Sysel A M, Pleasant R S, Jacobson J D, Moll H D, Warnick L D, Sponenberg D P, Eyre P
Department of Large Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, USA.
Vet Surg. 1997 Mar-Apr;26(2):141-9. doi: 10.1111/j.1532-950x.1997.tb01477.x.
The purpose of this study was to determine the systemic and local effects associated with long-term epidural catheterization and epidural morphine-detomidine administration in horses.
Development of systemic or local effects was assessed by placing caudal epidural catheters in study horses and administering injections through the catheters every 12 hours for 14 days.
Ten horses with epidural catheters that received daily injections; six uncatheterized horses presented for euthanasia.
Horses received either 0.2 mg/kg morphine sulfate and 30 micrograms/kg detomidine hydrochloride or an equivalent volume of physiologic saline solution through epidural catheters. Systemic effects were compared between control and treatment horses by measuring physical parameters and hay and water consumption, as well as by evaluating major organs after euthanasia. Local effects were studied by examining cerebrospinal fluid and by grading representative samples of the spinal cord and surrounding tissues histologically for inflammation and fibrosis. Local effects were compared between control and treatment horses, as well as between catheterized (control plus treatment) horses and uncatheterized horses.
No significant difference was identified in daily variables or hay and water consumption between control and treatment horses. No growth was obtained from cerebrospinal fluid cultures. No significant difference in cerebrospinal fluid values or spinal tissue inflammation or fibrosis grades was shown between control and treatment horses. However, when compared with uncatheterized horses, cerebrospinal fluid red blood cell values were marginally higher and protein concentrations were significantly higher in the catheterized group. Lumbosacral and sacral spinal tissue segment inflammation grades, and sacral segment fibrosis grades were significantly higher in catheterized horses.
Long-term epidural administration of a morphine-detomidine combination is not associated with apparent adverse systemic effects in horses. Localized inflammation and fibrosis seem to be catheter-related.
Potential systemic and local effects are important considerations with long-term administration of a morphine-detomidine combination through indwelling epidural catheters for alleviation of chronic musculoskeletal pain in horses.
本研究的目的是确定长期硬膜外置管及硬膜外注射吗啡-右美托咪定对马的全身和局部影响。
通过在研究马匹中放置尾段硬膜外导管，并每12小时通过导管注射一次，持续14天，来评估全身或局部影响的发展情况。
10匹接受每日注射的带硬膜外导管的马；6匹因安乐死而送来的未置管马。
马匹通过硬膜外导管接受0.2mg/kg硫酸吗啡和30μg/kg盐酸右美托咪定或等量的生理盐溶液。通过测量身体参数、干草和水的消耗量，并在安乐死后评估主要器官，比较对照组和治疗组马匹的全身影响。通过检查脑脊液，并对脊髓和周围组织的代表性样本进行组织学炎症和纤维化分级来研究局部影响。比较对照组和治疗组马匹之间以及置管（对照组加治疗组）马匹和未置管马匹之间的局部影响。
对照组和治疗组马匹在每日变量、干草和水的消耗量方面未发现显著差异。脑脊液培养未生长出细菌。对照组和治疗组马匹在脑脊液值、脊髓组织炎症或纤维化分级方面未显示出显著差异。然而，与未置管马相比，置管组脑脊液红细胞值略高，蛋白质浓度显著更高。置管马的腰骶部和骶部脊髓组织节段炎症分级以及骶部节段纤维化分级显著更高。
长期硬膜外注射吗啡-右美托咪定组合对马没有明显的不良全身影响。局部炎症和纤维化似乎与导管有关。
对于通过留置硬膜外导管长期注射吗啡-右美托咪定组合以缓解马的慢性肌肉骨骼疼痛，潜在的全身和局部影响是重要的考虑因素。
