Objective

To compare the perioperative use of analgesics and complication rates in dogs administered an erector spinae plane (ESP) block or a traditional opioid-based (OP) treatment as part of analgesic management during hemilaminectomy.

Study design

Retrospective cohort study.

Animals

Medical records of 114 client-owned dogs.

Methods

General data included demographics, duration of procedure, number of laminae fenestrated, perioperative use of steroid and non-steroidal anti-inflammatory drugs. Intra- and postoperative analgesics used in 48 hours and complications rates were compared between groups. Opioid use was expressed in morphine equivalents [ME (mg kg⁻¹)]. Continuous data were compared using the Mann–Whitney U test and incidence of events with a Fisher's exact tests. Multiple linear regression was used to evaluate association between perioperative ME consumption (dependent variable) with other independent variables. Data are presented as median (range). Differences were considered significant when p < 0.05.

Results

Group ESP comprised 42 dogs and group OP 72 dogs. No differences were observed in the general data. Intraoperative ME was 0.65 (0.20–3.74) and 0.79 (0.19–5.60) mg kg⁻¹ in groups ESP and OP, respectively (p = 0.03). Intraoperative infusion of lidocaine was administered intravenously (IV) to 23.8% and 68% of groups ESP and OP, respectively (p < 0.0001). Intraoperative infusion of ketamine was administered IV to 21% and 40% of groups ESP and OP, respectively (p = 0.04). Regression analysis revealed the ESP block as the only independent variable affecting the perioperative ME consumption. Pharmacological intervention to treat cardiovascular complications was administered to 21.4% and 47.2% of dogs in groups ESP and OP, respectively (p = 0.008). There were no differences in postoperative complication rates.

Conclusions and clinical relevance

ESP block was associated with reduced perioperative opioid consumption, intraoperative adjuvant analgesic use and incidence of pharmacological interventions to treat cardiovascular complications in dogs undergoing hemilaminectomy.

中文翻译：

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竖脊肌平面阻滞对半椎板切除术犬围手术期镇痛药用量和并发症的影响：一项回顾性队列研究

客观的

比较在半椎板切除术期间使用竖脊肌平面 (ESP) 阻滞或传统阿片类药物 (OP) 治疗作为镇痛剂管理的一部分的犬围手术期镇痛剂的使用和并发症发生率。

学习规划

回顾性队列研究。

动物

114 只客户拥有的狗的医疗记录。

方法

一般数据包括人口统计学、手术持续时间、开窗的椎板数量、围手术期使用类固醇和非类固醇抗炎药。比较组间48小时内和术后镇痛药的使用情况和并发症发生率。阿片类药物的使用以吗啡当量 [ME (mg kg ^-1 )] 表示。使用 Mann-Whitney U检验比较连续数据，并使用Fisher 精确检验比较事件发生率。多元线性回归用于评估围手术期 ME 消耗（因变量）与其他自变量之间的关联。数据以中位数（范围）表示。当p < 0.05时，差异被认为是显着的。

结果

ESP 组包括 42 只狗和 OP 组 72 只狗。在一般数据中没有观察到差异。ESP 和 OP 组的术中 ME 分别为 0.65 (0.20–3.74) 和 0.79 (0.19–5.60) mg kg ^-1 ( p  = 0.03)。ESP 和 OP 组中分别有 23.8% 和 68% 的患者在术中静脉内 (IV) 输注利多卡因 ( p < 0.0001)。分别向 ESP 和 OP 组的 21% 和 40% 静脉注射氯胺酮 ( p  = 0.04)。回归分析显示 ESP 阻滞是影响围手术期 ME 消耗的唯一自变量。ESP 和 OP 组中分别有 21.4% 和 47.2% 的狗接受了治疗心血管并发症的药物干预。p  = 0.008）。术后并发症发生率无差异。

结论和临床相关性

ESP 阻滞与围手术期阿片类药物消耗减少、术中辅助镇痛药的使用和药物干预的发生率有关，以治疗接受半椎板切除术的犬的心血管并发症。