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1.
ObjectiveTo assess the effect of continuous wound infusion (CWI) with preperitoneal ropivacaine on postoperative analgesia and compare it with the epidural administration of ropivacaine and morphine in bitches undergoing ovariohysterectomy.Study designA parallel, randomized, clinical, prospective and nonblinded study.AnimalsA group of 38 Greyhound bitches.MethodsIn the catheter group (CathG), CWI with ropivacaine 1% (1 mg kg–1 + 0.8 mg kg–1 hour–1) was applied to the preperitoneal space over the surgical incision. In the epidural group (EpiG), ropivacaine 0.5% (1.3 mg kg–1) and morphine (0.1 mg kg–1) were epidurally administered. Occipital-coccygeal length was used to calculate the volume for the epidural. Pain was scored using a dynamic interactive visual analogue scale (DIVAS) and Glasgow composite measure pain scale–short form (CMPS-SF) before anaesthesia and at 2, 4, 6, 18, 21 and 24 hours after extubation. Incisional sensitivity using a dynamometer (MWTs-incision) was evaluated simultaneously. Plasma ropivacaine and cortisol concentrations, degree of sedation, motor blockade and response to interdigital clamping were measured or assessed. A two-way mixed analysis of variance and a Mann–Whitney U test were used to analyse data; p < 0.05.ResultsNo differences were detected in the DIVAS (p = 0.301), CMPS-SF (p = 0.600) scores, MWTs-incision measurements (p = 0.257) and cortisol values (p = 0.878) between the groups. Rescue analgesia was required in two dogs, one in each group, at 2 hours. Sedation, motor blockade and negative response to interdigital clamping were detected in EpiG at 2, 4 and 6 hours. Mean plasma ropivacaine values were higher in CathG (0.475 ± 0.164 ng mL–1) than in EpiG (0.184 ± 0.213 ng mL–1; p = 0.001).Conclusion and clinical relevanceCompared with epidural ropivacaine and morphine, CWI with preperitoneal ropivacaine is an effective analgesic technique for postoperative pain management in bitches undergoing ovariohysterectomy without motor blockade.  相似文献   

2.
ObjectiveTo evaluate perfusion index (PI) as a noninvasive tool to determine effectiveness and onset of epidural anesthesia in dogs.Study designProspective clinical trial.AnimalsA total of 21 adult dogs, aged 6.5 ± 3 years and weighing 34.9 ± 6.4 kg, undergoing a tibial plateau leveling osteotomy.MethodsDogs were premedicated intramuscularly with acepromazine (0.03 mg kg–1) and hydromorphone (0.1 mg kg–1) and anesthetized with intravenous propofol (to effect) and isoflurane in oxygen. A surface transflectance probe was secured to the tail base to monitor PI and a dorsal pedal artery catheter was placed for invasive blood pressure monitoring. A lumbosacral epidural was performed with the dog in sternal recumbency. Dogs were randomly assigned for inclusion of epidural morphine (0.1 mg kg–1) or morphine (0.1 mg kg–1) and lidocaine (4 mg kg–1). PI was recorded following instrumentation of each dog just prior to the epidural (baseline), at 10 minute intervals for 30 minutes, before and after the surgical skin incision and before and after completion of the osteotomy. Physiological variables and end-tidal isoflurane were recorded at the same time points.ResultsThere was no significant difference in PI between the groups at any time point. There was a significant change in end-tidal isoflurane before and after the skin incision in the epidural morphine and epidural morphine–lidocaine groups (p = 0.04, p = 0.05, respectively) and before and after the osteotomy in each group for heart rate (p = 0.001, p = 0.04), diastolic (p = 0.01, p = 0.01) and mean arterial blood pressure (p = 0.03, p = 0.05).Conclusions and clinical relevancePI did not provide an objective means for determining the onset or effectiveness of epidural anesthesia in anesthetized dogs and alternate methods of noninvasive assessment should be investigated.  相似文献   

