{"title":"对接受半椎板切除术的狗进行脊柱后凸平面阻滞:前瞻性随机临床试验","authors":"Cristiano Bendinelli , Marianna D’Angelo , Fabio Leonardi , Natali Verdier , Francesca Cozzi , Rocco Lombardo , Diego A. Portela","doi":"10.1016/j.vaa.2024.02.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To compare the perioperative cumulative opioid consumption and the incidence of cardiovascular complications in dogs undergoing hemilaminectomy in which either an erector spinae plane (ESP) block or systemic opioids were administered.</p></div><div><h3>Study design</h3><p>Prospective randomized clinical trial.</p></div><div><h3>Animals</h3><p>A total of 60 client-owned dogs.</p></div><div><h3>Methods</h3><p>Dogs were randomized to one of three groups: an ESP block (group ESP), a constant rate infusion of fentanyl (group FNT, positive control) or a single dose of methadone as premedication (group MTD, negative control). Intraoperative nociceptive response was treated with fentanyl [1 μg kg<sup>–1</sup>, intravenously (IV)] boli. Before closure of the surgical site, morphine (0.1 mg kg<sup>–1</sup>) was applied to the dura mater. The cumulative dose of opioids was recorded and compared between groups. The incidence of intraoperative bradycardia and/or hypotension and the time to extubation were compared between groups. The short form of the Glasgow Composite Pain Scale (SF-GCPS) was used to score nociception before anaesthetic induction and 1, 2, 6, 12,18 and 24 hours postoperatively. Methadone 0.2 mg kg<sup>–1</sup> was administered IV if the SF-GCPS score was ≥ 5.</p></div><div><h3>Results</h3><p>Group MTD required more intraoperative rescue analgesia than groups ESP (<em>p</em> = 0.008) and FNT (<em>p</em> = 0.001). The total cumulative intraoperative dose of fentanyl was higher in groups FNT (<em>p</em> < 0.0001) and MTD (<em>p</em> = 0.002) than in group ESP. The incidence of cardiovascular complications was similar between groups. Extubation time was longer in group MTD (<em>p</em> = 0.03). Postoperatively, the time to first rescue analgesia was longer in group ESP than in group MTD (<em>p</em> = 0.03). The cumulative postoperative opioid consumption and pain scores were similar between groups.</p></div><div><h3>Conclusions and clinical relevance</h3><p>The ESP block resulted in a reduced intraoperative opioid consumption compared with the control positive and negative groups.</p></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Erector spinae plane block in dogs undergoing hemilaminectomy: A prospective randomized clinical trial\",\"authors\":\"Cristiano Bendinelli , Marianna D’Angelo , Fabio Leonardi , Natali Verdier , Francesca Cozzi , Rocco Lombardo , Diego A. Portela\",\"doi\":\"10.1016/j.vaa.2024.02.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To compare the perioperative cumulative opioid consumption and the incidence of cardiovascular complications in dogs undergoing hemilaminectomy in which either an erector spinae plane (ESP) block or systemic opioids were administered.</p></div><div><h3>Study design</h3><p>Prospective randomized clinical trial.</p></div><div><h3>Animals</h3><p>A total of 60 client-owned dogs.</p></div><div><h3>Methods</h3><p>Dogs were randomized to one of three groups: an ESP block (group ESP), a constant rate infusion of fentanyl (group FNT, positive control) or a single dose of methadone as premedication (group MTD, negative control). Intraoperative nociceptive response was treated with fentanyl [1 μg kg<sup>–1</sup>, intravenously (IV)] boli. Before closure of the surgical site, morphine (0.1 mg kg<sup>–1</sup>) was applied to the dura mater. The cumulative dose of opioids was recorded and compared between groups. The incidence of intraoperative bradycardia and/or hypotension and the time to extubation were compared between groups. The short form of the Glasgow Composite Pain Scale (SF-GCPS) was used to score nociception before anaesthetic induction and 1, 2, 6, 12,18 and 24 hours postoperatively. Methadone 0.2 mg kg<sup>–1</sup> was administered IV if the SF-GCPS score was ≥ 5.