Dhokarikar P, Caywood D D, Stobie D, Raffe M R, Albrecht M, Kannan M, King V, Hegstad B, Randall D
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul 55108, USA.
Am J Vet Res. 1996 Mar;57(3):375-80.
To evaluate effects of interpleural or IM administration of morphine and interpleural administration of bupivacaine on pulmonary function in dogs that have undergone median sternotomy.
Experimental trial.
18 healthy dogs.
Dogs underwent median sternotomy and were randomly assigned to groups of 6 dogs each. Group-A dogs were given morphine (1.0 mg/kg of body weight) i.m.; group-B dogs were given 0.5% bupivacaine (1.5 mg/kg) interpleurally; and group-C dogs were given morphine (1.0 mg/kg) interpleurally. Heart rate; systolic, diastolic, and mean arterial pressures; rectal temperature; pain score; and arterial blood gas partial pressures were measured and pulmonary function testing was performed immediately after extubation (time 0) and up to 48 hours later. Serum cortisol and morphine concentrations were measured at time 0 and up to 12 hours after surgery.
There was a significant decrease in pH, PaO2, mean oxygen saturation of hemoglobin, and dynamic compliance; and a significant increase in PaCO2, alveolar-arterial difference in partial pressure of oxygen, pulmonary resistance, and work of breathing for dogs in all groups after surgery. Serum cortisol concentrations were significantly increased, compared with preoperative values, in all dogs. Serum cortisol concentrations were significantly higher in group-B dogs between 3 and 5 hours after surgery, compared with group-A dogs.
Median sternotomy was associated with significant alterations in pulmonary function. Effects of interpleural administration of bupivacaine and morphine were similar to effects of i.m. administration of morphine.
评估经胸膜间或肌内注射吗啡以及经胸膜间注射布比卡因对接受正中胸骨切开术的犬肺功能的影响。
实验性试验。
18只健康犬。
犬接受正中胸骨切开术,并随机分为每组6只犬的3组。A组犬肌内注射吗啡(1.0毫克/千克体重);B组犬经胸膜间注射0.5%布比卡因(1.5毫克/千克);C组犬经胸膜间注射吗啡(1.0毫克/千克)。在拔管后即刻(时间0)及之后长达48小时测量心率、收缩压、舒张压和平均动脉压、直肠温度、疼痛评分以及动脉血气分压,并进行肺功能测试。在时间0及术后长达12小时测量血清皮质醇和吗啡浓度。
术后所有组犬的pH值、动脉血氧分压、血红蛋白平均氧饱和度和动态顺应性均显著降低;动脉血二氧化碳分压、肺泡-动脉氧分压差值、肺阻力和呼吸功均显著升高。与术前值相比,所有犬的血清皮质醇浓度均显著升高。术后3至5小时,B组犬的血清皮质醇浓度显著高于A组犬。
正中胸骨切开术与肺功能的显著改变有关。经胸膜间注射布比卡因和吗啡的效果与肌内注射吗啡的效果相似。