乳房切除術を受けたヤギにおけるくも膜下ケタミン-リドカイン投与の臨床効果と鎮痛効果の評価

Evaluation of the clinical and analgesic effects of subarachnoid ketamine-lidocaine administration in goats undergoing mastectomy.

• Mousa Daradka
• Zuhair Bani Ismail

抄録

慢性乳房炎に罹患した20頭の成雌ヤギを、ケタミンとリドカインの組み合わせを用いたくも膜下局所鎮痛下で乳房切除術または半乳房切除術を受けさせた。ケタミン（1.5 mg/kg）と塩酸リドカイン（1.25 mg/kg）を腰椎椎間腔に髄腔内投与した。その後、ヤギに動揺、落ち着きのなさ、後肢麻痺、痙攣などの全身症状や神経毒性のある症状を120分間の観察期間で観察させた。さらに、尾腹部の鎮痛と全身性鎮静の徴候を0-3の尺度でスコア化した。心拍数、呼吸数、直腸温も投与前（ベースライン値）と投与後5、15、30、60、90、120分後に記録した。乳房および尾腹部に対する鎮痛効果を十分に確認した上で、乳房切除術または血乳房切除術の手術を実施した。手術鎮痛の発現時間（スコア3）は15分で達成され、60分間持続した。最大鎮静スコアは15分に記録され、60分間持続し、その後減少し、最も低い鎮静スコアは120分に記録された。5-90分の間のある時点で心拍数の有意な(0.05)上昇があったが、呼吸数と直腸温はベースライン値から有意な変化はなかった。術後、動物は痛みや不快感の兆候を示さなかった。手術したヤギの追跡調査では、すべての傷が完全に治癒しており、重大な合併症は認められなかった。ヤギでは、ケタミンとリドカインの併用投与により、乳房切除術または血乳房切除術を行うのに十分な尾腹部および乳房部の安全かつ効果的な鎮痛効果が得られた。

Twenty adult female goats affected with chronic mastitis were subjected to mastectomy or hemimastectomy under subarachnoid regional analgesia using a ketamine-lidocaine combination. Ketamine at 1.5 mg/kg and lidocaine hydrochloride at 1.25 mg/kg were administered intrathecally at the lumbosacral intervertebral space. Goats were then subjected to a 120-minute observation period for systemic or neurotoxic symptoms such as agitation, restlessness, hind limb paralysis, or seizures. In addition, analgesia of the caudal abdominal region and signs of systemic sedation were scored on a scale of 0-3. Heart rate, respiratory rate, and rectal temperature were also recorded prior to (baseline values) and at 5, 15, 30, 60, 90, and 120 minutes after administration. Mastectomy or hemimastectomy operation was carried out after full assurance of the analgesic effect on the udder and caudal abdominal region. Time of onset of surgical analgesia (score 3) was achieved at 15 minutes and lasted for 60 minutes. Maximal sedation score was recorded at 15 minutes and lasted for 60 minutes, then decreased thereafter, with the lowest sedation score recorded at 120 minutes. There was a significant (0.05) rise in heart rate at some point between 5-90 minutes, while the respiratory rate and rectal temperature did not change significantly from baseline values. Postoperatively, animals did not show any signs of pain or discomfort. Follow-up on the operated goats showed that all wounds were fully healed without any significant complications. In goats, intrathecal administration of ketamine-lidocaine combination resulted in a safe and effective analgesia of the caudal abdominal and udder region sufficient to perform mastectomy or hemimastectomy.

© 2014 Daradka and Ismail.