</p></div><div><h3>Results</h3><p>Group MTD required more intraoperative rescue analgesia than groups ESP (<em>p</em> = 0.008) and FNT (<em>p</em> = 0.001). The total cumulative intraoperative dose of fentanyl was higher in groups FNT (<em>p</em> < 0.0001) and MTD (<em>p</em> = 0.002) than in group ESP. The incidence of cardiovascular complications was similar between groups. Extubation time was longer in group MTD (<em>p</em> = 0.03). Postoperatively, the time to first rescue analgesia was longer in group ESP than in group MTD (<em>p</em> = 0.03). The cumulative postoperative opioid consumption and pain scores were similar between groups.</p></div><div><h3>Conclusions and clinical relevance</h3><p>The ESP block resulted in a reduced intraoperative opioid consumption compared with the control positive and negative groups.</p></div>\",\"PeriodicalId\":23626,\"journal\":{\"name\":\"Veterinary anaesthesia and analgesia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-02-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Veterinary anaesthesia and analgesia\",\"FirstCategoryId\":\"97\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1467298724000072\",\"RegionNum\":2,\"RegionCategory\":\"农林科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"VETERINARY SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Veterinary anaesthesia and analgesia","FirstCategoryId":"97","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1467298724000072","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
Erector spinae plane block in dogs undergoing hemilaminectomy: A prospective randomized clinical trial
Objective
To compare the perioperative cumulative opioid consumption and the incidence of cardiovascular complications in dogs undergoing hemilaminectomy in which either an erector spinae plane (ESP) block or systemic opioids were administered.
Study design
Prospective randomized clinical trial.
Animals
A total of 60 client-owned dogs.
Methods
Dogs were randomized to one of three groups: an ESP block (group ESP), a constant rate infusion of fentanyl (group FNT, positive control) or a single dose of methadone as premedication (group MTD, negative control). Intraoperative nociceptive response was treated with fentanyl [1 μg kg–1, intravenously (IV)] boli. Before closure of the surgical site, morphine (0.1 mg kg–1) was applied to the dura mater. The cumulative dose of opioids was recorded and compared between groups. The incidence of intraoperative bradycardia and/or hypotension and the time to extubation were compared between groups. The short form of the Glasgow Composite Pain Scale (SF-GCPS) was used to score nociception before anaesthetic induction and 1, 2, 6, 12,18 and 24 hours postoperatively. Methadone 0.2 mg kg–1 was administered IV if the SF-GCPS score was ≥ 5.
Results
Group MTD required more intraoperative rescue analgesia than groups ESP (p = 0.008) and FNT (p = 0.001). The total cumulative intraoperative dose of fentanyl was higher in groups FNT (p < 0.0001) and MTD (p = 0.002) than in group ESP. The incidence of cardiovascular complications was similar between groups. Extubation time was longer in group MTD (p = 0.03). Postoperatively, the time to first rescue analgesia was longer in group ESP than in group MTD (p = 0.03). The cumulative postoperative opioid consumption and pain scores were similar between groups.
Conclusions and clinical relevance
The ESP block resulted in a reduced intraoperative opioid consumption compared with the control positive and negative groups.
期刊介绍:
Veterinary Anaesthesia and Analgesia is the official journal of the Association of Veterinary Anaesthetists, the American College of Veterinary Anesthesia and Analgesia and the European College of Veterinary Anaesthesia and Analgesia. Its purpose is the publication of original, peer reviewed articles covering all branches of anaesthesia and the relief of pain in animals. Articles concerned with the following subjects related to anaesthesia and analgesia are also welcome:
the basic sciences;
pathophysiology of disease as it relates to anaesthetic management
equipment
intensive care
chemical restraint of animals including laboratory animals, wildlife and exotic animals
welfare issues associated with pain and distress
education in veterinary anaesthesia and analgesia.
Review articles, special articles, and historical notes will also be published, along with editorials, case reports in the form of letters to the editor, and book reviews. There is also an active correspondence section.