比較靜脈注射lidocaine與meloxicam及二者合併使用於子宮卵巢摘除手術犬隻的止痛效果

Comparison of analgesic effects between lidocaine infusion, meloxicam, and their combination in dogs undergoing ovariohysterectomy

蔡騰猷(Teng-Yu Tsai)

指導教授 ： 葉力森

國立臺灣大學/獸醫專業學院/獸醫學研究所/碩士(2008年)

https://doi.org/10.6342/NTU.2008.00615

摘要

一、研究目的
本實驗的目的在研究lidocaine定速靜脈注射（constant rate infusion，CRI）、meloxicam與二者合併使用在進行子宮卵巢摘除手術（ovariohysterectomy，OHE）犬隻的止痛效果。

二、研究程序
對象為27隻預計於國立台灣大學生物資源暨農學院附設動物醫院外科進行子宮卵巢摘除手術的健康母犬。所有犬隻於手術前一天便先住進觀察室以減少環境的緊迫，並接受完整的理學檢查和血液學檢查。若犬隻具有潛在的全身性疾病或手術前有使用過任何的止痛藥物，皆不納入研究。

所有犬隻隨機分成三組：lidocaine（L）組，lidocaine以1 mg/kg靜脈注射後，接著以0.025 mg/kg/min的速率持續給予；meloxicam（M）組，0.2 mg/kg meloxicam靜脈注射後，乳酸林格氏液（Lacteated Ringer’s solution）以10 ml/kg/hr的速率給予；lidocaine + meloxicam（L + M）組，靜脈注射0.2 mg/kg meloxicam與1 mg/kg lidocaine後，以0.025 mg/kg/min的速率持續投予lidocaine。所有犬隻皆以propofol進行麻醉誘導，然後以isoflurane維持麻醉深度。

由三位不知動物已接受何種止痛藥物的評估員進行疼痛分數評估，評估的時間點為手術前、拔管的當下（t = 0），以及拔管後的第1、2、4、8、12小時；若動物的疼痛分數總分高於9分以上或單獨的評分項目為3分以上，則會給予挽救性止痛的fentanyl 3 μg/kg靜脈注射，同時此動物之後便不再納入研究資料中。另外，血清中cortisol和血糖濃度量測的進行與疼痛評估的時間點相同。最後全部的資料皆進行統計分析比較，評估三組止痛藥物的效果。

三、結果
本實驗中並無任何的動物需要挽救性的止痛藥物。三組術後的疼痛分數於統計上並無顯著的差異。

四、結論
實驗結果發現lidocaine定速靜脈注射與meloxicam在進行子宮卵巢摘除手術的犬隻具有相似的預防性止痛效果，而且實驗中並無任何動物出現明顯的副作用。

關鍵詞：犬、止痛、lidocaine、meloxicam、子宮卵巢摘除術

關鍵字

犬 ； 止痛 ； lidocaine ； meloxicam ； 子宮卵巢摘除術

並列摘要

Objective
To compare the systemic analgesic effects of intravenous lidocaine, meloxicam, and their combination in dogs undergoing ovariohysterectomy.

Study design Randomized, double blind, controlled clinical trial.

Animals
Twenty-seven dogs aged 16.4 ± 6.9 months and weighing 22.4 ± 17.6 kg.

Methods
Twenty-seven healthy dogs scheduled for ovariohysterectomy were randomly divided into 3 groups (n = 9): Meloxicam (M) group, which was given with 0.2 mg/kg intravenous (IV) meloxicam and consecutively with Lactated Ringer’s infusion at 10 ml/kg/hr; Lidocaine (L) group, which received a bolus of lidocaine (1 mg/kg IV) followed by a lidocaine infusion (0.025 mg/kg/min IV); and Lidocaine + Meloxicam (M + L) group, which was given with a combination of 0.2 mg/kg meloxicam and 1 mg/kg lidocaine intravenously and followed with a lidocaine infusion (0.025 mg/kg/min). Anesthesia was induced with propofol and maintained with isoflurane in oxygen. Serum cortisol and glucose concentrations were measured preoperatively and at 0, 1, 2, 4, 8, 12 hours after extubation (t = 0). Three different pain scores were assessed by three independent observers unaware of analgesic protocols used at t 0, 1, 2, 4, 8, and 12. Any dog with a total subjective pain score exceeding 9 (with the maximum possible of 24) or any sub-score above 3 in any one category received rescue analgesic (fentanyl 3 μg/kg IV) and was excluded from further data analysis.

Results
There was no significant differences in subjective pain scores, serum cortisol, and glucose concentrations within the three groups. No dogs received rescue analgesics in the study. Neither meloxicam, liodcaine infusion, nor of their combination caused any observable side effect.

Conclusion and clinical relevance
This study suggests that the intravenous lidocaine and meloxicam provide similar analgesic effect in healthy dogs undergoing ovariohysterectomy. No significant additive or synergic analgesic effect was observed in combination of the agents.

Keywords
dog, analgesia, lidocaine, meloxicam, ovariohysterectomy.

並列關鍵字

dog ； analgesia ； lidocaine ； meloxicam ； ovariohysterectomy

參考文獻

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