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Abstract：
OBJECTIVE: To retrospectively compare the efficacy and duration of effect of three commonly used locoregional blocks in dogs undergoing pelvic limb orthopaedic surgery.
METHODS: Retrospective clinical study.
METHODS: A total of 236 dogs that underwent pelvic limb surgery and were administered a locoregional technique.
METHODS: A total of 236 hospital records were reviewed and 230 included in statistical analysis. Dogs were grouped as following: electrostimulation-guided pre-iliac femoral and sciatic nerve block (group PFS, n = 70); ultrasound-guided saphenous and sciatic nerve block (group SS, n = 76); or lumbosacral epidural (group EPI, n = 84). In group EPI, bupivacaine 0.5% or ropivacaine 0.75% was used with morphine. Dogs were pain scored (short form of the Glasgow Composite Measure Pain Scale) hourly following recovery from anaesthesia. Analysed data included: time to first postoperative dose of methadone, pain score at that time, intraoperative rescue analgesia, intraoperative hypotension and ability to walk and urinate overnight. Separate analyses were performed including all pelvic limb surgeries and including only elective stifle surgeries. Kruskal-Wallis and Mann-Whitney tests were performed. A p value < 0.05 was considered significant. The median (range) is reported.
RESULTS: For all pelvic limb surgeries, the time to first postoperative methadone was 530 (110-1337), 440 (140-1030) and 466 (135-1094) minutes in groups EPI, PFS and SS, respectively, and was not significantly different. Postoperatively, 10/84, 15/70 and 12/76 dogs in groups EPI, PFS and SS, respectively, did not require methadone (nonsignificant). Significantly fewer dogs in group EPI (18%) required intraoperative rescue analgesia compared with group SS (38%), but not compared with PFS (30%). Significantly more dogs in group EPI had hypotension intraoperatively (30%) and urinary retention postoperatively (62%).
CONCLUSIONS: Intraoperative analgesia may be superior with EPI than SS for some surgeries of the pelvic limb, but not for stifle surgeries. All three techniques provided similar requirement for postoperative analgesia, but EPI caused higher incidence of intraoperative hypotension and postopertive urinary retention.
METHODS: Retrospective clinical study.
METHODS: A total of 236 dogs that underwent pelvic limb surgery and were administered a locoregional technique.
METHODS: A total of 236 hospital records were reviewed and 230 included in statistical analysis. Dogs were grouped as following: electrostimulation-guided pre-iliac femoral and sciatic nerve block (group PFS, n = 70); ultrasound-guided saphenous and sciatic nerve block (group SS, n = 76); or lumbosacral epidural (group EPI, n = 84). In group EPI, bupivacaine 0.5% or ropivacaine 0.75% was used with morphine. Dogs were pain scored (short form of the Glasgow Composite Measure Pain Scale) hourly following recovery from anaesthesia. Analysed data included: time to first postoperative dose of methadone, pain score at that time, intraoperative rescue analgesia, intraoperative hypotension and ability to walk and urinate overnight. Separate analyses were performed including all pelvic limb surgeries and including only elective stifle surgeries. Kruskal-Wallis and Mann-Whitney tests were performed. A p value < 0.05 was considered significant. The median (range) is reported.
RESULTS: For all pelvic limb surgeries, the time to first postoperative methadone was 530 (110-1337), 440 (140-1030) and 466 (135-1094) minutes in groups EPI, PFS and SS, respectively, and was not significantly different. Postoperatively, 10/84, 15/70 and 12/76 dogs in groups EPI, PFS and SS, respectively, did not require methadone (nonsignificant). Significantly fewer dogs in group EPI (18%) required intraoperative rescue analgesia compared with group SS (38%), but not compared with PFS (30%). Significantly more dogs in group EPI had hypotension intraoperatively (30%) and urinary retention postoperatively (62%).
