Objective

To evaluate anesthetic conditions and postoperative analgesia with the use of intraoperative constant rate infusions (CRIs) of fentanyl–lidocaine or fentanyl–ketamine in dogs undergoing thoracolumbar hemilaminectomy.

Study design

Prospective, randomized, blinded, clinical study.

Animals

A total of 32 client-owned dogs.

Methods

Dogs were premedicated with fentanyl (5 μg kg^–1) administered intravenously (IV), anesthesia was induced with IV alfaxalone and maintained with isoflurane. Fentanyl (0.083 μg kg^–1 minute^–1) was infused IV with either ketamine (0.5 mg kg^–1; then 40 μg kg^–1 minute^–1; group KF) or lidocaine (2 mg kg^–1; then 200 μg kg^–1 minute^–1; group LF) assigned randomly. Heart rate, noninvasive arterial pressures, respiratory rate, esophageal temperature, end-tidal partial pressure of carbon dioxide and isoflurane concentration were recorded throughout anesthesia. Maintenance of anesthesia, recovery and postoperative pain (Glasgow Composite Pain Scale) were scored. Cardiopulmonary data were analyzed using a two-way anova with repeated measures, demographics of the two groups with a t test, and scores with Mann–Whitney U test, with p < 0.05.

Results

All dogs recovered from anesthesia without complications. No significant difference was found between groups for cardiopulmonary variables, total anesthesia time, sedation score and requirement for postoperative sedation or for rescue analgesia. Anesthetic maintenance score was of lower quality in KF than in LF [median (interquartile range): 0 (0–0.5) versus 0 (0–0); p = 0.032)], but still considered ideal. Recovery score was higher and indicative of less sedation in LF than in KF [1 (1–1.5) versus 0.5 (0–1); p < 0.0001]. Pain score was higher in KF than in LF [2 (1–3) versus 1 (1–2); p = 0.0009].

Conclusions and clinical relevance

Both CRIs of KF and LF provided adequate anesthetic conditions in dogs undergoing thoracolumbar hemilaminectomy. Based on requirement for rescue analgesia, postoperative analgesia was adequate in both groups.

中文翻译：

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异氟醚麻醉犬胸腰椎半椎板切除术中芬太尼-氯胺酮和芬太尼-利多卡因恒速输注镇痛效果评价

客观的

使用芬太尼-利多卡因或芬太尼-氯胺酮的术中恒速输注 (CRI) 评估接受胸腰椎半椎板切除术的犬的麻醉条件和术后镇痛效果。

学习规划

前瞻性、随机、盲法、临床研究。

动物

共有32只客户拥有的狗。

方法

犬预先用静脉内（IV）施用的芬太尼（5μg/kg ^-1）给药，用IV阿法沙酮诱导麻醉并用异氟醚维持。芬太尼（0.083 μg kg ^–1 min ^–1）静脉内注入氯胺酮（0.5 mg kg ^–1；然后是 40 μg kg ^–1 min ^–1；KF 组）或利多卡因（2 mg kg ^–1；然后是 200 μg kg ^–1分钟^–1; 组 LF) 随机分配。在整个麻醉过程中记录心率、无创动脉压、呼吸频率、食管温度、呼气末二氧化碳分压和异氟醚浓度。对麻醉维持、恢复和术后疼痛（格拉斯哥复合疼痛量表）进行评分。心肺数据使用重复测量的双向方差分析、两组人口统计数据进行t检验以及 Mann-Whitney U检验评分，p < 0.05。

结果

所有的狗都从麻醉中恢复过来，没有出现并发症。两组之间在心肺变量、总麻醉时间、镇静评分和术后镇静或抢救镇痛要求方面没有显着差异。KF 的麻醉维持评分质量低于 LF [中位数（四分位距）：0 (0-0.5) vs 0 (0-0)；p  = 0.032)]，但仍被认为是理想的。与 KF 相比，LF 的恢复评分更高，表明镇静程度更低 [1 (1-1.5)比0.5 (0-1)；p < 0.0001]。KF 的疼痛评分高于 LF [2 (1-3) vs 1 (1-2); p  = 0.0009]。

结论和临床相关性

KF 和 LF 的 CRI 都为接受胸腰椎半椎板切除术的狗提供了足够的麻醉条件。根据抢救性镇痛的需要，两组术后镇痛均足够。