硬膜外麻醉通常作为围手术期镇痛的平衡麻醉的一部分进行。这项随机临床试验的主要目的是比较两种硬膜外入路对会阴疝手术犬的疗效。次要目的是比较运动阻滞。完整的ASA1和2只雄性狗,纳入体重≤25kg且既往未进行会阴疝手术的患者.在使用IM乙酰丙嗪0.02mg/kg和布托啡诺0.3mg/kg进行前用药后,全身麻醉用丙泊酚诱导,七氟醚维持在氧气中。狗被随机分配接受腰骶部(LS,n=30)或骶尾部(SC,n=26)在计算机断层扫描指导下硬膜外注射1%罗哌卡因(0.2mL/kg)。成功的镇痛定义为不需要术中抢救镇痛(芬太尼3μg/kgIV)。临床失败被定义为每只狗在手术结束时静脉内接受美洛昔康0.2mg/kg的芬太尼需要两次以上。格拉斯哥综合疼痛量表简表(GCPS-SF),触觉敏感性,在硬膜外注射后4,6,8和24h评估压痛阈值和运动阻滞.美沙酮(0.2mg/kg,如果GCPS-SF≥6/24分,则给予IV)。组间差异用Mann-WhitneyU检验分析,学生t检验或费舍尔精确检验,视情况而定。成功率在组间进行非劣效性评估。非劣效性幅度设定为-10%。LS组24只狗和SC组17只狗硬膜外镇痛成功(p=0.243),导致LS和SC组的成功率为80%和65%,分别。证实了SC组与LS组的非劣效性。在LS组中的两只狗和SC组中的一只狗中记录临床失败。组间GCPS-SF评分无显著差异,触觉敏感性,压力疼痛阈值,术后需要美沙酮,或马达封锁。两种硬膜外技术都是狗会阴疝修复的有价值的镇痛选择。
Epidural anesthesia is commonly administered as part of balanced anesthesia for perioperative analgesia. The main goal of this randomized clinical trial was to compare the efficacy of two epidural approaches in dogs undergoing surgery for a perineal hernia. A secondary aim was to compare motor blockade. Intact ASA 1 and 2 male dogs, weighing ≤25 kg with no previous surgery for perineal hernia were enrolled. After premedication with IM acepromazine 0.02 mg/kg and butorphanol 0.3 mg/kg, general anesthesia was induced with propofol and maintained with sevoflurane in oxygen. Dogs were randomly allocated to receive either a lumbosacral (LS, n = 30) or a
sacrococcygeal (SC, n = 26) epidural injection with ropivacaine 1% (0.2 mL/kg) under computed tomography guidance. Successful analgesia was defined as no need of intraoperative rescue analgesia (fentanyl 3 μg/kg IV). Clinical failure was defined as the need of more than two boluses of fentanyl/h each dog received meloxicam 0.2 mg/kg IV at the end of the surgery. The Glasgow Composite Pain Scale short form (GCPS-SF), tactile sensitivity, pressure pain thresholds and motor blockade were assessed at 4, 6, 8, and 24 h after the epidural injection. Methadone (0.2 mg/kg, IV) was administered if the GCPS-SF was ≥6/24 points. Differences between groups were analyzed with the Mann-Whitney U test, Student\'s t-test or Fisher\'s Exact test, as appropriate. Success rate was assessed for non-inferiority between groups. The non-inferiority margin was set at -10%. Epidural analgesia was successful in 24 dogs in group LS and 17 dogs in group SC (p = 0.243), resulting in success rates of 80 and 65% in LS and SC groups, respectively. The non-inferiority of group SC versus group LS was confirmed. Clinical failure was recorded in two dogs in group LS and one dog in group SC. No significant differences between groups were detected in the GCPS-SF score, tactile sensitivity, pressure pain thresholds, need of post-operative methadone, or motor blockade. Both epidural techniques are valuable analgesic options for perineal hernia repair in dogs.