3.
ObjectiveTo compare the cardiovascular effects of four epidural treatments in isoflurane anaesthetised dogs.Study designProspective, randomized. experimental study.AnimalsSix female, neutered Beagle dogs (13.3 ± 1.0 kg), aged 3.6 ± 0.1 years.MethodsAnaesthesia was induced with propofol (8.3 ± 1.1 mg kg?1) and maintained with isoflurane in a mixture of oxygen and air [inspiratory fraction of oxygen (FiO2) = 40%], using intermittent positive pressure ventilation. Using a cross-over model, NaCl 0.9% (P); methadone 1% 0.1 mg kg?1 (M); ropivacaine 0.75% 1.65 mg kg?1 (R) or methadone 1% 0.1 mg kg?1 + ropivacaine 0.75% 1.65 mg kg?1 (RM) in equal volumes (0.23 mL kg?1) using NaCl 0.9%, was administered epidurally at the level of the lumbosacral space. Treatment P was administered to five dogs only. Cardiovascular and respiratory variables, blood gases, and oesophageal temperature were recorded at T-15 and for 60 minutes after epidural injection (T0).ResultsMean overall heart rate (HR in beats minute?1) was significantly lower after treatment M (119 ± 16) (p = 0.0019), R (110 ± 18) (p < 0.0001) and RM (109 ± 13) (p < 0.0001), compared to treatment P (135 ± 21). Additionally, a significant difference in HR between treatments RM and M was found (p = 0.04). After both ropivacaine treatments, systemic arterial pressures (sAP) were significantly lower compared to other treatments. No significant overall differences between treatments were present for central venous pressure, cardiac output, stroke volume, systemic vascular resistance, oxygen delivery and arterial oxygen content (CaO2). Heart rate and sAP significantly increased after treatment P and M compared to baseline (T-15). With all treatments significant reductions from baseline were observed in oesophageal temperature, packed cell volume and CaO2. A transient unilateral Horner’s syndrome occurred in one dog after treatment R.Conclusions and clinical relevanceClinically important low sAPs were observed after the ropivacaine epidural treatments in isoflurane anaesthetised dogs. Systemic arterial pressures were clinically acceptable when using epidural methadone.  相似文献   

4.
ObjectiveTo compare two concentrations of ropivacaine administered for tumescent local anesthesia (TLA) in dogs undergoing mastectomy.Study designProspective randomized clinical study.AnimalsSeventeen bitches of various breeds, aged 12 ± 2 years and weighing 10 ± 6.5 kg requiring total unilateral or bilateral mastectomy.MethodsDogs were premedicated with acepromazine (0.04 mg kg?1) and morphine (0.4 mg kg?1) intramuscularly. Anesthesia was induced with propofol (2.5 mg kg?1) and midazolam (0.2 mg kg?1) intravenously, followed by intubation and maintenance with isoflurane and TLA. Dogs were randomly allocated to receive TLA either with 0.1% ropivacaine (group G1) or with 0.05% ropivacaine (group G05). TLA was performed by insertion of a multihole needle under the skin and infusion of ropivacaine and lactated Ringer’s solution at a fixed volume of 15 mL kg?1. Ropivacaine concentrations in arterial blood were measured by high-performance liquid chromatography. Post-operative pain was assessed using two scales (University of Melbourne pain scale and a modified composite measure pain scale) and von Frey filaments, 4 hours after TLA and at 1 hour intervals until sensitivity was regained. A score above 30% of the maximum possible score was considered a positive indicator of pain.ResultsPeak plasma concentrations of ropivacaine were measured 240 minutes after TLA in G1. Low concentrations were measured in G05 for 60 minutes, with subsequent increase. Analgesic rescue and return of sensitivity occurred at 7 ± 2.3 and 7 ± 1.9 hours (mean ± SD) after TLA for G1 and G05, respectively.Conclusions and clinical relevanceTumescent local anesthesia with ropivacaine provided satisfactory post-operative analgesia that lasted for several hours, with no difference in duration between the concentrations. No serious side effects were attributed to TLA. Results indicated that 0.05% ropivacaine provided adequate analgesia for mastectomy, however, more studies are required to support this conclusion.  相似文献   

5.
ObjectiveTo compare the effects of tramadol alone, or in combination with dipyrone or meloxicam, on postoperative pain and analgesia requirement after unilateral mastectomy with or without ovariohysterectomy in dogs.Study designProspective, randomized, clinical study.AnimalsTwenty seven bitches undergoing unilateral mastectomy with or without ovariohysterectomy.MethodsAnesthesia was induced with propofol and maintained with isoflurane and a constant rate infusion of morphine. Before the end of surgery, dogs were randomly assigned to receive intravenous tramadol alone (3 mg kg?1, group T), combined with dipyrone (30 mg kg?1, group TD) or meloxicam (0.2 mg kg?1, group TM). Dogs received additional doses of tramadol (groups T and TM) or tramadol with dipyrone (group TD) at 8 and 16 hours after extubation. Postoperative pain was assessed by a blinded observer before anesthesia (baseline) and at 1, 2, 3, 4, 6, 8, 12, 16 and 24 hours after extubation using a visual analog scale (VAS) and a modified Glasgow scale. Rescue analgesia (morphine, 0.5 mg kg?1) was administered if the Glasgow pain score was >3.5.ResultsThere were no significant differences among groups in pain scores evaluated by the VAS or the Glasgow scale. In groups T, TD and TM, pain scores were significantly higher than at baseline for 6, 8 and 2 hours, respectively. Rescue analgesia was administered to 3/9, 2/9 and 1/9 dogs in groups T, TD and TM, respectively (p > 0.05) [Correction added on 15 August 2013, after first online publication: ‘T, TM and TD’ was changed to ‘T, TD and TM’.].Conclusions and clinical relevanceUnder the conditions of this study, tramadol alone or in combination with dypyrone or meloxicam provided effective analgesia for 24 hours in most dogs after unilateral mastectomy with or without ovariohysterectomy. Further evaluation of combination therapies is needed in larger groups of dogs.  相似文献   

