Conzemius M G, Brockman D J, King L G, Perkowski S Z
Department of Surgery, Veterinary Hospital, University of Pennsylvania, Philadelphia.
Vet Surg. 1994 Jul-Aug;23(4):291-8. doi: 10.1111/j.1532-950x.1994.tb00487.x.
We prospectively studied 26 dogs that presented for intercostal thoracotomy. Dogs were premedicated with oxymorphone, induced with diazepam and etomidate, and anesthesia was maintained with isoflurane in oxygen. Preoperatively, animal patients were randomly assigned to one of two groups. Group 1 (n = 13) received buprenorphine (10 microgram/kg intravenously [IV]) every 6 hours for 24 hours starting 10 minutes before tracheal extubation. Group 2 (n = 13) received 0.5% bupivacaine (1.5 mg/kg) administered interpleural (IP) by slow injection through a pediatric feeding tube fixed to the most dorsal aspect of the thoracotomy incision. Interpleural injections were administered with each dog placed in lateral recumbency with the incision positioned ventrally; IP injections were administered every 4 hours for 24 hours starting 10 minutes before tracheal extubation. All cases were monitored in the intensive care unit for 24 hours postoperatively. The analgesic efficacy of each regimen was evaluated using a pain scoring system that included a subjective pain score, heart rate, and respiratory rate. Arterial blood pressure, arterial blood gases, oxygen saturation, body temperature, and changes in the electrocardiogram or neurological status were also noted. Significant increases in mean heart rate, respiratory rate, and total pain score occurred after surgery in dogs in the buprenorphine group. In contrast, dogs in the bupivacaine group had no significant changes when compared with their preoperative values. Dogs in the bupivacaine group had significantly decreased total pain scores and better PaO2 and oxygen saturation values when compared with the dogs receiving buprenorphine. Hypoventilation did not occur in either group.
我们前瞻性地研究了26只接受肋间开胸手术的犬。犬术前用羟吗啡酮进行预处理,用咪达唑仑和依托咪酯诱导麻醉,并用异氟烷在氧气中维持麻醉。术前,将动物患者随机分为两组。第1组(n = 13)在气管拔管前10分钟开始,每6小时静脉注射(IV)布托啡诺(10微克/千克),持续24小时。第2组(n = 13)通过固定在开胸切口最背侧的小儿饲管缓慢注射0.5%布比卡因(1.5毫克/千克)进行胸膜内(IP)给药。每只犬侧卧,切口位于腹侧时进行胸膜内注射;在气管拔管前10分钟开始,每4小时进行一次IP注射,持续24小时。所有病例术后在重症监护病房监测24小时。使用包括主观疼痛评分、心率和呼吸频率的疼痛评分系统评估每种方案的镇痛效果。还记录动脉血压、动脉血气、血氧饱和度、体温以及心电图或神经状态的变化。布托啡诺组犬术后平均心率、呼吸频率和总疼痛评分显著增加。相比之下,布比卡因组犬与术前值相比无显著变化。与接受布托啡诺的犬相比,布比卡因组犬的总疼痛评分显著降低,且动脉血氧分压和血氧饱和度值更好。两组均未发生通气不足。