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Fuertes-Recuero M, de Segura IAG, López AS, Suárez-Redondo M, Arrabé SC, Hidalgo SP, Fontanillas-Pérez JC, Ortiz-Diez G. Postoperative pain in dogs undergoing either laparoscopic or open ovariectomy. Vet J 2024; 306:106156. [PMID: 38834104 DOI: 10.1016/j.tvjl.2024.106156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 05/13/2024] [Accepted: 05/31/2024] [Indexed: 06/06/2024]
Abstract
A prospective, quasi-experimental, clinical trial was performed to assess acute postoperative pain in healthy female dogs following elective ovariectomy by either laparoscopy (n=13) or laparotomy (n=14). Pain was assessed by both a veterinarian at the hospital, and by the owner once the patient was discharged. The Spanish version of the short form of the Glasgow Composite Measuring Pain Scale (CMPS-SF) was used. Pain scores were assessed by the veterinarian preoperatively and at 1, 2, 4, and 6 h after extubation, whilst owner-assessed scores were performed preoperatively and at postoperative days 0, 1, 2, 3, 5 and 7. Data were compared with Mann-Whitney-U test. Veterinarian-assessed CMPS-SF scores were different between both groups at all postoperative times but not at baseline, being below 6/24 in all dogs in the laparoscopy group, but equal to or greater than 6/24 in the laparotomy group at 1 h (n=12), and 4 h (n=4) (P<0.001 and P=0.029, respectively). There were also differences in pain scores between both groups at 2 h (P=0.012) and 6 h (P=0.007), being below 6/24 in all of them. However, there were no differences in owner assessments between groups. In conclusion, ovariectomy performed by laparoscopy induced lower pain scores that were below the pain threshold set by the CMPS-SF during the first 6 h postoperatively. After discharge, and up to one week later, ongoing owner-assessed scores suggest no pain was induced with neither of the techniques. Owners were proactive allowing real-time pain assessment to be reported. The development and validation of instruments for acute pain assessment by owners is warranted, as these tools are currently lacking.
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Affiliation(s)
- M Fuertes-Recuero
- Department of Physiology, College of Veterinary Medicine, Complutense University of Madrid, Avda. Puerta de Hierro s/n, Madrid 28040, Spain; Complutense Veterinary Teaching Hospital, Complutense University of Madrid, Avda. Puerta de Hierro s/n, Madrid 28040, Spain.
| | - I A Gómez de Segura
- Complutense Veterinary Teaching Hospital, Complutense University of Madrid, Avda. Puerta de Hierro s/n, Madrid 28040, Spain; Department of Animal Medicine and Surgery, College of Veterinary Medicine, Complutense University of Madrid, Avda. Puerta de Hierro s/n, Madrid 28040, Spain
| | - A Sánchez López
- Puchol Veterinary Hospital, C/Sauceda 8, Madrid 28050, Spain
| | - M Suárez-Redondo
- Complutense Veterinary Teaching Hospital, Complutense University of Madrid, Avda. Puerta de Hierro s/n, Madrid 28040, Spain
| | - S Canfrán Arrabé
- Complutense Veterinary Teaching Hospital, Complutense University of Madrid, Avda. Puerta de Hierro s/n, Madrid 28040, Spain; Department of Animal Medicine and Surgery, College of Veterinary Medicine, Complutense University of Madrid, Avda. Puerta de Hierro s/n, Madrid 28040, Spain
| | - S Penelo Hidalgo
- Complutense Veterinary Teaching Hospital, Complutense University of Madrid, Avda. Puerta de Hierro s/n, Madrid 28040, Spain
| | - J C Fontanillas-Pérez
- Department of Physiology, College of Veterinary Medicine, Complutense University of Madrid, Avda. Puerta de Hierro s/n, Madrid 28040, Spain
| | - G Ortiz-Diez
- Complutense Veterinary Teaching Hospital, Complutense University of Madrid, Avda. Puerta de Hierro s/n, Madrid 28040, Spain; Department of Animal Medicine and Surgery, College of Veterinary Medicine, Complutense University of Madrid, Avda. Puerta de Hierro s/n, Madrid 28040, Spain
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Costa GL, Spadola F, Di Pietro S, Nava V, Licata P, Giudice E, Leonardi F, Bruno F, Messina L, Macrì F, Macrì D, Ferrantelli V, Tabbì M, Interlandi C. Tramadol vs. Lidocaine Administered Intraperitoneally and in Incisional Lines for the Intraoperative and Postoperative Pain Management of Romifidine-Telazol-Anesthetized Swine Undergoing Umbilical Hernia Repair. Animals (Basel) 2023; 13:2905. [PMID: 37760305 PMCID: PMC10525986 DOI: 10.3390/ani13182905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
The aim of the study was to compare the analgesic efficacy of tramadol and lidocaine for local anesthesia during umbilical hernia repair in swine. The study was performed on 66 large white crossbred swine. The swine received a mixture of tiletamine/zolazepam at 5 mg/kg and romifidine at 80 µg/kg, administered intramuscularly. Then, they were divided into three groups (n = 22) that received different treatments with lidocaine at 4 mg/kg and tramadol at 4 mg/kg. The LL group received lidocaine both by infiltration of the surgical planes and intraperitoneally. The LT group received lidocaine by infiltration of the surgical planes and tramadol intraperitoneally. The TT group received tramadol both by infiltration of the surgical planes and intraperitoneally. In all groups, the infiltration of the surgical planes into the umbilical region involved both the skin and muscle planes. Heart rate, noninvasive arterial blood pressure, and respiratory frequency were recorded during surgery. The response to the surgical stimulus was evaluated using a cumulative pain scale (the cut-off point for rescue analgesia was set to 10). Postoperative pain was assessed using the UNESP-Botucatu pig composite acute pain scale (the cut-off point was set to 4). The trend of physiological variables was adequate for patients under anesthesia. No subject required intraoperative and postoperative rescue analgesia. Tramadol could therefore be used for pain management in livestock.