6.
ObjectiveTo compare post-operative motor function in dogs that received epidural morphine and low dose bupivacaine versus epidural morphine alone following splenectomy.Study designProspective, randomized study.Animals16 client owned dogs undergoing routine splenectomy.MethodsFollowing splenectomy dogs were randomly allocated into one of two groups. The morphine group (MOR) was administered epidural morphine (0.1 mg kg?1); the morphine-bupivacaine group (MORB) received epidural morphine (0.1 mg kg?1) and low dose bupivacaine [0.25 mg kg?1, (0.167%)]. The adjusted final volume was 0.15 mL kg?1 in both groups. Motor function and pain assessment were performed at pre-determined times using a simple numerical motor score and the University of Melbourne Pain Scale (UMPS) respectively. An arterial blood gas was performed 2 hours following epidural administration to check for respiratory compromise. If patients scored >7 on the UMPS or were deemed painful by the observer they were administered hydromorphone intravenously and dose and time of rescue analgesia were recorded.ResultsThere were no statistically significant differences in motor scores, pain scores, amount of rescue analgesia administered or PaCO2 between treatment groups. No dogs demonstrated respiratory depression or profound motor dysfunction at any time point during the study. 9/16 (56%) dogs did not require rescue analgesia during the first 18 hours following splenectomy.Conclusions and clinical relevanceThe combination of low dose bupivacaine (0.25 mg kg?1) and morphine (0.1 mg kg?1) when administered epidurally has little effect on post-operative motor function. This combination can be used without concern of motor paralysis in healthy animals.  相似文献   

7.
ObjectiveTo evaluate the efficacy of a perineural injection of dexmedetomidine combined with ropivacaine for reducing postoperative methadone requirements in dogs after tibial plateau levelling osteotomy (TPLO).Study designA prospective, clinical, randomized and blinded trial.AnimalsA total of 58 client-owned dogs.MethodsUltrasound-guided midfemoral sciatic and inguinal femoral nerve blocks with ropivacaine (1 mg kg–1 per nerve block) combined with either dexmedetomidine (0.5 μg kg–1 per nerve block; group DEX) or the same volume of saline (group CON) were performed in dogs undergoing TPLO. Pain was assessed 30 minutes, 2 hours and then every 4 hours for 24 hours after surgery with a validated pain scale (4AVet). Meloxicam (0.15 mg kg–1) was administered intravenously (IV) at recovery. Rescue methadone (0.2 mg kg–1 IV) was administered if a score ≥ 6 (maximal score 18) was recorded and the number of postoperative doses was analysed by Fisher exact tests. The study was performed in parallel at a Veterinary Teaching Hospital (VTH) and a private Veterinary Referral Centre (VRC).ResultsDogs received a total of 22 and 31 postoperative doses of methadone in groups DEX (14 doses at VRC, eight doses at VTH) and CON (28 doses at VRC, three doses at VTH), respectively. Overall, there was no difference in the postoperative rescue analgesia requirements between groups (p = 0.244). At the VRC, dogs received less methadone (p = 0.026) in group DEX compared with group CON, whereas at the VTH, there was no difference between groups (p = 0.216).Conclusions and clinical relevancePerineural dexmedetomidine combined with ropivacaine did not reduce postoperative methadone requirements in dogs after TPLO, but results may differ from one centre to another. This discrepancy might be linked to variations in clinical practices and questions the validity of results obtained from single-centre randomized controlled trials but applied to different clinical settings.  相似文献   

