Objective

To compare the quality of postoperative analgesia and sedation after preoperative saphenous and sciatic nerve blockade, preoperative lumbosacral epidural injection and perioperative intravenous (IV) morphine, lidocaine and ketamine infusions in dogs undergoing stifle arthroscopy and tibial plateau leveling osteotomy (TPLO) under general anesthesia.

Study design

Prospective, blinded, randomized, clinical comparison study.

Animals

A total of 45 dogs weighing 33.9 (15.9–56.7) kg and aged 5.2 (1.0–12.0) years, mean (range), undergoing elective unilateral TPLO for spontaneous cranial cruciate ligament rupture.

Methods

Client-owned dogs were enrolled. Dogs were randomly assigned to one of three groups: group MLK, perioperative IV morphine, lidocaine and ketamine infusion; group EPID, lumbosacral epidural with ropivacaine and morphine; or group SSNB, saphenous and sciatic nerve blockade with ropivacaine. Routine stifle arthroscopy followed by TPLO surgery was performed. Sedation and pain scores were assessed at 0, 2, 4, 8 and 24 hours following extubation. Rescue analgesia was administered as prescribed by Glasgow composite pain score–short form score >5.

Results

Sedation scores for MLK were higher than EPID and SSNB. Pain scores for SSNB were lower than those for EPID and MLK. No significant differences were found in anesthesia duration or surgery duration among groups. No dogs required rescue analgesia.

Conclusions and clinical relevance

Although analgesia was adequate in all groups, the best combination of analgesia without increased sedation was recorded for SSNB.

中文翻译：

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围手术期大隐神经和坐骨神经阻滞、腰骶部硬膜外或吗啡-利多卡因-氯胺酮输注对犬胫骨平台平整截骨术后疼痛和镇静的影响

客观的

比较全麻下进行膝关节镜检查和胫骨平台平整截骨术（TPLO）的犬，在术前大隐神经和坐骨神经阻滞、术前腰骶硬膜外注射和围手术期静脉注射吗啡、利多卡因和氯胺酮后的术后镇痛和镇静效果。

学习规划

前瞻性、盲法、随机、临床比较研究。

动物

共有 45 只狗，体重 33.9 (15.9–56.7) kg，年龄 5.2 (1.0–12.0) 岁，平均（范围），接受选择性单侧 TPLO 治疗自发性颅交叉韧带断裂。

方法

招募了客户拥有的狗。狗被随机分配到三组之一：MLK组、围手术期静脉注射吗啡、利多卡因和氯胺酮输注；EPID组，腰骶硬膜外联合罗哌卡因和吗啡；或 SSNB 组，用罗哌卡因进行大隐神经和坐骨神经阻滞。进行了常规的膝关节镜检查，然后进行了 TPLO 手术。在拔管后 0、2、4、8 和 24 小时评估镇静和疼痛评分。按照格拉斯哥综合疼痛评分 - 简短评分 > 5 的规定进行救援镇痛。

结果

MLK 的镇静评分高于 EPID 和 SSNB。SSNB 的疼痛评分低于 EPID 和 MLK。组间麻醉时间或手术时间无显着差异。没有狗需要救援镇痛。

结论和临床相关性

尽管所有组的镇痛都足够，但 SSNB 记录的镇痛最佳组合不增加镇静。