Topikal administrering av lidokain över mesovarium vid ovariehysterektomi på katt
Feline ovariohysterectomy (OHE) is a common surgical procedure in veterinary medicine. This procedure is assumed to cause moderate pain. In addition to general anesthesia there are available techniques for nerve block with local anesthesia, yet these techniques are underutilized and the effects of a...
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| Formato: | H3 |
| Lenguaje: | sueco Inglés |
| Publicado: |
SLU/Dept. of Clinical Sciences (until 231231)
2018
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| Materias: |
| _version_ | 1855572255084380160 |
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| author | Jonsson, Caroline |
| author_browse | Jonsson, Caroline |
| author_facet | Jonsson, Caroline |
| author_sort | Jonsson, Caroline |
| collection | Epsilon Archive for Student Projects |
| description | Feline ovariohysterectomy (OHE) is a common surgical procedure in veterinary medicine. This procedure is assumed to cause moderate pain. In addition to general anesthesia there are available techniques for nerve block with local anesthesia, yet these techniques are underutilized and the effects of administering local anesthesia during OHE are not well-studied in cats. The objective of this study was to assess the intraoperative and postoperative analgetic effect of lidocaine administrated topically on the ovarian pedicles in cats undergoing OHE during dissociative anesthesia.
This prospective, randomized and blinded study included 25 female cats. Body weight was 3.1 ± 0.8 kg (mean ± SD) and age was 28 ± 27 months. Cats were pre-medicated with medetomidine and methadone, and were also given meloxicam preoperatively. All cats received lidocaine 1 mg/kg as a subcutaneous injection at the incision site. Ketamine 5 mg/kg was injected intramuscular for induction of anesthesia. Cats were randomly assigned to one of two groups; 12 cats received lidocaine 1 mg/kg as topical application on the ovarian pedicles (group L) and 13 cats received an equal volume of sodium chloride at the same sites (group NaCl). In case of increased muscle tone or sudden movement during surgery, cats were given additional ketamine ± medetomidine ± propofol. At end of surgery cats were given atipamezole.
Following parameters were measured continuously every second minute during anesthesia: systolic blood pressure, diastolic blood pressure and heart rate. Mean values for those parameters were then compared between the two groups at seven different times: T1 = after ketamine induction; T2 = start of surgery; T3 = administration of local anesthesia; T4 = ligation and extirpation of the first ovary; T5 = ligation and extirpation of the second ovary; T6 = cervix; T7 = suturation of linea alba.
Postoperative pain was assessed according to two feline-specific, validated and multidimensional pain scales: UNESP-Botucatu Multidimensional Composite Pain Scale and Glasgow Composite Measure Pain Scale - Feline. Assessments were made at times H0 = preoperatively; H1 = one hour after atipamezole was given; H2 = two hours after atipamezole was given; H3 = three hours after atipamezole was given.
