目的:这是随机的,prospective,蒙面临床试验评估了超声引导下布比卡因腹横肌平面阻滞(TAPB)对接受卵巢子宫切除术的猫的术后镇痛效果.
方法:32只接受选择性卵巢子宫切除术的健康成年雌性猫随机接受布比卡因TAPB(治疗组[TG],n=16)与安慰剂(对照组[CG],n=16),除了术前镇痛用丁丙诺啡(0.02mg/kgIM)。所有患者都接受了全身麻醉,手术切口前,使用0.25%布比卡因1ml/kg(0.25ml/kg/点)或生理盐水进行双侧两点(肋下和侧纵)TAPB.在术前(0小时)和术后1、2、3、4、8、10和24小时,使用UNESP-Botucatu猫科动物疼痛量表-简表,由盲法研究者评估每只猫。当疼痛评分为4/12时,给予丁丙诺啡(0.02mg/kgIV)和美洛昔康(0.2mg/kgSC)。术后10小时,美洛昔康用于未接受抢救镇痛的猫。统计分析包括学生t检验,Wilcoxon检验和χ2检验,和具有Bonferroni校正的线性混合模型(P<0.05)。
结果:在注册的32只猫中,CG中的3例被排除在分析之外.CG(n=13/13)的镇痛率明显高于TG(n=3/16;P<0.001)。CG中只有一只猫需要两次抢救镇痛。术后2、4和8小时,CG的疼痛评分明显高于TG。CG的平均±SD疼痛评分明显更高,但不是在TG中,在2(2.1±1.9),3(1.9±1.6),4(3.0±1.4)和术后8h(4.7±0.6)比0h(0.1±0.3)。
结论:在接受卵巢子宫切除术的猫中,双侧超声引导的两点TAPB联合布比卡因和全身丁丙诺啡的术后镇痛效果优于单用丁丙诺啡。
This randomised, prospective, masked clinical trial evaluated the postoperative analgesic efficacy of an ultrasound-guided transversus abdominis plane block (TAPB) with bupivacaine in cats undergoing ovariohysterectomy.
Thirty-two healthy adult female cats undergoing elective ovariohysterectomy were randomised to undergo TAPB with bupivacaine (treatment group [TG], n = 16) vs placebo (control group [CG], n = 16) in addition to preoperative analgesia with buprenorphine (0.02 mg/kg IM). All patients received a general anaesthetic and, before surgical incision, a bilateral two-point (subcostal and lateral-longitudinal) TAPB was performed using 1 ml/kg bupivacaine 0.25% (0.25 ml/kg/point) or saline. Each cat was assessed by a blinded investigator before premedication (0 h) and at 1, 2, 3, 4, 8, 10 and 24 h postoperatively using the UNESP-Botucatu Feline Pain Scale - short form. Buprenorphine (0.02 mg/kg IV) and meloxicam (0.2 mg/kg SC) were administered when pain scores were ⩾4/12. Ten hours postoperatively, meloxicam was administered to cats that did not receive rescue analgesia. Statistical analysis included Student\'s t-tests, Wilcoxon tests and χ2 tests, and a linear mixed model with Bonferroni corrections (P <0.05).
Of the 32 cats enrolled, three in the CG were excluded from the analysis. The prevalence of rescue analgesia was significantly higher in the CG (n = 13/13) than in the TG (n = 3/16; P <0.001). Only one cat in the CG required rescue analgesia twice. Pain scores were significantly higher in the CG compared with the TG at 2, 4 and 8 h postoperatively. Mean ± SD pain scores were significantly higher in the CG, but not in the TG, at 2 (2.1 ± 1.9), 3 (1.9 ± 1.6), 4 (3.0 ± 1.4) and 8 h postoperatively (4.7 ± 0.6) than at 0 h (0.1 ± 0.3).
A bilateral ultrasound-guided two-point TAPB with bupivacaine in combination with systemic buprenorphine provided superior postoperative analgesia than buprenorphine alone in cats undergoing ovariohysterectomy.