Abass Marwa, Farag Alshimaa M, Fahmy Reham A
Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516, Egypt.
Department of Internal Medicine, and Infectious Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516, Egypt.
Ir Vet J. 2025 Aug 6;78(1):16. doi: 10.1186/s13620-025-00303-5.
Acute pain management and the efficacy of analgesic therapies are essential in orthopedic surgery on the distal extremities of dogs' forelimbs. This is due to the manipulation of both soft and orthopedic tissues. Therefore, this study aimed to compare the antinociceptive, akinesia, cardiovascular, and plasma-level effects of adding atracurium to intravenous regional anesthesia (IVRA) with lidocaine in dogs.
Fifty male Mongrel dogs weighing 15 ± 5 kg and aged 2.5 ± 0.6 years were premedicated with 0.045 mg/kg of atropine sulfate and 0.05 mg/kg of acepromazine. While under general anaesthesia, the dogs were randomly allocated into two IVRA groups (n = 25/group): the lidocaine group (LG; 3 mg/kg) and the atracurium (0.3 mg/kg) combined with the lidocaine (3 mg/kg) group (LAG). Following IVRA injections, the toe pinch response and nerve stimulation test were performed, with the contralateral limb serving as its control limb. The mean blood pressure (MAP), pulse rate (PR), respiratory rate (RR), end-tidal carbon dioxide level (EtCO), rectal temperature, echocardiographic indices, and plasma lidocaine concentrations were measured.
At 25, 35, 45, and 55 min post-induction, the LAG exhibited a significantly lower (P ≤ 0.01) nociception limb withdrawal reflex score indicated by an absence of the limb withdrawal reflex (score 1) than the LG, which showed a mild limb trembling (score 2). Moreover, at 30, 40, 50, and 60 min post-induction, the LAG had an absence of the carpus twitch (score 1) with a significantly deeper degree of nerve block (P ≤ 0.01) compared to the LG. There were no significant differences in the physiological parameters between groups during anesthesia time. Meanwhile, the MAP, PR, and RR were significantly higher (P ≤ 0.05) in the LG than in the LAG post-nociception stimuli and during the recovery period. After tourniquet removal, hypersalivation and muscle tremors were observed in four dogs in the LAG and one in the LG.
The use of IVRA with atracurium/lidocaine is a potentially effective IVRA agent for enhancing analgesia and akinesia in the distal extremities of dogs. However, it is important to consider the potential signs compatible with systemic toxicity that may occur, such as hypersalivation and muscle tremors, after releasing the tourniquet.
急性疼痛管理和镇痛疗法的疗效在犬前肢远端的骨科手术中至关重要。这是由于软组织和骨科组织都需要进行操作。因此，本研究旨在比较在犬静脉区域麻醉（IVRA）中加入阿曲库铵与利多卡因的抗伤害感受、运动不能、心血管和血浆水平效应。
50只体重15±5kg、年龄2.5±0.6岁的雄性杂种犬，预先用0.045mg/kg硫酸阿托品和0.05mg/kg乙酰丙嗪进行预处理。在全身麻醉下，将犬随机分为两个IVRA组（每组n = 25）：利多卡因组（LG；3mg/kg）和阿曲库铵（0.3mg/kg）联合利多卡因（3mg/kg）组（LAG）。在进行IVRA注射后，进行趾捏反应和神经刺激试验，对侧肢体作为对照肢体。测量平均血压（MAP）、脉搏率（PR）、呼吸率（RR）、呼气末二氧化碳水平（EtCO）、直肠温度、超声心动图指标和血浆利多卡因浓度。
诱导后25、35、45和55分钟，LAG组表现出明显更低（P≤0.01）的伤害感受肢体退缩反射评分，表现为无肢体退缩反射（评分1），而LG组表现为轻度肢体颤抖（评分2）。此外，诱导后30、40、50和60分钟，LAG组无腕关节抽搐（评分1），与LG组相比，神经阻滞程度明显更深（P≤0.01）。麻醉期间两组生理参数无显著差异。同时，在伤害感受刺激后和恢复期，LG组的MAP、PR和RR显著高于LAG组（P≤0.05）。松开止血带后，LAG组有4只犬出现流涎过多和肌肉震颤，LG组有1只犬出现此情况。
使用阿曲库铵/利多卡因进行IVRA是一种潜在有效的IVRA药物，可增强犬远端肢体的镇痛和运动不能效果。然而，重要的是要考虑到松开止血带后可能出现的与全身毒性相关的潜在体征，如流涎过多和肌肉震颤。