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Affiliation(s)
- Giovanna Lucrezia Costa
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Filippo Spadola
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Simona Di Pietro
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Vincenzo Nava
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Patrizia Licata
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Elisabetta Giudice
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Fabio Leonardi
- Department of Veterinary Science, University of Parma, Via del Taglio 10, 43126 Parma, Italy;
| | - Fabio Bruno
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Laura Messina
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Francesco Macrì
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Daniele Macrì
- Zooprophylactic Institute, Via Gino Marinuzzi 4, 90100 Palermo, Italy; (D.M.); (V.F.)
| | - Vincenzo Ferrantelli
- Zooprophylactic Institute, Via Gino Marinuzzi 4, 90100 Palermo, Italy; (D.M.); (V.F.)
| | - Marco Tabbì
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
| | - Claudia Interlandi
- Department of Veterinary Sciences, University of Messina, Via Palatucci Annunziata, 98168 Messina, Italy; (F.S.); (S.D.P.); (V.N.); (P.L.); (E.G.); (F.B.); (L.M.); (F.M.); (M.T.); (C.I.)
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Henze IS, Navarro Altuna V, Steiger JI, Torgerson PR, Kutter APN. Evaluation of the Analgesic Efficacy of Undiluted Intraperitoneal and Incisional Ropivacaine for Postoperative Analgesia in Dogs after Major Abdominal Surgery. Animals (Basel) 2023; 13:ani13091489. [PMID: 37174527 PMCID: PMC10177421 DOI: 10.3390/ani13091489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Recommendations for intraperitoneal (IP) and incisional (INC) administration of local anaesthetics after visceral surgery exist, but evidence is scarce. This prospective, randomized, blinded, controlled, clinical trial compared postoperative pain in dogs undergoing major abdominal surgery. Sixteen client-owned dogs were anaesthetized with a standardized balanced protocol including opioids and received either 2 mg/kg ropivacaine IP (0.27 mL/kg) and a 1 mg/kg INC splash (0.13 mL/kg) or equal volumes of saline. Influence of the treatment on heart rate (HR) and postoperative pain was assessed using the Short Form of the Glasgow Composite Pain Scale (GCPS-SF), a dynamic interactive visual analogue scale (DIVAS) and mechanical nociceptive threshold testing (MNT). Data was tested with mixed ordinal regression and log linear mixed models for 0.5, 1, 2, 3, 4, 6, 8, 10 and 12 h after extubation. Rescue analgesia was given to 3/8 dogs after ropivacaine and 0/8 dogs after saline. GCPS-SF and MNT were not different between groups. DIVAS was slightly higher after ropivacaine (odds increased by 5.44 (confidence interval (CI) 1.17-9.96, p = 0.012)), and HR after ropivacaine was 0.76 * that after saline (CI 0.61-0.96, p = 0.02) with no effect of time (p = 0.1). Undiluted ropivacaine IP and INC was not beneficial for postoperative analgesia.
