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Sacrococcygeal epidural administration of 0.5% bupivacaine in seven cats undergoing pelvic or hind limb orthopaedic procedures
Irish Veterinary Journal ( IF 2.9 ) Pub Date : 2023-02-02 , DOI: 10.1186/s13620-023-00231-2
Xavier Torruella 1 , Joanna Potter 1 , Vilhelmiina Huuskonen 1
Affiliation  

Epidural administration of local anaesthetic agents provides good intraoperative antinociception for orthopaedic procedures of the pelvis and the pelvic limb. However, in cats the spinal cord extends approximately to the level of the first sacrococcygeal vertebra, and therefore the sacrococcygeal epidural could be a safer alternative to the lumbosacral epidural in cats. This case series describes perioperative analgesia and the haemodynamic status of seven client-owned cats that received sacrococcygeal epidural injection of 0.5% bupivacaine and underwent orthopaedic hind leg or pelvic surgeries under general anaesthesia. Each cat received either 0.2 or 0.3 mL/kg of 0.5% bupivacaine with or without 0.2 mg/kg of morphine in the sacrococcygeal epidural space. Intraoperative antinociceptive response to surgical stimulus and haemodynamic changes were monitored and reported. In these seven anaesthetised cats, 0.2 or 0.3 mL/kg of 0.5% bupivacaine, administered alone or in combination with morphine into the sacrococcygeal epidural space, enhanced antinociception so that intraoperative rescue analgesia was unnecessary in all but one cat. It also reduced the anticipated requirement for postoperative opioid use. However, a high incidence of hypotension was observed in the cats in this report, and hence intraoperative blood pressure monitoring should be considered mandatory in anaesthetised cats following epidural injection of local anaesthetic agents, regardless of injection site.

中文翻译:

七只接受骨盆或后肢矫形手术的猫骶尾部硬膜外给药 0.5% 布比卡因

局部麻醉剂的硬膜外给药为骨盆和骨盆肢体的整形外科手术提供了良好的术中镇痛作用。然而,在猫中,脊髓大约延伸到第一骶尾椎的水平,因此骶尾硬膜外麻醉可能是猫腰骶硬膜外麻醉的更安全替代方法。本病例系列描述了七只接受骶尾部硬膜外注射 0.5% 布比卡因并在全身麻醉下接受矫形后腿或骨盆手术的猫的围手术期镇痛和血流动力学状态。每只猫在骶尾部硬膜外腔接受 0.2 或 0.3 mL/kg 的 0.5% 布比卡因,有或没有 0.2 mg/kg 的吗啡。监测和报告术中对手术刺激和血液动力学变化的抗伤害反应。在这七只麻醉的猫中,0.2 或 0.3 mL/kg 的 0.5% 布比卡因单独或与吗啡联合给药至骶尾部硬膜外腔,增强了抗伤害感受,因此除了一只猫外,所有猫都不需要术中抢救镇痛。它还减少了术后阿片类药物使用的预期需求。然而,在本报告中观察到猫的低血压发生率很高,因此无论注射部位如何,在硬膜外注射局部麻醉剂后麻醉的猫都应考虑强制进行术中血压监测。单独或与吗啡联合给药至骶尾部硬膜外腔,增强了抗伤害作用,因此除了一只猫外,所有猫都不需要术中抢救镇痛。它还减少了术后阿片类药物使用的预期需求。然而,在本报告中观察到猫的低血压发生率很高,因此无论注射部位如何,在硬膜外注射局部麻醉剂后麻醉的猫都应考虑强制进行术中血压监测。单独或与吗啡联合给药至骶尾部硬膜外腔,增强了抗伤害作用,因此除了一只猫外,所有猫都不需要术中抢救镇痛。它还减少了术后阿片类药物使用的预期需求。然而,在本报告中观察到猫的低血压发生率很高,因此无论注射部位如何,在硬膜外注射局部麻醉剂后麻醉的猫都应考虑强制进行术中血压监测。
更新日期:2023-02-02
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