Antinociceptive activity of pre- versus post-operative intra-articular bupivacaine in goats undergoing stifle arthrotomy

作者：Krohm Patricia; Levionnois Olivier; Ganster Murielle; Zilberstein Luca; Spadavecchia Claudia^*

来源：Veterinary Anaesthesia and Analgesia, 2011, 38(4): 363-373.

DOI：10.1111/j.1467-2995.2011.00623.x

• bupivacaine
• goat
• intra-articular
• pain
• peri-operative

Objective To evaluate the pen-operative analgesic efficacy of intra-articular bupivacaine administered before or after stifle arthrotomy.
Study design Prospective, randomized, blind, placebo-controlled experimental trial.
Animals Thirty-nine healthy goats.
Methods The goats were allocated randomly to one of three intra-articular treatment groups: group PRE (bupivacaine before and saline after surgery), group POST (saline before and bupivacaine after surgery) and group CON (saline before and after surgery). Anaesthesia was maintained with a constant end-tidal sevoflurane of 2.5%. Intra-operatively heart rate (HR). respiratory rate and mean arterial blood pressure (MAP) after critical surgical events (CSE) were recorded and compared with pre-incision values. Propofol requirements to maintain surgical anaesthesia were recorded. Flunixin was administered for 5 days. Post-operative pain assessment at 20 minutes. 2 hours, 4 hours after recovery and on day 2 and 3 included a multidimensional pain score (MPS). a lameness score and mechanical nociceptive threshold (MNT) testing. Rescue analgesia consisted of systemic opioids. Data were analysed using Kruskal-Wallis, Mann-Whitney. Friedman or chi-square tests as appropriate.
Results Intra-operatively, group PRE had lower HR and MAP at several CSEs than groups POST/CON and required less propofol [0 mg kg(-1) (0-0 mg kg(-1))] than group POST/CON [0.3 mg kg(-1) (0-0.6 mg kg(-1))]. Post-operatively, group POST had significantly higher peri-articular MNTs than groups PRE and CON up to 4 hours after recovery. No treatment effect was detected for MPS, lameness scores and rescue analgesic consumption at any time point.
Conclusions and clinical relevance Pre-operative intra-articular bupivacaine provided notable intra-operative analgesia in goats undergoing stifle arthrotomy but did not reduce post-operative pain. Post-operative intra-articular bupivacaine provided a short lasting reduction of peri-articular hyperalgesia without affecting the requirements for systemic analgesia. Multimodal perioperative pain therapy is recommended to provide adequate analgesia for stifle arthrotomy in goats.

• 出版日期2011-7