The results showed no significant difference between groups concerning systolic blood pressure, diastolic blood pressure or heart rate at any of the times measured. In group (L) systolic blood pressure was significantly higher at the time T4 compared to T2, T3 and T7. In group (NaCl) systolic blood pressure was significantly higher at the time T5 compared to T1, T2, T3 and T7 as also diastolic blood pressure was significantly higher at T5 compared to T1, T2 and T7. Significant difference in heart rate could neither be seen between the two groups, nor within one of the groups at any of the times measured. Three cats in the lidocaine group and eight cats in the placebo group needed supplementary general anesthesia within 45 minutes from ketamine induction. Local anesthesia on the ovarian pedicles was not shown to imply lower pain scores in the postoperative pain assessment in this study. |
| format | H3 |
| id | RepoSLU13502 |
| institution | Swedish University of Agricultural Sciences |
| language | swe Inglés |
| publishDate | 2018 |
| publishDateSort | 2018 |
| publisher | SLU/Dept. of Clinical Sciences (until 231231) |
| publisherStr | SLU/Dept. of Clinical Sciences (until 231231) |
| record_format | eprints |
| spelling | RepoSLU135022019-02-25T13:51:09Z Topikal administrering av lidokain över mesovarium vid ovariehysterektomi på katt Topical administration of lidocaine on mesovarium during ovariohysterectomy in cats Jonsson, Caroline Ovariehysterektomi OHE Katt Lidokain Tropikal Lokalbedövning Mesovarium Feline ovariohysterectomy (OHE) is a common surgical procedure in veterinary medicine. This procedure is assumed to cause moderate pain. In addition to general anesthesia there are available techniques for nerve block with local anesthesia, yet these techniques are underutilized and the effects of administering local anesthesia during OHE are not well-studied in cats. The objective of this study was to assess the intraoperative and postoperative analgetic effect of lidocaine administrated topically on the ovarian pedicles in cats undergoing OHE during dissociative anesthesia. This prospective, randomized and blinded study included 25 female cats. Body weight was 3.1 ± 0.8 kg (mean ± SD) and age was 28 ± 27 months. Cats were pre-medicated with medetomidine and methadone, and were also given meloxicam preoperatively. All cats received lidocaine 1 mg/kg as a subcutaneous injection at the incision site. Ketamine 5 mg/kg was injected intramuscular for induction of anesthesia. Cats were randomly assigned to one of two groups; 12 cats received lidocaine 1 mg/kg as topical application on the ovarian pedicles (group L) and 13 cats received an equal volume of sodium chloride at the same sites (group NaCl). In case of increased muscle tone or sudden movement during surgery, cats were given additional ketamine ± medetomidine ± propofol. At end of surgery cats were given atipamezole. Following parameters were measured continuously every second minute during anesthesia: systolic blood pressure, diastolic blood pressure and heart rate. Mean values for those parameters were then compared between the two groups at seven different times: T1 = after ketamine induction; T2 = start of surgery; T3 = administration of local anesthesia; T4 = ligation and extirpation of the first ovary; T5 = ligation and extirpation of the second ovary; T6 = cervix; T7 = suturation of linea alba. Postoperative pain was assessed according to two feline-specific, validated and multidimensional pain scales: UNESP-Botucatu Multidimensional Composite Pain Scale and Glasgow Composite Measure Pain Scale - Feline. Assessments were made at times H0 = preoperatively; H1 = one hour after atipamezole was given; H2 = two hours after atipamezole was given; H3 = three hours after atipamezole was given. The results showed no significant difference between groups concerning systolic blood pressure, diastolic blood pressure or heart rate at any of the times measured. In group (L) systolic blood pressure was significantly higher at the time T4 compared to T2, T3 and T7. In group (NaCl) systolic blood pressure was significantly higher at the time T5 compared to T1, T2, T3 and T7 as also diastolic blood pressure was significantly higher at T5 compared to T1, T2 and T7. Significant difference in heart rate could neither be seen between the two groups, nor within one of the