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Affiliation(s)
- Inken S Henze
- Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Victoria Navarro Altuna
- Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Joëlle I Steiger
- Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Paul R Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Annette P N Kutter
- Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
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Brioschi FA, Ravasio G, Ferrari F, Amari M, Di Cesare F, Valentini Visentin M, Rabbogliatti V. Comparison of intraperitoneal and incisional lidocaine or ropivacaine irrigation for postoperative analgesia in dogs undergoing major abdominal surgeries. PLoS One 2023; 18:e0284379. [PMID: 37053210 PMCID: PMC10101502 DOI: 10.1371/journal.pone.0284379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/29/2023] [Indexed: 04/14/2023] Open
Abstract
This study compared the postoperative analgesic efficacy of intraperitoneal and incisional lidocaine versus ropivacaine in dogs undergoing major abdominal surgeries. Dogs randomly received intraperitoneal lidocaine irrigation (4 mg kg-1, diluted to 5 ml kg-1, L group), ropivacaine (4 mg kg-1, diluted to 5 ml kg-1, R group) or 0.9% saline (5 ml kg-1, C group). Prior to skin closure, dogs received incisional lidocaine 2 mg kg-1 (group L), incisional ropivacaine 2 mg kg-1 (group R) or incisional saline 0.2 ml kg-1 (group C). Pain was assessed at different time points up to 24 hours after extubation, using the Short Form-Glasgow Composite Measure Pain Scale and VAS Scale. In group C, postoperative pain scores were significantly higher than in groups L and R from T0.5 to T6 (p < 0.05). In R group, postoperative pain scores were significantly lower than in groups L and C from T12 to T24 (p < 0.05). Rescue analgesia was administered to 5/11 dogs in L group, 1/10 dogs in R group and 8/10 dogs in C group. Groups L and R experienced a significantly lower postoperative pain during the first 6 hours after extubation, compared with group C. Ropivacaine provided lower postoperative pain scores than lidocaine and saline up to 24 hours after extubation. According to the obtained results, ropivacaine seemed to provide better and longer lasting postoperative analgesia compared with lidocaine. Therefore, intraperitoneal and incisional administration of ropivacaine in dogs undergoing major abdominal surgeries is recommended.
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Affiliation(s)
| | - Giuliano Ravasio
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Francesco Ferrari
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Martina Amari
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Federica Di Cesare
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | | | - Vanessa Rabbogliatti
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
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5
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Evaluation of the Two-Point Ultrasound-Guided Transversus Abdominis Plane Block for Laparoscopic Canine Ovariectomy. Animals (Basel) 2022; 12:ani12243556. [PMID: 36552477 PMCID: PMC9774418 DOI: 10.3390/ani12243556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
The transversus abdominis plane (TAP) block causes desensitization of the abdominal wall and peritoneum. Of all the approaches proposed to perform it, the two-injection-point TAP showed the best results in terms of the area reached by the anesthetic solution. However, to date, no clinical data exist. The aim of this study was to evaluate the intra- and postoperative analgesic efficacy of a two-injection-point TAP block in dogs undergoing laparoscopic ovariectomy. A total of 26 animals were assigned to receive general inhalation anesthesia (control group), and 26 dogs were assigned to general inhalation anesthesia combined with TAP block (TAP group). The ultrasound-guided TAP block was carried out with a subcostal and cranial-to-ilium injection per hemiabdomen. The end-tidal concentration of isoflurane (EtISO) was recorded at different moments during the surgery. Postoperative pain was assessed at different time points during the first 24 h after surgery. The control group required significantly higher EtISO concentration during the ovarian resection and showed higher postoperative pain scores than the TAP group. Fewer dogs in the TAP group required intra- or postoperative rescue analgesia. TAP block can be implemented to improve postoperative pain management after laparoscopy, reducing the dosage of the systemic drugs used and, hence, their possible side effects.
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Cicirelli V, Matteo B, Di Bella C, Lacalandra GM, Aiudi G. The ultrasound-guided funicular block in cats undergoing orchiectomy: ropivacaine injection into the spermatic cord to improve intra and postoperative analgesia. BMC Vet Res 2022; 18:169. [PMID: 35538544 PMCID: PMC9088067 DOI: 10.1186/s12917-022-03279-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The orchiectomy in cats is a common surgical procedure with medium level of pain and for this reason requires intra and postoperative analgesia management. The aim of this study was to compare intra and postoperative pain in two groups of cats undergoing orchiectomy. Sixty healthy cats were randomly assigned in two groups (n = 30) to receive pre surgery ropivacaine hydrochloride (0.2 mL/kg at 0.5%) (R Group) or NaCl 0.9% (C group) into the spermatic cord. The intraoperative evaluation was carried out using the cardiorespiratory stability parameters and eventually administration of rescue analgesia. A rescue analgesia (fentanyl 2 µg/kg) was administered during orchiectomy in case of considerable increase of blood pressure, heart rate or respiratory rate. The postoperative evaluation was been done using scores following a UNESP-Botucatu multimodal scale for 6 h post-surgery. RESULTS As result, cats in R group responded better to surgical procedure, maintaining lower postoperative pain scores than C group. CONCLUSIONS The ultrasound-guided funicular block used in this study, as already demonstrated in dogs, is a good method to protect the cats from surgical pain and ensure a good level of surgical analgesia.
