A controlled randomized clinical trial to assess postoperative analgesia after thiopental-isoflurane anaesthesia or total intravenous anaesthesia with alfaxalone in dogs
A controlled randomized clinical trial to assess postoperative analgesia after thiopental-isoflurane anaesthesia or total intravenous anaesthesia with alfaxalone in dogs
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DOI：
10.1111/jvp.12740
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发表时间：
2019-05-01
影响因子：
1.3
通讯作者：
Tudor, Elizabeth
中科院分区：
文献类型：
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作者：
Bennell, Paula M.;Whittem, Ted;Tudor, Elizabeth
阿法沙酮是一种合成的神经活性类固醇，具有镇静、麻醉和镇痛等作用。阿法沙酮的任何镇痛特性的临床相关性尚未得到证实。本研究是一项前瞻性、设盲、随机、阴性对照临床试验，在65只健康犬中进行卵巢子宫切除术。第1组（TIVA）犬（n = 30）单独静脉注射阿法沙酮诱导并维持麻醉，第2组犬（n = 35）在100%氧气吸入下使用硫喷妥钠，随后使用异氟烷诱导并维持麻醉。卵巢子宫切除术后，使用三个独立的评分系统，复合测量疼痛量表（CMPS），von Frey阈值测试和芬太尼补救镇痛措施，每隔15分钟记录一次疼痛或伤害性感受的定量测量，持续4小时。术后15 - 135 min，第2组（THIO/ISO）犬的平均CMPS评分仍高于第1组（TIVA）犬，但该差异无统计学显著性。两组间需要芬太尼镇痛的犬比例、使用的芬太尼总剂量或首次芬太尼给药的时间无显著差异。发现Von Frey阈值测试不适合于在该实验模型中测量疼痛。当作为全静脉麻醉给药时，阿法沙酮在术后期间不提供镇痛。
Alfaxalone, a synthetic neuroactive steroid, has been attributed with properties including sedation, anaesthesia and analgesia. The clinical relevance of any analgesic properties of alfaxalone has not been demonstrated. This study was a prospective, blinded, randomized, negative control clinical trial in 65 healthy dogs presented for ovariohysterectomy. Anaesthesia was induced and maintained, for Group 1 (TIVA) dogs (n = 30) with intravenous alfaxalone alone and for Group 2 dogs (n = 35) with thiopental followed by isoflurane in 100% oxygen inhalation. After ovariohysterectomy, quantitative measures of pain or nociception were recorded at 15 min intervals for 4 hr using three independent scoring systems, a composite measure pain scale (CMPS), von Frey threshold testing and measures of fentanyl rescue analgesia. The mean CMPS scores of Group 2 (THIO/ISO) dogs remained higher than Group 1 (TIVA) dogs from 15 to 135 min post-surgery but this difference was not statistically significant. There were no significant differences between groups in the proportions of dogs requiring rescue fentanyl analgesia, the total fentanyl dose used or the time to first fentanyl dose. The Von Frey threshold testing was found to be unsuitable for measurement of pain in this experimental model. When administered as total intravenous anaesthesia, alfaxalone did not provide analgesia in the postoperative period.