Effects of epidural morphine and transdermal fentanyl analgesia on physiology and behaviour after abdominal surgery in pigs
Effects of epidural morphine and transdermal fentanyl analgesia on physiology and behaviour after abdominal surgery in pigs
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DOI：
10.1258/002367706775404453
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发表时间：
2006-01-01
影响因子：
2.4
通讯作者：
Jensen-Waern, M
中科院分区：
文献类型：
--
作者：
Malavasi, LM;Nyman, G;Jensen-Waern, M
这项工作的目的是评价阿片类镇痛剂治疗对腹部手术猪的生理和行为影响。10头瑞典长白猪x约克郡猪（20 +/- 4 kg b.w.）被送去做肠插管在术前一天、手术一天和术后两天将猪分为两组。所有猪均用美托咪定、替来他明和唑拉西泮麻醉。一组在术前硬膜外吗啡（0.1 mg/kg）治疗，术后立即在耳后应用芬太尼透皮贴剂（50 μ g/kg/h）。另一组接受硬膜外生理盐水（等体积）和安慰剂贴剂。定期对所有猪称重并进行临床检查，并重复分析血样中皮质醇、β-内啡肽和芬太尼的血清浓度。由对处理不知情的猪专家每天三次评价术前和术后行为，并且还对每只猪进行总共84小时的录像。观察员未观察到行为差异。在术后第一个12小时内，治疗猪的活动与术前记录相比没有差异，而未治疗的猪被发现活动较少。治疗组在麻醉恢复后立即开始对进食感兴趣，而安慰剂组则没有。在术后12-60 h期间，治疗组的活动水平低于术前水平，与安慰剂组相似。在随后的两个术后天，治疗的猪增加了0.5+/-0.2 kg，而未治疗的猪在整个实验中体重减轻。术后即刻皮质醇浓度不同：P组为325+/-120 nmol/L，M组为159+/-49 nmol/L。β-内啡肽浓度在各组之间没有差异。术后24小时测得最高血清芬太尼浓度（0.37+/-0.3 ng/mL）。术前硬膜外吗啡联合术后芬太尼透皮贴剂可使患者更早恢复正常活动水平，术后体重立即增加。
The objective of this work was to evaluate the physiological and behavioural effects of opioid analgesic treatment in pigs subjected to abdominal surgery. Ten Swedish Landrace x Yorkshire pigs (20 +/- 4 kg b.w.) were submitted for intestinal cannulation. The pigs were allocated into two groups during one preoperative, one surgical and two postoperative days. All pigs were anaesthetized with medetomidine, tiletamine and zolazepam. One group was treated with epidural morphine (0.1 mg/kg) preoperatively, and transdermal fentanyl patches (50 mu g/kg/h) were applied behind the ear immediately after surgery. The other group received epidural saline (equivalent volume) and placebo patches. All pigs were regularly weighed and clinically examined and repeated blood samples were analysed for serum concentrations of cortisol, P-endorphin and fentanyl. Pre- and postoperative behaviours were evaluated by a swine specialist blinded to the treatment, three times a day, and were also videotape recorded for a total of 84 h per pig. No differences in behaviour were noted by the observer. During the first postoperative 12 h, treated pigs did not differ in activity compared with preoperative recordings, while untreated pigs were found to be less active. The treated group started to show interest in eating immediately after anaesthesia recovery, whereas the placebo group did not. During the 12-60 h postoperative period, the treated group had lower activity levels compared with the preoperative levels, which were similar to those in the placebo group. Treated pigs gained 0.5+/-0.2 kg during the subsequent two postoperative days, whereas the untreated pigs lost weight throughout the experiment. Cortisol concentration differed immediately after the surgery: Group P had 325+/-120 nmol/L and Group M 159+/-49 nmol/L. beta-endorphin concentration did not differ between groups. The highest serum fentanyl concentration (0.37+/-0.3 ng/mL) was measured 24 h postoperatively. Preoperative epidural morphine in combination with postoperative transdermal fentanyl resulted in earlier return to normal activity levels and an immediate weight gain after surgery.