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Affiliation(s)
- Vincenzo Cicirelli
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy.
| | - Burgio Matteo
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Caterina Di Bella
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | | | - Giulio Aiudi
- Department of Veterinary Medicine, University of Bari "Aldo Moro", Bari, Italy
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Rubio M, Satué K, Carrillo JM, Hernández Guerra Á, Cuervo B, Chicharro D, Damiá E, Del Romero A, Sopena J. Changes in Hematological and Biochemical Profiles in Ovariohysterectomized Bitches Using an Alfaxalone–Midazolam–Morphine–Sevoflurane Protocol. Animals (Basel) 2022; 12:ani12070914. [PMID: 35405902 PMCID: PMC8997066 DOI: 10.3390/ani12070914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/25/2022] [Accepted: 03/31/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Laboratory tests are an integral part of the overall diagnostic procedures for both physiological and pathological conditions. Ovariohysterectomy (OHE) in bitches is an invasive procedure, producing moderate to severe pain. The response to surgical stress is characterized by a series of neuroendocrine and metabolic changes that can be represented on hematological and biochemical profiles. The objective of this study was to evaluate the physiological response to surgical stress, predict the presence of possible post-surgical complications, and where appropriate, establish the appropriate treatment based on the hematochemical changes during and after OHE in healthy bitches. OHE in this study induced transient changes in certain hematological and biochemical parameters. Knowledge of the hematochemical changes in response to stress and trauma induced by OHE in healthy dogs would allow to predict possible post-surgical complications. Abstract The aim of this study was to monitor hematochemical changes during and after OHE in bitches. Twenty-four females were anesthetized with alfaxalone, midazolam, morphine and sevoflurane. Blood samples were taken before anesthesia (T0), at 30 (T1), and 60 min (T2), at 3 (T3), 6 (T4), 12 (T5), and 24 h (T6), and at 3 (T7) and 7 days (T8) from the start of surgery. Red blood cells (RBC) and packed cell volume (PCV) decreased significantly from T1 to T5 and hemoglobin (HB) concentration from T4 to T6. Both the white blood cell (WBC) and neutrophil (NFS) count increased significantly from T3 to T6, monocyte (MON) from T2 to T5, and eosinophil (EOS) at T5. Platelet (PLT) and plateletcrit (PCT) significantly decreased at T5 and increased from T6 to T8; platelet distribution width (PDW) increased significantly from T3 to T6. Creatine kinase (CK) activity increased significantly from T5 to T7. Glucose (GLU) concentrations increased significantly at T2 and P from T2 to T3. TG levels decreased from T2 to T4 and blood urea nitrogen (BUN) levels from T1 to T7, subsequently increasing until T8. Changes possibly resulting from stress and surgical trauma, as well as hemodilution and splenic storage, are due to anesthesia and surgery. In healthy bitches, these changes tend to gradually stabilize after the ending of OHE. A post-operative follow-up is essential to detect possible post-operative complications.
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Gruen ME, Lascelles BDX, Colleran E, Gottlieb A, Johnson J, Lotsikas P, Marcellin-Little D, Wright B. 2022 AAHA Pain Management Guidelines for Dogs and Cats. J Am Anim Hosp Assoc 2022; 58:55-76. [PMID: 35195712 DOI: 10.5326/jaaha-ms-7292] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
These updated guidelines present a practical and logical approach to the assessment and management of acute and chronic pain in canine and feline patients. Recognizing pain is fundamental to successful treatment, and diagnostic guides and algorithms are included for assessment of both acute and chronic pain. Particularly for chronic pain, capturing owner evaluation is important, and pain-assessment instruments for pet owners are described. Expert consensus emphasizes proactive, preemptive pain management rather than a reactive, "damage control" approach. The guidelines discuss treatment options centered on preemptive, multimodal analgesic therapies. There is an extensive variety of pharmacologic and nonpharmacologic therapeutic options for the management of acute and chronic pain in cats and dogs. The guidelines include a tiered decision tree that prioritizes the use of the most efficacious therapeutic modalities for the treatment of acute and chronic pain.
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Affiliation(s)
- Margaret E Gruen
- North Carolina State University, Department of Clinical Sciences (M.E.G.)
| | - B Duncan X Lascelles
- North Carolina State University, Translational Research in Pain, Department of Clinical Sciences (B.D.X.L.)
| | | | | | | | | | - Denis Marcellin-Little
- University of California, Davis, Department of Surgical and Radiological Sciences (D.M-L.)
