=0.015)。术后,利多卡因-右美托咪定组母牛的ZCMPS显著更低(P=0.048),且伤口左侧的MNT更高(P=0.026)。在利多卡因PPNB中加入右美托咪定可提高术中麻醉质量,并具有潜在的术后镇痛益处。

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