Hendrix P K, Raffe M R, Robinson E P, Felice L J, Randall D A
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul 55108, USA.
J Am Vet Med Assoc. 1996 Aug 1;209(3):598-607.
To compare the analgesic effects of epidural administration of morphine (MOR), bupivacaine hydrochloride (BUP), their combination (COM), and 0.9% sterile NaCl solution (SAL) in dogs undergoing hind limb orthopedic surgeries.
Blinded, randomized clinical trial.
41 healthy dogs admitted for elective orthopedic surgeries involving the pelvis or hind limbs.
Analgesic and control agents were administered postoperatively prior to recovery from isoflurane anesthesia. Ten dogs received MOR, 0.1 mg/kg of body weight; 10 received BUP, 0.5%, 1 ml/10-cm distance from the occipital protuberance to the lumbosacral space; 11 received COM; and 10 received SAL epidurally. Dogs were monitored for 24 hours after epidural injection for pain score, heart and respiratory rates, blood pressure, time to required administration of supplemental analgesic agent, total number of supplemental doses of analgesic agent required, and plasma concentrations of cortisol, MOR, and BUP.
Pain scores were significantly lower in dogs in the COM and BUP groups than in dogs in the SAL group. Pain scores also were significantly lower in dogs in the COM group than in dogs in the MOR group. Time to required administration of supplemental analgesic agent was longer for dogs in the COM group than for dogs in the MOR and SAL groups. Total number of supplemental doses of analgesic agent required was lower for dogs in the BUP and COM groups than for dogs in the SAL group.
Postoperative epidural administration of COM or BUP alone provides longer-lasting analgesia, compared with MOR or SAL.
比较硬膜外注射吗啡（MOR）、盐酸布比卡因（BUP）、二者联合用药（COM）以及0.9%无菌氯化钠溶液（SAL）对接受后肢骨科手术犬的镇痛效果。
双盲随机临床试验。
41只因骨盆或后肢择期骨科手术入院的健康犬。
在异氟烷麻醉苏醒前术后给予镇痛和对照药物。10只犬接受MOR，0.1mg/kg体重；10只接受BUP，0.5%，从枕外隆凸至腰骶间隙每10厘米距离注射1ml；11只接受COM；10只硬膜外注射SAL。硬膜外注射后对犬进行24小时监测，记录疼痛评分、心率和呼吸频率、血压、需要追加镇痛剂的时间、所需追加镇痛剂的总剂量以及血浆皮质醇、MOR和BUP浓度。
COM组和BUP组犬的疼痛评分显著低于SAL组犬。COM组犬的疼痛评分也显著低于MOR组犬。COM组犬需要追加镇痛剂的时间比MOR组和SAL组犬长。BUP组和COM组犬所需追加镇痛剂的总剂量低于SAL组犬。
与MOR或SAL相比，术后硬膜外单独给予COM或BUP可提供更持久的镇痛效果。