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Rezaeipour A, Naddaf H, Jalali SM, Sabiza S. Evaluation of intraperitoneal administration of morphine on post-operative pain management after ovariohysterectomy in dogs. Vet Med Sci 2021; 8:150-156. [PMID: 34821072 PMCID: PMC8788973 DOI: 10.1002/vms3.668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The present prospective randomized experimental study was designed to assess pain control with intraperitoneal morphine following ovariohysterectomy in dogs. A group of 12 mixed breed female dogs, aged 1-2 years, weighing 19.95 ± 0.95 kg were included. Forty minutes after sedation with 0.05 mg/kg intramuscular acepromazine 1%, anaesthesia was induced with propofol (4 mg/kg). The dogs were connected to the inhalation anaesthesia circuit using isoflurane. Ovariohysterectomy was performed, and before the closure of linea alba, the animals received intraperitoneal morphine (0.5 mg/kg) (in group M) and saline (0.2 ml/kg) (in group S). No significant difference was detected in total protein and glucose levels between the groups, while the cortisol level in group M was significantly lower than group S 1, 3 and 6 h after surgery. Furthermore, the comparison of the rectal temperature, heart rates and respiratory rates showed no major differences. Additionally, no significant alterations were detected between the groups considering the changes in the pain scores with simple descriptive score, Glasgow, University of Melbourne pain scale, sedation status and Sammarco methods. Finally, three cases in group S and two cases in group M were given an intramuscular analgesic rescue dose of morphine. Although a significant decline was observed in cortisol levels following intraperitoneal morphine administration, there were no beneficial changes in the efficiency of post-operative analgesia in status and clinical signs compared to the control group. Further studies are required to investigate intraperitoneal morphine effectiveness in post-operative pain management.
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Affiliation(s)
- Aida Rezaeipour
- DVM, Department of clinical sciences, Faculty of veterinary medicineShahid Chamran University of AhvazAhvazIran
| | - Hadi Naddaf
- Professor, Department of clinical sciences, Faculty of veterinary medicineShahid Chamran University of AhvazAhvazIran
| | - Seyedeh Missagh Jalali
- Associate Professor, Department of clinical sciences, Faculty of veterinary medicineShahid Chamran University of AhvazAhvazIran
| | - Soroush Sabiza
- Assistant Professor, Department of clinical sciences, Faculty of veterinary medicineShahid Chamran University of AhvazAhvazIran
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Scott EM, Vallone LV, Olson NL, Han G, Loria Lepiz MA, Simon BT. Analgesic effects of a retrobulbar block with 0.75% ropivacaine in dogs undergoing enucleation. Vet Anaesth Analg 2021; 48:749-758. [PMID: 34144876 DOI: 10.1016/j.vaa.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 04/20/2021] [Accepted: 04/24/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the analgesic effects of a retrobulbar block with ropivacaine in dogs undergoing enucleation. STUDY DESIGN Prospective, randomized, masked placebo-controlled trial. ANIMALS A total of 23 client-owned dogs. METHODS Dogs were randomized to be administered a preoperative inferior-temporal palpebral retrobulbar injection of either ropivacaine 0.75% (1 mL 10 kg-1; group RG) or equivalent volume of 0.9% saline (control; group CG). Intraoperative variables recorded to detect a response to noxious stimuli included heart rate (HR) and mean arterial pressure (MAP). Three observers assessed and recorded pain using a numerical rating pain scale and visual analog scale (VAS) before anesthesia (baseline) and postoperatively at 0, 0.5, 1, 2, 3, 4, 5, 6 and 24 hours after extubation. Rescue analgesia was administered if intraoperative HR or MAP increased by ≥ 20% from the previously recorded surgical time point, average postoperative pain scores totaled ≥ 9/20, scored ≥ 3/4 in any one category with VAS ≥ 35/100, or if VAS was ≥ 35/100 with a palpation score > 0/4. RESULTS Intraoperatively, there was no significant difference in HR or MAP between groups. Rescue analgesia was administered intraoperatively to four and one dogs and postoperatively to five and seven dogs in groups CG and RG, respectively, with no significant difference between groups. VAS scores were significantly lower in ropivacaine dogs at extubation (p = 0.02), but not at other postoperative time points. Adverse events were not observed in either group. CONCLUSIONS AND CLINICAL RELEVANCE Preoperative retrobulbar 0.75% ropivacaine injection (1 mL 10 kg-1) provided analgesia in dogs following enucleation at extubation; however, intraoperative and postoperative pain control did not differ from a placebo injection with saline. Lack of differences between groups may have been influenced by sample size limitations.