8.
ObjectiveTo evaluate the effects of methadone, administered alone or in combination with acepromazine or xylazine, on sedation and on physiologic values in dogs.Study designRandomized cross-over design.AnimalsSix adult healthy mixed-breed dogs weighing 13.5 ± 4.9 kg.MethodsDogs were injected intramuscularly with physiologic saline (Control), or methadone (0.5mg kg−1) or acepromazine (0.1 mg kg−1) or xylazine (1.0 mg kg−1), or acepromazine (0.05 mg kg−1) plus methadone (0.5 mg kg−1) or xylazine (0.5 mg kg−1) plus methadone (0.5 mg kg−1) in a randomized cross-over design, with at least 1-week intervals. Sedation, pulse rate, indirect systolic arterial pressure, respiratory rate (RR), body temperature and pedal withdrawal reflex were evaluated before and at 15-minute intervals for 90 minutes after treatment.ResultsSedation was greater in dogs receiving xylazine alone, xylazine plus methadone and acepromazine plus methadone. Peak sedative effect occurred within 30 minutes of treatment administration. Pulse rate was lower in dogs that received xylazine either alone or with methadone during most of the study. Systolic arterial pressure decreased only in dogs receiving acepromazine alone. When methadone was administered alone, RR was higher than in other treatments during most of the study and a high prevalence of panting was observed. In all treatments body temperature decreased, this effect being more pronounced in dogs receiving methadone alone or in combination with acepromazine. Pedal withdrawal reflex was absent in four dogs receiving methadone plus xylazine but not in any dog in the remaining treatments.Conclusions and clinical relevanceMethadone alone produces mild sedation and a high prevalence of panting. Greater sedation was achieved when methadone was used in combination with acepromazine or xylazine. The combination xylazine–methadone appears to result in better analgesia than xylazine administered alone. Both combinations of methadone/sedative were considered effective for premedication in dogs.  相似文献   

9.
ObjectiveTo investigate the analgesic effect of epidural morphine after surgical extrahepatic portosystemic shunt (EHPSS) attenuation.Study designRandomized clinical trial.AnimalsA total of 20 dogs with a congenital EHPSS.MethodsDogs were randomly allocated to be given either a single epidural dose of 0.2 mg kg–1 preservative-free morphine (group M) or not (group C) before surgery. All dogs were administered 0.3 mg kg–1 methadone intravenously (IV) as preanaesthetic medication. Pain scores were determined every 2 hours for the first 24 hours postoperatively using the short-form Glasgow Composite Measure Pain Scale (GCMPS-SF). Dogs with a GCMPS-SF pain score >4/20 or >5/24 received 0.1 mg kg–1 methadone IV as rescue analgesia and were reassessed 30 minutes later. If more than three doses of methadone were administered in a 2 hour period, alternative pain relief was provided and a treatment failure recorded. The GCMPS-SF pain scores and number of rescue analgesia injections were analysed over 24 hours. The last observation carried forward method was applied in case of treatment failure. Food consumption and time to first urination were recorded. Data were analysed using a Mann–Whitney U test and presented as median (minimum–maximum range), with significance set at p < 0.05.ResultsGroup M showed lower GCMPS-SF pain scores [15 (11–41) versus 31 (11–86); p = 0.023] and lower postoperative methadone requirements [0 (0–0.2) versus 0.25 (0–0.5) mg kg–1; p = 0.029] than group C. There were three treatment failures in group C only. Food consumption and time to first urination did not differ between groups.Conclusions and clinical relevanceEpidural morphine reduced the requirement for postoperative analgesia in this study population.  相似文献   

10.
ObjectiveEvaluate antinociception, anesthesia, and recovery in llamas given tiletamine-zolazepam (TZ) with either morphine, xylazine, morphine and xylazine, or saline.Study designRandomized crossover experimental study.AnimalsSix healthy, adult intact male llamas.MethodsLlamas were given each of four treatments intramuscularly with a 1-week washout: TZ (2 mg kg?1) combined with either morphine (0.5 mg kg?1; M), xylazine (0.15 mg kg?1; X), morphine (0.5 mg kg?1) and xylazine (0.15mg kg?1) (MX), or saline (C). Llamas breathed room air during the experiment. Characteristics of anesthesia, recovery, and selected cardiopulmonary variables were recorded. Antinociception was assessed by clamping a claw at 5-minute intervals. Data were analyzed using a mixed-model anova and Tukey-Kramer test, and are expressed as least squares mean ± SEM. Significance was set at p < 0.05.ResultsNo llama in the control group demonstrated antinociception. Antinociception was longest with treatment MX, followed by treatments X and M, respectively. Heart rates in llamas given treatments X and MX were significantly lower than with other treatments. The respiratory rate in llamas given treatment C was greater (p < 0.05) than for all other treatments, however, the respiratory rate was not significantly different among treatments X, M and MX. The PaO2 for llamas given MX remained <60 mmHg throughout the 20 minute period of blood gas analysis. Mean arterial blood pressure in llamas in treatment MX was less than for treatments M or C.Conclusion and clinical relevanceThe combination of morphine (0.5 mg kg?1) and xylazine (0.15 mg kg?1) increased the duration of antinociception compared with xylazine alone, in TZ-anesthetized llamas. Treatments X, M and MX were associated with hypoxemia (PaO2 < 60 mmHg).  相似文献   

