Epidural analgesia and anesthesia.

This review describes the beneficial effects of the use of epidural drugs for pre-emptive analgesia, intraoperative analgesia with an inhalant-sparing effect, and prolonged postoperative analgesia. Epidural morphine oxymorphone, or hydromorphone is recommended for use in small animals in combination with a local anesthetic of appropriate duration for procedures involving the hind end, although epidural morphine or hydromorphone may be more appropriate for procedures on the thorax and forelimbs. Side effects are few and can usually be easily managed, with the benefits outweighing any detrimental effects that might occur.     

右美托咪啶—兽医镇静剂中的新秀

美托咪啶,化学名为α-4-[1-(2,3-二甲基苯基)乙基-1H-咪唑],具有左旋和右旋两种立体异构体,是一种高效且高度特异的α2-肾上腺受体激动剂,临床上具有非常好的镇静和止痛效果.它在34个国家被注册使用并在欧洲和北美被广泛使用[1].但其左旋体基本不具备活性,因此应用右旋体就成了其发展的必然趋势.1999年美国FDA批准右美托咪啶(结构见图1),其独特的作用使其能在围术期发挥良好的镇静止痛作用[2],目前已广泛的应用于ICU.α2-激动剂作为兽用麻醉药已有较长的时间,但美托咪啶在1996年才用于犬猫的镇静和止痛.近来更强效的右美托咪啶实施完全麻醉的可能性越来越明显[2],但其在国内临床应用刚刚开始.为让更多人熟悉该药物,本文拟就其作用机制,镇静,止痛,心血管,呼吸系统等几个临床主要关注的方面综述如下.     

Propofol: application in veterinary sedation and anesthesia

Propofol can be used for sedation, induction of anesthesia, and maintenance of anesthesia in small animal patients. In all these situations recovery from its effects is typically rapid and smooth. The drug should be administered slowly, intravenously, to minimize the negative cardiac and respiratory effects seen after rapid bolus administration. The currently available formulations do not contain preservatives, and sterile technique should be strictly followed during its use. Propofol can be used for induction of anesthesia in patients with preexisting disease with minimal delays in recovery. It does not cause excitement at low doses so is also useful for sedation of patients undergoing nonpainful procedures such as radiological examination. This review focuses on the diverse clinical applications for propofol in a small animal practice including indications, recommendations, and contraindications as well as a discussion of the controversies that surround its use.     

Epidural anesthesia and analgesia in horses.

Intercoccygeal, or caudal, epidural injection of local anesthetics is a convenient method of producing analgesia and local anesthesia of the tail and perineal structures in conscious standing horses. This technique has been further developed to provide long duration analgesia and anesthesia by placement of catheters into the epidural space of horses. More recently, opioid, alpha-2 adrenergic agonists, ketamine and other analgesic agents have been administered by caudal epidural injection, providing pain relief in both conscious, standing and anesthetized, recumbent horses. This chapter describes the development of different anesthetic and analgesic epidural techniques in horses, methods for epidural injection and catheterization, and reviews the current literature related to epidural analgesia and pain control in horses.