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Affiliation(s)
- Erin M Scott
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA.
| | - Lucien V Vallone
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Natalie L Olson
- Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Gang Han
- Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Mauricio A Loria Lepiz
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Bradley T Simon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, USA
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Ultrasound-Guided Funicular Block: Ropivacaine Injection into the Tissue around the Spermatic Cord to Improve Analgesia during Orchiectomy in Dogs. Animals (Basel) 2021; 11:ani11051275. [PMID: 33925210 PMCID: PMC8146739 DOI: 10.3390/ani11051275] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Orchiectomy is a common surgical procedure performed on small animals and postoperative analgesia is very important because pain causes various negative effects that prevent patient recovery. Our study aimed to compare the intraoperative ultrasound-guided funicular block with ropivacaine and general anaesthesia using hypnotic and/or analgesic drugs and the postoperative hemodynamic stability and pain scores. This study demonstrated that the use of ultrasound-guided funicular, using ropivacaine, guarantees long-lasting and high-quality analgesic coverage and minimises the post-surgical pain inevitably associated with orchiectomy. This study stemmed from a general trend towards increasing attention on postoperative pain after orchiectomy in dog. Since veterinarians are becoming more focused on relieving surgical pain, anaesthetists are expected to use better protocols that can minimise pain. In fact, acute postsurgical pain is of great interest due to potential risk of becoming chronic if not treated properly. The routine use of the intraoperative ultrasound-guided funicular block with ropivacaine block is considered a useful alternative for pain management for orchiectomy in dogs, which can be performed under sedation or superficial general anaesthesia. In addition, the intraoperative ultrasound-guided funicular block with ropivacaine block ensures satisfactory analgesic coverage that lasts for at least 6 h postoperatively. Abstract Orchiectomy is a common surgical procedure performed on small animals, and it requires postoperative pain management despite its relative simplicity. This study aimed to evaluate the hemodynamic stability, intraoperative administration of additional hypnotic and/or analgesic drugs, and postoperative pain scores following the combination of ultrasound-guided injection of ropivacaine hydrochloride into the spermatic cord and infiltration by the same anaesthetic of the incisional prescrotal line (ROP) or general anaesthesia. Dogs in the ROP group showed greater intraoperative hemodynamic stability and lower pain scores than the control group. The locoregional approach used in this study proved effective in minimising the responses to the surgical stimulus and ensured adequate analgesia intra- and postoperatively. This method, called ultrasound-guided funicular block, allows orchiectomy to be performed under deep sedation without general anaesthesia.
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Use of Spinal Anaesthesia with Anaesthetic Block of Intercostal Nerves Compared to a Continuous Infusion of Sufentanyl to Improve Analgesia in Cats Undergoing Unilateral Mastectomy. Animals (Basel) 2021; 11:ani11030887. [PMID: 33804684 PMCID: PMC8003676 DOI: 10.3390/ani11030887] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Postoperative analgesia is very important because pain causes various negative effects that prevent patient recovery. Our study aimed to evaluate the analgesic efficacy of subarachnoid anaesthesia combined with intercostal nerve block compared with a constant-rate infusion of sufentanyl citrate in cats undergoing unilateral mastectomy. This study demonstrated that the use of spinal anaesthesia with anaesthetic block of intercostal nerves, using levobupivacaine, guarantees long-lasting and high-quality analgesic coverage and minimises the post-surgical pain inevitably associated with invasive surgical procedures such as radical mastectomy. This study stemmed from a general trend towards increasing attention on postoperative pain after spaying procedures in cats. Since veterinarians are becoming more focused on relieving surgical pain, anaesthetists are expected to use better protocols that can minimise pain and therefore optimise surgical results. This method, considering the relative simplicity of its execution, can be used in daily clinical practice. Abstract Unilateral mastectomy is a common surgical procedure in feline species and requires postoperative pain management. Our study aimed to evaluate the analgesic efficacy of subarachnoid anaesthesia combined with an intercostal nerve block, in comparison with the use of sufentanyl citrate administered as a constant-rate infusion (CRI). Twenty cats were randomly divided into two groups (n = 10/group) based on the analgesic protocol used: the first received loco-regional anaesthesia with levobupivacaine (LR group), and the second received a CRI of sufentanyl (SUF group). The evaluation criteria during surgery were the need for a bolus of fentanyl in the event of an increased heart rate or increased blood pressure. In the postoperative period, the levels of comfort/discomfort and pain were used to obtain a score according to the UNESP-Botucatu multimodal scale. Subjects who scored above seven received analgesic drug supplementation. Intraoperative analgesia was satisfactory, with good haemodynamic stability in both groups. Four patients in the LR group required an extra dose of methadone after they achieved the sternal decubitus position, whereas those in the SUF group required many more doses. The analgesia achieved in the LR group was more satisfactory than that in the SUF group.