11.
ObjectiveTo determine the intraoperative and early postoperative opioid requirement after ultrasound-guided sciatic and/or femoral nerve block or epidural anaesthesia in dogs undergoing tibial plateau levelling osteotomy (TPLO).Study designProspective, masked, pilot, randomized, clinical trial.AnimalsA total of 40 client-owned dogs undergoing TPLO.MethodsEach dog was randomly assigned to group SF (combined sciatic and femoral nerve block), group S (sciatic nerve block), group F (femoral nerve block) or group E (epidural anaesthesia). A total of 0.3 mL kg–1 of ropivacaine 0.5% was administered to each nerve or in the epidural space. Intraoperatively, fentanyl (2 μg kg–1) was administered intravenously when heart rate, mean arterial pressure or respiratory rate increased by >30% compared with baseline values. Postoperatively, a visual analogue scale (VAS) and a modified German version of the French pain scale (4AVet) were used to assess pain every 30 minutes for 150 minutes and again once the morning after surgery. Methadone (0.1 mg kg–1) was administered intravenously if the VAS was ≥ 4 cm [maximal value 10 cm; median (interquartile range)] or the composite pain score was ≥5 [maximal value 15; median (interquartile range)]. Significance was defined as p ≤ 0.05.ResultsGroups SF and E required less total intraoperative and early postoperative opioid doses compared with groups S and F (p = 0.031). No dogs in group SF had a block failure or required postoperative methadone. A reduced methadone requirement was found in group SF compared with all the other groups up to 150 minutes after recovery (p = 0.041).Conclusions and clinical relevanceCombined sciatic and femoral nerve block and epidural anaesthesia lead to less cumulative consumption of perioperative opioids than single nerve blockade. Sciatic or femoral nerve block alone might be insufficient to control nociception and early postoperative pain in dogs undergoing TPLO.  相似文献   

12.
ObjectiveTo investigate the intraperitoneal (IP) administration of ropivacaine or ropivacaine–dexmedetomidine for postoperative analgesia in cats undergoing ovariohysterectomy.Study designProspective, randomized, blinded, positively controlled clinical study.AnimalsA total of 45 client-owned cats were enrolled.MethodsThe cats were administered intramuscular (IM) meperidine (6 mg kg−1) and acepromazine (0.05 mg kg−1). Anesthesia was induced with propofol and maintained with isoflurane. Meloxicam (0.2 mg kg−1) was administered subcutaneously in all cats after intubation. After the abdominal incision, the cats were administered one of three treatments (15 cats in each treatment): IP instillation of 0.9% saline solution (group Control), 0.25% ropivacaine (1 mg kg−1, group ROP) or ropivacaine and dexmedetomidine (4 μg kg−1, group ROP–DEX). During anesthesia, heart rate (HR), electrocardiography, noninvasive systolic arterial pressure (SAP) and respiratory variables were monitored. Sedation and pain were assessed preoperatively and at various time points up to 24 hours after extubation using sedation scoring, an interactive visual analog scale, the UNESP-Botucatu multidimensional composite pain scale (MCPS) and mechanical nociceptive thresholds (MNT; von Frey anesthesiometer). Rescue analgesia (morphine, 0.1 mg kg−1) IM was administered if the MCPS ≥6. Data were analyzed using the chi-square test, Tukey test, Kruskal–Wallis test and Friedman test (p < 0.05).ResultsHR was significantly lower in ROP–DEX compared with Control (p = 0.002). The pain scores, MNT, sedation scores and the postoperative rescue analgesia did not differ statistically among groups.Conclusions and clinical relevanceAs part of a multimodal pain therapy, IP ropivacaine–dexmedetomidine was associated with decreased HR intraoperatively; however, SAP remained within normal limits. Using the stated anesthetic protocol, neither IP ropivacaine nor ropivacaine–dexmedetomidine significantly improved analgesia compared with IP saline in cats undergoing ovariohysterectomy.  相似文献   

13.
ObjectiveTo evaluate the effects of nalbuphine, butorphanol and morphine combined with acepromazine on intraoperative and early postoperative pain management in dogs anesthetized for ovariohysterectomy.Study designProspective, randomized blinded clinical study.AnimalsA total of 48 healthy female dogs of different breeds, aged 1–6 years, weighing (mean ± standard deviation) 14.5 ± 4.8 kg.MethodsDogs were randomly assigned into four groups to be intravenously administered nalbuphine (0.5 mg kg–1; group N0.5), nalbuphine (1.0 mg kg–1; group N1.0), butorphanol (0.4 mg kg–1; group B0.4) or morphine (0.2 mg kg–1; group M0.2) combined with acepromazine (0.02 mg kg–1) prior to propofol and isoflurane for anesthesia. Heart rate (HR), respiratory rate, systolic arterial pressure and rectal temperature (RT) were recorded at time points during anesthesia. A dynamic interactive visual analog scale applied in three phases (DIVAS I, II and III) and the modified Glasgow composite measure pain scale were used to assess pain before premedication and 1, 2, 3, 4, 5 and 6 hours after extubation. Administration of rescue analgesia was recorded.ResultsAt the left ovarian pedicle ligation, HR was higher in N1.0 than in B0.4 (p = 0.020). RT decreased significantly by the end of surgery in N0.5 (p = 0.043) and B0.4 (p = 0.010). Rescue analgesia was administered postoperatively over 6 hours to eight, seven, nine and 10 dogs in N0.5, N1.0, B0.4 and M0.2, respectively (p = 0.57). DIVAS II was higher in B0.4 than in N1.0 at 2 and 3 hours (p = 0.038 and p = 0.002, respectively) and N0.5 at 3 hours (p = 0.003).Conclusions and clinical relevanceAt the doses used, all premedication protocols provided insufficient intraoperative analgesia, with minimal clinical differences between groups. No premedication provided satisfactory analgesia in the first 6 hours postoperatively.  相似文献   