CONCLUSIONS: Intraoperative analgesia may be superior with EPI than SS for some surgeries of the pelvic limb, but not for stifle surgeries. All three techniques provided similar requirement for postoperative analgesia, but EPI caused higher incidence of intraoperative hypotension and postopertive urinary retention.
摘要：
目的：回顾性比较三种常用的局部区域阻滞在接受骨盆肢体骨科手术的犬中的疗效和持续时间。
方法：回顾性临床研究。
方法：共有236只狗接受了骨盆肢体手术，并接受了局部技术。
方法：共审查了236份医院记录，其中230份纳入统计分析。狗分为以下几类：电刺激引导的髂前股骨和坐骨神经阻滞（PFS组，n=70）；超声引导下隐神经和坐骨神经阻滞（SS组，n=76）；或腰骶骨硬膜外（EPI组，n=84）。在EPI组中，0.5％布比卡因或0.75％罗哌卡因与吗啡一起使用。从麻醉中恢复后，每小时对狗进行疼痛评分（格拉斯哥综合疼痛量表的简称）。分析数据包括：美沙酮术后第一次剂量的时间，当时的疼痛评分，术中抢救镇痛,术中低血压和夜间行走和排尿能力。进行了单独的分析，包括所有骨盆肢体手术，仅包括选择性窒息手术。进行Kruskal-Wallis和Mann-Whitney测试。P值<0.05被认为是显著的。报告中位数（范围）。
结果：对于所有骨盆肢体手术，术后第一次美沙酮的时间为530（110-1337），EPI组440（140-1030）和466（135-1094）分钟，PFS和SS，分别,并且没有显着差异。术后,EPI组中的10/84、15/70和12/76只狗，PFS和SS，分别,不需要美沙酮（无意义）。与SS组（38％）相比，EPI组（18％）需要术中抢救镇痛的狗明显减少，但与PFS（30％）相比。EPI组中明显更多的狗在术中低血压（30％）和术后尿潴留（62％）。
结论：对于某些骨盆肢体手术，EPI术中镇痛可能优于SS，但不适用于窒息手术。所有这三种技术都为术后镇痛提供了相似的要求，但EPI导致术中低血压和术后尿潴留的发生率较高。
方法：回顾性临床研究。
方法：共有236只狗接受了骨盆肢体手术，并接受了局部技术。
方法：共审查了236份医院记录，其中230份纳入统计分析。狗分为以下几类：电刺激引导的髂前股骨和坐骨神经阻滞（PFS组，n=70）；超声引导下隐神经和坐骨神经阻滞（SS组，n=76）；或腰骶骨硬膜外（EPI组，n=84）。在EPI组中，0.5％布比卡因或0.75％罗哌卡因与吗啡一起使用。从麻醉中恢复后，每小时对狗进行疼痛评分（格拉斯哥综合疼痛量表的简称）。分析数据包括：美沙酮术后第一次剂量的时间，当时的疼痛评分，术中抢救镇痛,术中低血压和夜间行走和排尿能力。进行了单独的分析，包括所有骨盆肢体手术，仅包括选择性窒息手术。进行Kruskal-Wallis和Mann-Whitney测试。P值<0.05被认为是显著的。报告中位数（范围）。
结果：对于所有骨盆肢体手术，术后第一次美沙酮的时间为530（110-1337），EPI组440（140-1030）和466（135-1094）分钟，PFS和SS，分别,并且没有显着差异。术后,EPI组中的10/84、15/70和12/76只狗，PFS和SS，分别,不需要美沙酮（无意义）。与SS组（38％）相比，EPI组（18％）需要术中抢救镇痛的狗明显减少，但与PFS（30％）相比。EPI组中明显更多的狗在术中低血压（30％）和术后尿潴留（62％）。
结论：对于某些骨盆肢体手术，EPI术中镇痛可能优于SS，但不适用于窒息手术。所有这三种技术都为术后镇痛提供了相似的要求，但EPI导致术中低血压和术后尿潴留的发生率较高。