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Farokhzad B, Sabiza S, Razi Jalali M, Baniadam A. Intraperitoneal administration of lidocaine or tramadol alone or in combination on postoperative pain after ovariohysterectomy in dogs. Vet Med Sci 2021; 7:634-641. [PMID: 33528116 PMCID: PMC8136923 DOI: 10.1002/vms3.437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 01/04/2021] [Accepted: 01/16/2021] [Indexed: 12/05/2022] Open
Abstract
The present prospective randomized experimental study aimed to assess the intraperitoneal (ip) administration of lidocaine or tramadol, alone or in combination, on postoperative pain management following ovariohysterectomy in dogs. Eighteen healthy female mixed‐breed dogs, aged 1–2 years, weighed 16.7 ± 3.8 kg, were used. Animals were sedated with acepromazine (0.1 mg/kg, intramuscular). Forty minutes later, anaesthesia was induced through intravenous titration with diazepam (0.5 mg/kg) and ketamine (10 mg/kg) and maintained with isoflurane 1.5%. Afterwards, ovariohysterectomy was performed, and prior to the closure of the linea alba, animals received lidocaine containing epinephrine (8.8 mg/kg, ip) in group L, tramadol (4 mg/kg, ip) in group T and lidocaine containing epinephrine (8.8 mg/kg, ip) plus tramadol (4 mg/kg, ip) in the LT group. Cortisol, vital signs and pain scoring systems were evaluated at different time points. Vital signs did not change among the groups. Cortisol level in the LT group significantly decreased compared to the L and T groups one, three and six hours after surgery. Pain scores also did not change among the groups based on Sammarco and Simple descriptive (SDS) scoring method. However, pain scores in the LT group were higher than the two other groups according to the University of Melbourne pain scale (UMPS) and the short form of Glasgow pain scale (CMPS‐SF). According to the obtained results, the combination of lidocaine and tramadol seemed to be able to provide better analgesia compared with their separate administration. Therefore, combined intraperitoneal administration of lidocaine (8.8 mg/kg) and tramadol (4 mg/kg) with a final volume of (0.2 ml/kg) following ovariohysterectomy is recommended.
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Affiliation(s)
- Behnam Farokhzad
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Soroush Sabiza
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Mohammad Razi Jalali
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Ali Baniadam
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
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14
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de O L Carapeba G, Nicácio IPGA, Stelle ABF, Bruno TS, Nicácio GM, Costa Júnior JS, Giuffrida R, Teixeira Neto FJ, Cassu RN. Comparison of perioperative analgesia using the infiltration of the surgical site with ropivacaine alone and in combination with meloxicam in cats undergoing ovariohysterectomy. BMC Vet Res 2020; 16:88. [PMID: 32178668 PMCID: PMC7075011 DOI: 10.1186/s12917-020-02303-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 03/03/2020] [Indexed: 01/31/2023] Open
Abstract
Background Infiltration of the surgical site with local anesthetics combined with nonsteroidal anti-inflammatory drugs may play an important role in improving perioperative pain control. This prospective, randomized, blinded, controlled clinical trial aimed to evaluate intraoperative isoflurane requirements, postoperative analgesia, and adverse events of infiltration of the surgical site with ropivacaine alone and combined with meloxicam in cats undergoing ovariohysterectomy. Forty-five cats premedicated with acepromazine/meperidine and anesthetized with propofol/isoflurane were randomly distributed into three treatments (n = 15 per group): physiological saline (group S), ropivacaine alone (1 mg/kg, group R) or combined with meloxicam (0.2 mg/kg, group RM) infiltrated at the surgical site (incision line, ovarian pedicles and uterus). End-tidal isoflurane concentration (FE’ISO), recorded at specific time points during surgery, was adjusted to inhibit autonomic responses to surgical stimulation. Pain was assessed using an Interactive Visual Analog Scale (IVAS), UNESP-Botucatu Multidimensional Composite Pain Scale (MCPS), and mechanical nociceptive thresholds (MNT) up to 24 h post-extubation. Rescue analgesia was provided with intramuscular morphine (0.1 mg/kg) when MCPS was ≥6. Results Area under the curve (AUC) of FE’ISO was significantly lower (P < 0.0001) in the RM (17.8 ± 3.1) compared to S (23.1 ± 2.2) and R groups (22.8 ± 1.1). Hypertension (systolic arterial pressure > 160 mmHg) coinciding with surgical manipulation was observed only in cats treated with S and R (4/15 cats, P = 0.08). The number of cats receiving rescue analgesia (4 cats in the S group and 1 cat in the R and RM groups) did not differ among groups (P = 0.17). The AUC of IVAS, MCPS and MNT did not differ among groups (P = 0.56, 0.64, and 0.18, respectively). Significantly lower IVAS pain scores were recorded at 1 h in the RM compared to the R and S groups (P = 0.021–0.018). There were no significant adverse effects during the study period. Conclusions Local infiltration with RM decreased intraoperative isoflurane requirements and resulted in some evidence of improved analgesia during the early postoperative period. Neither R nor RM infiltration appeared to result in long term analgesia in cats undergoing ovariohysterectomy.