14.
ObjectiveTo evaluate and compare the postoperative analgesia provided by epidural lidocaine, lidocaine/morphine or lidocaine/tramadol in dogs following elective orchiectomy.Study designProspective experimental trial.AnimalsThirty-six mongrel dogs aged 2-8 years old, weighing 6.6-22 kg.MethodsThe dogs received 6.0 mg kg?1 of lidocaine combined with 1.0 mg kg?1 of tramadol, 0.1 mg kg?1 of morphine or 0.01 mL kg?1 of 0.9% NaCl epidurally. Analgesia was assessed at 4, 8, 12, 18 and 24 hours (T4, T8, T12 and T24) after the offset of lidocaine using a scale composed of physiologic and behavioral parameters. Rescue analgesia with morphine (0.2 mg kg?1, IM) was performed if the evaluation score exceeded 10 during the postoperative period. The scores over time were analyzed using the Friedman’s two-way analysis of variance and the comparison between groups was made by the Kruskal-Wallis test with statistical significances accepted if p = 0.05.ResultsThere were no differences in the pain scores between the morphine and tramadol groups over time and no rescue analgesia was administered. In the NaCl group, rescue analgesia was needed at T4, T8 and T12. Within this group, the final evaluation times (T18 and T24) had lower pain scores than at T4, T8 and T12.Conclusions and clinical relevanceEpidural lidocaine/tramadol provided an analgesic effect comparable to that of epidural lidocaine/morphine during the first 12 hours after surgical castration without substantial side effects, suggesting that tramadol may be an effective postoperative analgesic in dogs submitted to this surgical procedure.  相似文献   

15.
ObjectiveTo determine the effective dosage of the combination tiletamine–zolazepam–ketamine–xylazine (TKX), with or without methadone, in dogs.Study designProspective, randomized, experimental study.AnimalsA total of 29 dogs.MethodsDogs were randomly administered TKX (group TKX, n = 13) or combined with 0.3 mg kg–1 of methadone (group TKXM, n = 16) intramuscularly. The TKX solution contained tiletamine (50 mg mL–1), zolazepam (50 mg mL–1), ketamine (80 mg mL–1) and xylazine (20 mg mL–1). The effective dosages for immobility in 50% and 95% of the population (ED50 and ED95) were estimated using the up-and-down method. Approximately 20 minutes after drug administration, a skin incision was performed and the response was judged as positive or negative if the dogs moved or did not move, respectively. The TKX volume for the subsequent dog in the same group was increased or decreased by 0.005 mL kg–1 if the response of the previous dog was positive or negative, respectively. Heart and respiratory rates, and sedation/anesthesia scores (range 0–21) were recorded before and 15 minutes after drug administration.ResultsEstimated ED50 and ED95 (95% confidence intervals) were: TKX, 0.025 (0.020–0.029) and 0.026 (0.010–0.042) mL kg–1; TKXM, 0.022 (0.018–0.025) and 0.033 (0.017–0.049) mL kg–1. Median (interquartile range) scores for sedation/anesthesia were 17 (16–18) and 17 (15–20), and times until lateral recumbency were 5 (4–6) and 6 (4–10) minutes in TKX and TKXM, respectively (p > 0.05). In both groups heart and respiratory rates decreased, but values remained acceptable for anesthetized dogs.Conclusions and clinical relevanceThe results provide a guide for volumes of TKX and TKXM in dogs requiring restraint for minimally invasive procedures. Inclusion of methadone in the TKX combination did not influence ED50.  相似文献   

