硬膜外布比卡因对56例膀胱切除术犬围手术期阿片类药物需求、恢复特征和住院时间的影响:回顾性研究

D. Floriano, Michael J Sahagian, L. Chiavaccini
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引用次数: 6

摘要

目的比较麻醉犬在膀胱切开术中接受阿片镇痛(OBA)与布比卡因硬膜外镇痛(EPID)的围手术期阿片消耗和住院时间(DOH)。研究设计:回顾性横断面研究。动物:56只客户拥有的狗正在接受膀胱切除术。方法回顾2015年1月至2017年12月接受膀胱切除术的犬的临床记录。记录人口统计学数据、麻醉和手术持续时间、麻醉管理、围手术期阿片类药物消耗(吗啡当量)、围手术期辅助镇痛药使用、首次排尿时间、进食时间、行走时间和DOH。采用Wilcoxon秩和检验比较阿片类药物消费量和DOH,并酌情进行线性回归分析。第一次排尿时间、进食时间和独立行走时间采用cox -比例风险模型建模。结果EPID组术中代谢能比OBA组减少1.5 mg/kg (P = 0.04)。19只接受EPID治疗的犬中有3只需要术中辅助镇痛,37只接受OBA治疗的犬中有15只需要术中辅助镇痛(P = 0.06)。EPID组运动功能恢复较OBA组慢(P = 0.01);然而,两种治疗方法在排尿时间、进食时间或DOH方面没有差异。结论围术期腰骶部硬膜外布比卡因可减少膀胱切除术麻醉犬术中阿片类药物的消耗。临床意义硬膜外布比卡因在膀胱切除术犬中应用可减少术中阿片类药物需求,且不影响膀胱功能恢复或DOH。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of epidural bupivacaine on perioperative opioid requirements, recovery characteristics, and duration of hospitalization in dogs undergoing cystotomy: A retrospective study of 56 cases.
OBJECTIVE To compare perioperative opioid consumption and duration of hospitalization (DOH) in anesthetized dogs receiving opioid-based analgesia (OBA) vs those receiving bupivacaine epidural-based analgesia (EPID) during cystotomy. STUDY DESIGN Retrospective cross-sectional study. ANIMALS Fifty-six client-owned dogs undergoing cystotomy. METHODS Clinical records of dogs undergoing cystotomy between January 2015 and December 2017 were reviewed. Demographic data, duration of anesthesia and surgery, anesthetic management, perioperative opioid consumption expressed in morphine equivalents (ME), perioperative use of adjuvant analgesics, time to first micturition, time to eat, time to ambulate, and DOH were recorded. Opioid consumption and DOH were compared with a Wilcoxon rank-sum test, followed by linear regression analysis as appropriate. Time to first micturition, time to eat, and time to walk unassisted were modeled with Cox-proportional hazard models. RESULTS Dogs treated with EPID during surgery required 1.5 mg/kg ME less compared with those treated with OBA (P = .04) during surgery. Three of 19 dogs treated with EPID vs 15 of 37 dogs receiving OBA required intraoperative adjuvant analgesics (P = .06). Dogs treated with EPID regained motor function slower than dogs treated with OBA (P = .01); however, there was no difference in time to urinate, time to eat, or DOH between treatments. CONCLUSION Perioperative lumbosacral epidural with bupivacaine reduced intraoperative opioid consumption in dogs anesthetized for cystotomy. CLINICAL SIGNIFICANCE The use of epidural bupivacaine in dogs undergoing cystotomy may reduce intraoperative opioid requirements without affecting return of bladder function or DOH.
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