Infiltration of the surgical site with local anesthetics combined with nonsteroidal anti-inflammatory drugs may play an important role in improving perioperative pain control. This prospective, randomized, blinded, controlled clinical trial aimed to evaluate intraoperative isoflurane requirements, postoperative analgesia, and adverse events of infiltration of the surgical site with ropivacaine alone and combined with meloxicam in cats undergoing ovariohysterectomy. Forty-five cats premedicated with acepromazine/meperidine and anesthetized with propofol/isoflurane were randomly distributed into three treatments (n = 15 per group): physiological saline (group S), ropivacaine alone (1 mg/kg, group R) or combined with meloxicam (0.2 mg/kg, group RM) infiltrated at the surgical site (incision line, ovarian pedicles and uterus). End-tidal isoflurane concentration (FE’ISO), recorded at specific time points during surgery, was adjusted to inhibit autonomic responses to surgical stimulation. Pain was assessed using an Interactive Visual Analog Scale (IVAS), UNESP-Botucatu Multidimensional Composite Pain Scale (MCPS), and mechanical nociceptive thresholds (MNT) up to 24 h post-extubation. Rescue analgesia was provided with intramuscular morphine (0.1 mg/kg) when MCPS was ≥6. Area under the curve (AUC) of FE’ISO was significantly lower (P < 0.0001) in the RM (17.8 ± 3.1) compared to S (23.1 ± 2.2) and R groups (22.8 ± 1.1). Hypertension (systolic arterial pressure > 160 mmHg) coinciding with surgical manipulation was observed only in cats treated with S and R (4/15 cats, P = 0.08). The number of cats receiving rescue analgesia (4 cats in the S group and 1 cat in the R and RM groups) did not differ among groups (P = 0.17). The AUC of IVAS, MCPS and MNT did not differ among groups (P = 0.56, 0.64, and 0.18, respectively). Significantly lower IVAS pain scores were recorded at 1 h in the RM compared to the R and S groups (P = 0.021–0.018). There were no significant adverse effects during the study period. Local infiltration with RM decreased intraoperative isoflurane requirements and resulted in some evidence of improved analgesia during the early postoperative period. Neither R nor RM infiltration appeared to result in long term analgesia in cats undergoing ovariohysterectomy.

中文翻译：

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单独使用罗哌卡因或与美洛昔康联合在卵巢子宫切除术猫中使用手术部位浸润进行围手术期镇痛的比较

局部麻醉药联合非甾体类抗炎药渗入手术部位可能在改善围手术期疼痛控制中起重要作用。这项前瞻性，随机，盲，对照临床试验旨在评估在接受卵巢子宫切除术的猫中，术中异氟醚的需求量，术后镇痛以及仅用罗哌卡因和美洛昔康联合手术部位浸润的不良事件。将45只预先注射了乙丙嗪/哌啶并用异丙酚/异氟醚麻醉的猫随机分为3种治疗方法（每组n = 15）：生理盐水（S组），单独罗哌卡因（1 mg / kg，R组）或与美洛昔康（0.2 mg / kg，RM组）在手术部位（切口线，卵巢蒂和子宫）浸润。调整了在手术过程中特定时间点记录的潮气末异氟烷浓度（FE'ISO），以抑制对手术刺激的自主反应。使用交互式视觉模拟量表（IVAS），UNESP-Botucatu多维综合疼痛量表（MCPS）和机械伤害阈值（MNT）评估拔管后24小时的疼痛。MCPS≥6时，以肌注吗啡（0.1 mg / kg）进行抢救性镇痛。与S组（23.1±2.2）和R组（22.8±1.1）相比，RM（17.8±3.1）的FE'ISO曲线下面积（AUC）明显更低（P <0.0001）。仅在接受S和R治疗的猫（4/15猫，P = 0.08）中观察到与手术操作相吻合的高血压（收缩动脉压> 160 mmHg）。各组之间接受抢救镇痛的猫数（S组为4只猫，R组和RM组为1只猫）没有差异（P = 0.17）。IVAS，MCPS和MNT的AUC在各组之间没有差异（分别为P = 0.56、0.64和0.18）。与R和S组相比，RM组在1 h时的IVAS疼痛评分明显更低（P = 0.021–0.018）。在研究期间没有明显的不良反应。RM局部浸润降低了术中异氟醚的需求量，并导致了术后早期镇痛效果改善的一些证据。在进行卵巢子宫切除术的猫中，R和RM浸润似乎均未导致长期镇痛。与R和S组相比，RM组在1 h时的IVAS疼痛评分明显更低（P = 0.021–0.018）。在研究期间没有明显的不良反应。RM局部浸润降低了术中异氟醚的需求量，并导致了术后早期镇痛效果改善的一些证据。在进行卵巢子宫切除术的猫中，R和RM浸润似乎均未导致长期镇痛。与R和S组相比，RM组在1 h时的IVAS疼痛评分明显更低（P = 0.021–0.018）。在研究期间没有明显的不良反应。RM局部浸润降低了术中异氟醚的需求量，并导致了术后早期镇痛效果改善的一些证据。在进行卵巢子宫切除术的猫中，R和RM浸润似乎均未导致长期镇痛。