16.
ObjectiveVarious drugs administered to horses undergoing surgical procedures can release histamine. Histamine concentrations were evaluated in horses prepared for surgery and administered butorphanol or morphine intraoperative infusions.Study designProspective studies with one randomized.AnimalsA total of 44 client-owned horses.MethodsIn one study, anesthesia was induced with xylazine followed by ketamine–diazepam. Anesthesia was maintained with guaifenesin–xylazine–ketamine (GXK) during surgical preparation. For surgery, isoflurane was administered with intravenous (IV) morphine (group M: 0.15 mg kg–1 and 0.1 mg kg–1 hour–1; 15 horses) or butorphanol (group B: 0.05 mg kg–1 and 0.01 mg kg–1 hour–1; 15 horses). Histamine and morphine concentrations were measured using enzyme-linked immunoassay before opioid injection (time 0), and after 1, 2, 5, 30, 60 and 90 minutes. In a subsequent study, plasma histamine concentrations were measured in 14 horses before drug administration (baseline), 15 minutes after IV sodium penicillin and 15 minutes after starting GXK IV infusion. Statistical comparison was performed using anova for repeated measures. Pearson correlation compared morphine and histamine concentrations. Data are presented as mean ± standard deviation. Significance was assumed when p ≤ 0.05.ResultsWith histamine, differences occurred between baseline (3.2 ± 2.4 ng mL–1) and GXK (5.2 ± 7.1 ng mL–1) and between baseline and time 0 in group B (11.9 ± 13.4 ng mL–1) and group M (11.1 ± 12.4 ng mL–1). No differences occurred between baseline and after penicillin or between groups M and B. Morphine concentrations were higher at 1 minute following injection (8.1 ± 5.1 ng mL–1) than at 30 minutes (4.9 ± 3.1 ng mL–1) and 60 minutes (4.0 ± 2.5 ng mL–1). Histamine correlated with morphine at 2, 30 and 60 minutes.Conclusions and clinical relevanceGXK increased histamine concentration, but concentrations were similar with morphine and butorphanol.  相似文献   

17.
ObjectiveTo investigate the clinical efficacy of four analgesia protocols in dogs undergoing tibial tuberosity advancement (TTA).Study designProspective, randomized, blinded study.AnimalsThirty-two client owned dogs undergoing TTA-surgery.MethodsDogs (n= 8 per treatment) received an oral placebo (PM and PRM) or tepoxalin (10 mg kg?1) tablet (TM and TRM) once daily for 1 week before surgery. Epidural methadone (0.1 mg kg?1) (PM and TM) or the epidural combination methadone (0.1 mg kg?1)/ropivacaine 0.75% (1.65 mg kg?1) (PRM and TRM) was administered after induction of anaesthesia. Intra-operative fentanyl requirements (2 μg kg?1 IV) and end-tidal isoflurane concentration after 60 minutes of anaesthesia (Fe′ISO60) were recorded. Post-operative analgesia was evaluated hourly from 1 to 8 and at 20 hours post-extubation with a visual analogue scale (VAS) and the University of Melbourne Pain Scale (UMPS). If VAS > 50 and/or UMPS > 10, rescue methadone (0.1 mg kg?1) was administered IV. Analgesic duration (time from epidural until post-operative rescue analgesia) and time to standing were recorded. Normally distributed variables were analysed with an F-test (α = 0.05) or t-test for pairwise inter-treatment comparisons (Bonferonni adjusted α = 0.0083). Non-normally distributed data were analysed with the Kruskall–Wallis test (α = 0.05 or Bonferonni adjusted α = 0.005 for inter-treatment comparison of post-operative pain scores).ResultsMore intra-operative analgesia interventions were required in PM [2 (0–11)] [median (range)] and TM [2 (1–2)] compared to PRM (0) and TRM (0). Fe′ISO60 was significantly lower in (PRM + TRM) compared to (PM + TM). Analgesic duration was shorter in PM (459 ± 276 minutes) (mean ± SD) and TM (318 ± 152 minutes) compared to TRM (853 ± 288 minutes), but not to PRM (554 ± 234 minutes). Times to standing were longer in the ropivacaine treatments compared to TM.Conclusions and clinical relevanceInclusion of epidural ropivacaine resulted in reduction of Fe′ISO60, avoidance of intra-operative fentanyl administration, a longer duration of post-operative analgesia (in TRM) and a delay in time to standing compared to TM.  相似文献   

