Objective

To assess the effect of continuous wound infusion (CWI) with preperitoneal ropivacaine on postoperative analgesia and compare it with the epidural administration of ropivacaine and morphine in bitches undergoing ovariohysterectomy.

Study design

A parallel, randomized, clinical, prospective and nonblinded study.

Animals

A group of 38 Greyhound bitches.

Methods

In the catheter group (CathG), CWI with ropivacaine 1% (1 mg kg^–1 + 0.8 mg kg^–1 hour^–1) was applied to the preperitoneal space over the surgical incision. In the epidural group (EpiG), ropivacaine 0.5% (1.3 mg kg^–1) and morphine (0.1 mg kg^–1) were epidurally administered. Occipital-coccygeal length was used to calculate the volume for the epidural. Pain was scored using a dynamic interactive visual analogue scale (DIVAS) and Glasgow composite measure pain scale–short form (CMPS-SF) before anaesthesia and at 2, 4, 6, 18, 21 and 24 hours after extubation. Incisional sensitivity using a dynamometer (MWTs-incision) was evaluated simultaneously. Plasma ropivacaine and cortisol concentrations, degree of sedation, motor blockade and response to interdigital clamping were measured or assessed. A two-way mixed analysis of variance and a Mann–Whitney U test were used to analyse data; p < 0.05.

Results

No differences were detected in the DIVAS (p = 0.301), CMPS-SF (p = 0.600) scores, MWTs-incision measurements (p = 0.257) and cortisol values (p = 0.878) between the groups. Rescue analgesia was required in two dogs, one in each group, at 2 hours. Sedation, motor blockade and negative response to interdigital clamping were detected in EpiG at 2, 4 and 6 hours. Mean plasma ropivacaine values were higher in CathG (0.475 ± 0.164 ng mL^–1) than in EpiG (0.184 ± 0.213 ng mL^–1; p = 0.001).

Conclusion and clinical relevance

Compared with epidural ropivacaine and morphine, CWI with preperitoneal ropivacaine is an effective analgesic technique for postoperative pain management in bitches undergoing ovariohysterectomy without motor blockade.

中文翻译：

---

腹膜前罗哌卡因输注与硬膜外罗哌卡因-吗啡用于接受卵巢子宫切除术犬术后镇痛的随机临床试验

客观的

评估腹膜前罗哌卡因持续伤口输注 (CWI) 对术后镇痛的影响，并将其与接受卵巢子宫切除术的母犬的罗哌卡因和吗啡硬膜外给药进行比较。

学习规划

一项平行、随机、临床、前瞻性和非盲法研究。

动物

一群 38 只灰狗母狗。

方法

在导管组 (CathG) 中，将含有 1% 罗哌卡因 (1 mg kg ^–1  + 0.8 mg kg ^–1小时^–1 ) 的CWI应用于手术切口上方的腹膜前间隙。在硬膜外组 (EpiG) 中，罗哌卡因 0.5% (1.3 mg kg ^–1 ) 和吗啡 (0.1 mg kg ^–1) 进行硬膜外给药。枕骨-尾骨长度用于计算硬膜外的体积。在麻醉前和拔管后 2、4、6、18、21 和 24 小时，使用动态交互式视觉模拟量表 (DIVAS) 和格拉斯哥综合测量疼痛量表 (CMPS-SF) 对疼痛进行评分。同时评估使用测功机（MWTs-切口）的切口敏感性。测量或评估血浆罗哌卡因和皮质醇浓度、镇静程度、运动阻滞和对叉指钳夹的反应。使用双向混合方差分析和 Mann-Whitney U检验来分析数据；p < 0.05。

结果

两组之间的 DIVAS ( p  = 0.301)、CMPS-SF ( p  = 0.600) 评分、MWTs-切口测量值 ( p  = 0.257) 和皮质醇值 ( p  = 0.878) 均未检测到差异。两只狗在 2 小时时需要救援镇痛，每组一只。在 2、4 和 6 小时的 EpiG 中检测到镇静、运动阻滞和对叉指钳夹的负面反应。CathG (0.475 ± 0.164 ng mL ^–1 ) 的平均血浆罗哌卡因值高于EpiG (0.184 ± 0.213 ng mL ^–1；p  = 0.001)。

结论和临床相关性

与硬膜外罗哌卡因和吗啡相比，腹膜前罗哌卡因 CWI 是一种有效的镇痛技术，用于无运动阻滞进行卵巢子宫切除术的母犬术后疼痛管理。