目的:这项研究的目的是比较镇痛效果以及使用曲马多对生理变量和行为的影响,美沙酮和吗啡在健康猫选择性卵巢子宫切除术中的术前镇痛作用。
方法:接受卵巢子宫切除术的猫被随机分配接受以下肌内预处理治疗之一:美沙酮(0.2mg/kg;n=10);吗啡(0.2mg/kg;n=10);曲马多(3mg/kg;n=10)。用异丙酚进行麻醉诱导,用异氟烷维持麻醉。术中心率,动脉血压,呼吸频率,比较两组间潮气末异氟醚浓度和抢救镇痛频率(芬太尼2.5µg/kg).使用UNESP-Botucatu多维复合疼痛量表评估术后镇痛,围手术期血清葡萄糖,评估皮质醇浓度和术后抢救镇痛。
结果:76.5%的猫在手术过程中需要术中抢救镇痛,27%的猫在拔管后6小时内需要术后抢救镇痛。两组在术中和术后抢救镇痛方面无显著差异,疼痛评分和呼气末异氟醚浓度。在术后即刻,拔管后,大多数患者出现体温过低;然而,术后1-6h,在大多数患者中观察到热疗,最常见于曲马多组。
结论:在本研究条件下,美沙酮,吗啡和曲马多在大多数接受卵巢子宫切除术的猫中产生令人满意的术后镇痛效果,效果持续至术后6小时。术中镇痛在大多数情况下是不够的。未发现使用这些药物的明显心血管或呼吸影响。所有研究的阿片类药物都会发生麻醉后热疗,曲马多组更常见。
The aim of this study was to compare the analgesic efficacy and the effect on physiological variables and behavior of the use of tramadol, methadone and morphine as preoperative analgesia in healthy cats undergoing elective
ovariohysterectomy.
Cats undergoing
ovariohysterectomy were randomly assigned to receive one of the following premedication treatments intramuscularly: methadone (0.2 mg/kg; n = 10); morphine (0.2 mg/kg; n = 10); or tramadol (3 mg/kg; n = 10). Induction of anesthesia was done with propofol, and maintenance of anesthesia was done with isoflurane. Intraoperative heart rate, arterial blood pressure, respiratory rate, end-tidal isoflurane concentration and frequency of rescue analgesia (fentanyl 2.5 µg/kg) were compared between groups. Postoperative analgesia was assessed using the UNESP-Botucatu Multidimensional Composite Pain Scale, and perioperative serum glucose, cortisol concentrations and postoperative rescue analgesia were evaluated.
Intraoperative rescue analgesia was required in 76.5% of cats at some time during surgery, and 27% of cats required postoperative rescue analgesia up to 6 h after extubation. There were no significant differences between groups with respect to intraoperative and postoperative rescue analgesia, pain scale scores and end-tidal isoflurane concentrations. In the immediate postoperative period, after extubation, most of the patients presented with hypothermia; however, 1-6 h postoperatively, hyperthermia was observed in most of the patients, and was most common in the tramadol group.
Under the conditions of this study, methadone, morphine and tramadol produced satisfactory postoperative analgesia in most of the cats undergoing
ovariohysterectomy, and the effects lasted up to 6 h postoperatively. Intraoperative analgesia was not sufficient in most cases. Significant cardiovascular or respiratory effects contraindicating the use of these drugs were not found. Postanesthetic hyperthermia occurred with all opioids studied and was more frequent in the tramadol group.