Takusagawa Fumihiko, Takusagawa Yoshimi, Kimura Taro
Seibozaka Animal Hospital, Tokyo, Japan.
Vet Surg Tokyo, Tokyo, Japan.
Front Vet Sci. 2025 Sep 3;12:1648665. doi: 10.3389/fvets.2025.1648665. eCollection 2025.
This prospective, randomized clinical study with a sequential design aimed to evaluate whether a novel quadratus lumborum block (QLB) technique applied in sternal recumbency could reduce isoflurane requirements and enhance procedural safety in cats undergoing ovariohysterectomy.
Thirty-five American Society of Anesthesiologists physical status (ASA-PS) I female cats, either client-owned or sheltered, undergoing ovariohysterectomy. Cats were randomly assigned to different groups to undergo either conventional QLB technique in lateral recumbency (CQLB group, = 17) or novel QLB technique in sternal recumbency (NQLB group, = 18). Ultrasound-guided injections were performed bilaterally, targeting the fascial plane between the quadratus lumborum and psoas minor muscles, with 0.4 mL kg bupivacaine administered per side. Cats were premedicated with dexmedetomidine, anesthetized with propofol and isoflurane. The end-tidal isoflurane concentration (ETiso) was adjusted based on heart rate (HR), respiratory rate, and mean arterial pressure (MAP). Outcomes included total mean ETiso, phase-specific ETiso, total mean HR and MAP, rate of needle proximity to abdominal organs, rates of bradycardia, hypotension, and the need for postoperative analgesics, assessed using both the Short-form UNESP-Botucatu Multidimensional Composite Pain Scale and the Feline Grimace Scale.
Cats in the NQLB group demonstrated slightly lower total mean ETiso ( = 0.046) and significantly reduced ETiso during right ovariectomy ( = 0.022) and hysterectomy ( = 0.007) compared with cats in the CQLB group. Total mean HR and MAP did not differ between groups. Needle proximity to abdominal organs was observed in all CQLB cats but not in any NQLB cats. No bradycardia or hypotension was observed. There was no significant difference in the requirement for postoperative rescue analgesic between the groups.
The novel QLB technique demonstrated a superior isoflurane-sparing effect and safety compared with that of conventional QLB in cats. This approach may benefit cats undergoing ovariohysterectomy.
这项采用序贯设计的前瞻性随机临床研究旨在评估一种应用于仰卧位的新型腰方肌阻滞（QLB）技术是否能降低接受卵巢子宫切除术的猫的异氟烷需求量，并提高手术安全性。
35只美国麻醉医师协会身体状况（ASA-PS）I级的雌性猫，包括客户拥有的或收容所的，接受卵巢子宫切除术。猫被随机分配到不同组，分别接受侧卧位的传统QLB技术（CQLB组，n = 17）或仰卧位的新型QLB技术（NQLB组，n = 18）。双侧进行超声引导注射，目标是腰方肌和腰小肌之间的筋膜平面，每侧注射0.4 mL/kg布比卡因。猫用右美托咪定进行预处理，用丙泊酚和异氟烷麻醉。根据心率（HR）、呼吸频率和平均动脉压（MAP）调整呼气末异氟烷浓度（ETiso）。结果包括总平均ETiso、特定阶段的ETiso、总平均HR和MAP、针靠近腹部器官的发生率、心动过缓发生率、低血压发生率以及术后镇痛药的需求，使用简短版的圣保罗大学-博图卡图多维综合疼痛量表和猫面部表情量表进行评估。
与CQLB组的猫相比，NQLB组的猫总平均ETiso略低（P = 0.046），在右侧卵巢切除术中ETiso显著降低（P = 0.022），在子宫切除术中ETiso显著降低（P = 0.007）。各组之间的总平均HR和MAP没有差异。在所有CQLB组的猫中都观察到针靠近腹部器官，但在任何NQLB组的猫中都没有观察到。未观察到心动过缓或低血压。两组之间术后急救镇痛药的需求没有显著差异。
与传统QLB相比，新型QLB技术在猫中显示出更好的异氟烷节省效果和安全性。这种方法可能对接受卵巢子宫切除术的猫有益。