18.
ObjectiveTo evaluate the analgesic and physiological effects of epidural morphine administered at the sixth and seventh lumbar or the fifth and sixth thoracic vertebrae in dogs undergoing thoracotomy.Study designProspective, randomized, blinded trial.AnimalsFourteen mixed-breed dogs, weighing 8.6 ± 1.4 kg.MethodsThe animals received acepromazine (0.1 mg kg?1) IM and anesthesia was induced with propofol (4 mg kg?1) IV. The lumbosacral space was punctured and an epidural catheter was inserted up to the region between the sixth and seventh lumbar vertebrae (L, n = 6) or up to the fifth or sixth intercostal space (T, n = 8). The dogs were allowed to recover and after radiographic confirmation of correct catheter position, anesthesia was reinduced with propofol IV and maintained with 1.7% isoflurane. Following stabilization of monitored parameters, animals received morphine (0.1 mg kg?1) diluted in 0.9% NaCl to a final volume of 0.25 mL kg?1 via the epidural catheter, and after 40 minutes, thoracotomy was initiated. Heart rate and rhythm, systolic, mean and diastolic arterial pressures, respiratory rate, arterial hemoglobin oxygen saturation, partial pressure of expired CO2 and body temperature were measured immediately before the epidural administration of morphine (0 minute) and every 10 minutes during the anesthetic period. The Melbourne pain scale and the visual analog scale were used to assess post-operative pain. The evaluation began 3 hours after the epidural administration of morphine and occurred each hour until rescue analgesia.ResultsThere were no important variations in the physiological parameters during the anesthetic period. The post-operative analgesic period differed between the groups, being longer in T (9.9 ± 1.6 hours) compared with L (5.8 ± 0.8 hours).ConclusionsThe use of morphine, at a volume of 0.25 mL kg?1, administered epidurally over the thoracic vertebrae provided longer lasting analgesia than when deposited over the lumbar vertebrae.Clinical relevanceThe deposition of epidural morphine provided longer lasting analgesia when administered near to the innervation of the injured tissue without increasing side effects.  相似文献   

19.
ObjectiveTo assess analgesic efficacy and the pharmacokinetics of intranasal (IN) tramadol in dogs following ovariohysterectomy.Study designRandomized, blinded clinical study.AnimalsA total of 30 bitches undergoing elective ovariohysterectomy.MethodsDogs were randomly assigned to one of three experimental groups (10 dogs per group): IN tramadol 4 mg kg–1 (group T-IN), intravenous (IV) tramadol 4 mg kg–1 (group T-IV) and IV methadone 0.2 mg kg–1 (group M). Drugs were administered at extubation. At established time points (before surgery and up to 8 hours after drug administration) analgesia was assessed using the Italian version of the Glasgow Composite Measure Pain Scale Short Form and physiological variables were recorded. To determine the pharmacokinetics of IN tramadol, blood samples were collected at predetermined time points. Shapiro–Wilk test was used to assess whether data were normally distributed and consequently parametric or non parametric tests were applied. A p value < 0.05 was considered significant.ResultsNo significant intergroup differences were observed in the dogs that were administered rescue analgesia and time of its administration. Excluding dogs that were administered rescue analgesia, no significant intergroup differences emerged in pain scores and physiological variables, except for a lower rectal temperature in group M compared with the tramadol groups. After IN administration, tramadol was rapidly absorbed into the systemic circulation, reaching its maximum concentration (range 74.74–200.29 ng mL–1) within 30–60 minutes, it then decreased rapidly and was detectable in plasma for up to 2 hours after treatment in all dogs.Conclusions and clinical relevanceIN tramadol administration appears to be as effective as IV tramadol and methadone treatments in pain management of dogs after elective ovariohysterectomy. Given its low concentrations and short detection time in plasma after the IN route, systemic tramadol action appears unlikely.  相似文献   

20.
ObjectiveTo evaluate and compare the effect of epidural bupivacaine on analgesia produced by epidural xylazine or medetomidine in buffaloes.Study designProspective, blinded study.AnimalsTen male buffalo calves (6-8 months of age; body weight 70-90 kg) were used on two occasions to conduct a total of 20 investigations.MethodsCaudal extradural analgesia was produced in four buffalo calves each by the injection of either xylazine (0.05 mg kg?1), medetomidine (15 μg kg?1) or 0.5% bupivacaine (0.125 mg kg?1), or combinations of xylazine and bupivacaine (0.05 and 0.125 mg kg?1), or medetomidine and bupivacaine (15 μg kg?1 and 0.125 mg kg?1) at the first intercoccygeal extradural space. Analgesia was tested using deep pinprick stimuli.ResultsExtradural administration of xylazine or medetomidine resulted in complete analgesia of the tail, perineum, inguinal region and the upper parts of the hind limbs, which was faster in onset and longer in duration in the medetomidine group than in the xylazine group. Addition of bupivacaine increased the intensity of the analgesia produced by xylazine, but not that produced by medetomidine. All the drugs caused mild to moderate ataxia, but signs of sedation were apparent only in animals which received xylazine or medetomidine. The extradural injections of all the drugs caused significant decrease in heart rate (p = 0.024), respiratory rate (p = 0.026) and rectal temperature (p = 0.036) from the respective baseline values, but the differences between the groups were not significant.ConclusionsMedetomidine produced a longer duration of analgesia than that produced by xylazine. Bupivacaine prolonged the analgesia produced by xylazine, but the analgesia produced by the combination of medetomidine and bupivacaine was not superior to that produced by medetomidine alone.Clinical relevanceBupivacaine may be used to prolong the extradural analgesia produced by xylazine, but not that produced by medetomidine in buffaloes.  相似文献   

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