groups at any of the times measured. Three cats in the lidocaine group and eight cats in the placebo group needed supplementary general anesthesia within 45 minutes from ketamine induction. Local anesthesia on the ovarian pedicles was not shown to imply lower pain scores in the postoperative pain assessment in this study. Ovariehysterektomi (OHE) på katt är ett vanligt kirurgiskt ingrepp inom veterinärmedicin. Ingreppet bedöms orsaka måttlig smärta. Utöver generell anestesi finns vedertagna tekniker för nervblockad med lokalanestesi, men dessa tekniker är underutnyttjade och effekterna av att tillföra lokalanestesi under OHE är inte välstuderade på katt. Syftet med den här studien var att bedöma den intraoperativa och postoperativa analgetiska effekten av att administrera lidokain topikalt över mesovarierna på honkatter som genomgår OHE under dissociativ anestesi. I denna prospektiva, randomiserade och blindade studie ingick totalt 25 honkatter. Kroppsvikt var 3,1 ± 0,8 kg (medelvikt ± SD) och ålder var 28 ± 27 månader. Katterna premedicinerades med medetomidin och metadon samt fick meloxicam preoperativt. Samtliga katter gavs lidokain 1 mg/kg som subkutan injektion i incisionslinjen. Narkosen inducerades med ketamin 5 mg/kg intramuskulärt. Katterna lottades slumpmässigt att ingå i en av två gruppen; 12 katter fick lidokain 1 mg/kg som topikal administrering över mesovarierna (grupp L) och 13 katter fick motsvarande mängd natriumklorid över samma områden (grupp NaCl). Vid förhöjd muskeltonus eller plötslig rörelse under narkosen administrerades ytterligare generell anestesi med ketamin ± medetomidin ± propofol. Vid uppvakning gavs atipamezol. Följande parametrar lästes av kontinuerligt varannan minut under narkostiden: systoliskt blodtryck, diastoliskt blodtryck och hjärtfrekvens. Medelvärden för dessa parametrar jämfördes sedan mellan de två grupperna vid sju olika tidpunkter: T1 = efter narkosinduktion; T2 = operationsstart; T3 = administrering av lokalbedövning; T4 = ligering och exstirpering av första ovariet; T5 = ligering och exstirpering av andra ovariet; T6 = cervix; T7 = suturering av linje alba. Postoperativ smärta bedömdes efter två validerade och multidimensionella smärtskalor specifikt framtagna för katt: UNESP-Botucatu Multidimensional Composite Pain Scale och Glasgow Composite Measure Pain Scale - Feline. Bedömningarna gjordes vid tidpunkterna H0 = preoperativt; H1 = en timme efter atipamezolgiva; H2 = två timmar efter atipamezolgiva; H3 = tre timmar efter atipamezolgiva. Resultatet visade inga signifikanta skillnader i systoliskt blodtryck, diastoliskt blodtryck eller hjärtfrekvens mellan grupperna vid någon av tidpunkterna. Inom grupp (L) sågs ett signifikant högre systoliskt blodtryck vid tidpunkten T4 jämfört med tidpunkterna T2, T3 och T7. Inom grupp (NaCl) sågs ett signifikant högre systoliskt blodtryck vid tidpunkten T5 jämfört med tidpunkterna T1, T2, T3 och T7 och därtill ett signifikant högre diastoliskt blodtryck vid tidpunkten T5 jämfört med tidpunkterna T1, T2 och T7. Ingen signifikant skillnad sågs i hjärtfrekvens varken mellan grupperna eller inom grupperna under någon av tidpunkterna. Tre katter i lidokaingruppen och åtta katter i placebogruppen behövde ytterligare generell anestesi inom 45 minuter efter ketamininduktion. Lokalbedövning av mesovarium sågs ej medföra lägre smärtpoäng vid postoperativ smärtbedömning i denna studie. SLU/Dept. of Clinical Sciences (until 231231) 2018 H3 swe eng https://stud.epsilon.slu.se/13502/ |
| spellingShingle | Ovariehysterektomi OHE Katt Lidokain Tropikal Lokalbedövning Mesovarium Jonsson, Caroline Topikal administrering av lidokain över mesovarium vid ovariehysterektomi på katt |
| title | Topikal administrering av lidokain över mesovarium vid ovariehysterektomi på katt |
| title_full | Topikal administrering av lidokain över mesovarium vid ovariehysterektomi på katt |
| title_fullStr | Topikal administrering av lidokain över mesovarium vid ovariehysterektomi på katt |
| title_full_unstemmed | Topikal administrering av lidokain över mesovarium vid ovariehysterektomi på katt |
| title_short | Topikal administrering av lidokain över mesovarium vid ovariehysterektomi på katt |
| title_sort | topikal administrering av lidokain över mesovarium vid ovariehysterektomi på katt |
| topic | Ovariehysterektomi OHE Katt Lidokain Tropikal Lokalbedövning Mesovarium |