猪硬膜外和非故意脊髓麻醉对心血管、抗痛觉和脑电图的影响：一项观察性前瞻性试验。

IF 1.9 2区农林科学 Q2 VETERINARY SCIENCES

Veterinary anaesthesia and analgesia Pub Date : 2025-03-20 DOI:10.1016/j.vaa.2025.03.010

Chiara Parodi , Marie Rabinovici , Luisana G. Garcia Casalta , Mariafrancesca Petrucci , Manuel Egle , Sarah L. Longnus , Daniela Casoni

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引用次数: 0

摘要

目的：报道腰骶部硬膜外腔与蛛网膜下腔联合0.2 mL kg-1剂量吗啡与罗哌卡因术中意外穿刺率及效果比较。研究设计：前瞻性、观察性、实验性研究。实验动物：36头雪绒猪（公34头，母2头），4±0.5月龄，体重55.6±6.5 kg（平均±标准差）。方法：猪胸骨平卧麻醉后，在腰骶椎间隙处插入一根18号的Tuohy针，目的是到达硬膜外间隙。如意外刺穿硬脑膜囊，脊髓给予相同体积的0.75%罗哌卡因（1.45 mg kg-1）和吗啡（0.1 mg kg-1）。记录注射前后有创血压（IBP）、心率（HR）（n = 36）和脑电图变量（n = 17）。采用双向重复测量（RM）方差分析研究IBP随时间和组间的差异。剩余值比较秩（随时间）的RM方差分析和U检验（组间，仅HR）。P < 0.05。在循环性死亡前行胸骨切开术的11只动物中报告了需要抢救性镇痛。结果：意外穿刺率为36%。硬膜外或脊髓注射后，IBP随时间显著降低，但平均动脉压未降至治疗临界值（65 mmHg）以下。各组间无显著差异。心率随时间没有显著变化，脑电图变量也没有显著变化。总体抗伤感受效能为81.8%。结论和临床意义：腰骶部硬膜外或脊髓给予罗哌卡因和吗啡（0.2 mL kg-1）可引起轻度心血管改变，阻止胸骨切开术时的自主神经反应，且不会加重脑电图皮质抑制。在猪中，当硬脑膜囊意外被刺穿时，减少注射量似乎没有必要。

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Cardiovascular, antinociceptive and electroencephalographic effects of epidural and unintentional spinal anaesthesia in pigs: an observational prospective trial

Objective

To report rate of unintentional spinal puncture and compare intraoperative effects of a combination of morphine and ropivacaine at a volume of 0.2 mL kg^–1 in the lumbosacral epidural or subarachnoid space.

Study design

Prospective, observational, experimental study.

Animals

A total of 36 Edelschwein pigs (34 males and two females) 4 ± 0.5 months old, 55.6 ± 6.5 kg bodyweight (mean ± standard deviation).

Methods

With pigs anaesthetized in sternal recumbency, an 18 gauge Tuohy needle was inserted at the lumbosacral intervertebral space intending to reach the epidural space. If the dural sac was accidentally punctured, the same volumes of ropivacaine 0.75% (1.45 mg kg^–1) and morphine (0.1 mg kg^–1) were administered spinally. Invasive blood pressure (IBP) and heart rate (HR) (n = 36) and electroencephalogram variables (n = 17) were recorded before and at regular intervals after injection. Differences in IBP over time and between groups were investigated with two-way repeated measures (RM) ANOVA. Remaining values were compared with RM ANOVA on ranks (over time) and U test (between groups, only for HR). p < 0.05. Need for rescue analgesia was reported in the 11 animals that underwent sternotomy before circulatory death.

Results

Rate of accidental spinal puncture was 36%. After epidural or spinal injection, IBP significantly decreased over time but mean arterial pressure did not decrease below the treatment cut-off (65 mmHg). There was no significant difference between groups. HR did not vary significantly over time, nor did electroencephalogram variables. Overall antinociceptive efficacy was 81.8%.

Conclusions and clinical relevance

Lumbosacral epidural or spinal administration of ropivacaine and morphine (0.2 mL kg–1) caused mild cardiovascular alterations, prevented autonomic responses during sternotomy and did not worsen electroencephalographic cortical depression. In pigs, reducing the volume injected when the dural sac is accidentally punctured does not seem necessary.

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来源期刊

Veterinary anaesthesia and analgesia 农林科学-兽医学

CiteScore

3.10

自引率

17.60%

发文量

审稿时长

97 days

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.