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Affiliation(s)
- Gabriel de O L Carapeba
- Postgraduate Program in Animal Science, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Isabela P G A Nicácio
- Postgraduate Program in Animal Science, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Ana Beatriz F Stelle
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Tatiane S Bruno
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Gabriel M Nicácio
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - José S Costa Júnior
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Rogerio Giuffrida
- Postgraduate Program in Animal Science, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Francisco J Teixeira Neto
- Department of Veterinary Surgery and Animal Reproduction, Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista (UNESP), Botucatu, Brazil
| | - Renata N Cassu
- Postgraduate Program in Animal Science, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil. .,Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil.
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15
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Gomes DR, Nicácio IPGA, Cerazo LML, Dourado L, Teixeira-Neto FJ, Cassu RN. Addition of magnesium sulfate to intraperitoneal ropivacaine for perioperative analgesia in canine ovariohysterectomy. J Vet Pharmacol Ther 2020; 43:355-363. [PMID: 32144805 DOI: 10.1111/jvp.12851] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 02/06/2020] [Accepted: 02/15/2020] [Indexed: 01/09/2023]
Abstract
Magnesium may be used as an adjunctive analgesic for perioperative pain management because of its antinociceptive properties. This study investigated the analgesic efficacy of intraperitoneal ropivacaine combined with magnesium sulfate in canine ovariohysterectomy. Forty-five dogs sedated with acepromazine/meperidine and anesthetized with propofol/isoflurane were randomly distributed into three treatments, administered intraperitoneally (n = 15 per group): saline solution (group S), 0.25% ropivacaine (3 mg/kg) alone (group R), or in combination with magnesium sulfate (20 mg/kg, group R-Mg). Intravenous fentanyl was given to control cardiovascular responses to surgical stimulation. Postoperative pain was assessed using an Interactive Visual Analog Scale (IVAS), the short form of the Glasgow Composite Pain Scale, and mechanical nociceptive thresholds. Morphine/meloxicam was administered as rescue analgesia. Intraoperatively, the R-Mg group required less fentanyl (p = .02) and exhibited higher incidence of hypotension (systolic arterial pressure <90 mm Hg, p = .006) compared with the S group. Lower IVAS pain scores were recorded during the first hour in the R-Mg group than the other groups (p = .007-.045). Postoperative rescue analgesia did not differ between groups. Intraperitoneal magnesium sulfate administration, in spite of decreasing intraoperative opioid requirements, increased the incidence of hypotension with minimal evidence of postoperative analgesic benefits.
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Affiliation(s)
- Denis R Gomes
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Isabela P G A Nicácio
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Letícia M L Cerazo
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Larissa Dourado
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Francisco J Teixeira-Neto
- Department of Veterinary Surgery and Animal Reproduction, Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista (UNESP), Botucatu, Brazil
| | - Renata N Cassu
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária, Universidade do Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
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16
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Nicácio IP, Stelle ABF, Bruno TS, Nicácio GM, Costa JS, Cassu RN. Comparison of intraperitoneal ropivacaine and ropivacaine-dexmedetomidine for postoperative analgesia in cats undergoing ovariohysterectomy. Vet Anaesth Analg 2020; 47:396-404. [PMID: 32199795 DOI: 10.1016/j.vaa.2020.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 12/20/2019] [Accepted: 01/05/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the intraperitoneal (IP) administration of ropivacaine or ropivacaine-dexmedetomidine for postoperative analgesia in cats undergoing ovariohysterectomy. STUDY DESIGN Prospective, randomized, blinded, positively controlled clinical study. ANIMALS A total of 45 client-owned cats were enrolled. METHODS The cats were administered intramuscular (IM) meperidine (6 mg kg-1) and acepromazine (0.05 mg kg-1). Anesthesia was induced with propofol and maintained with isoflurane. Meloxicam (0.2 mg kg-1) was administered subcutaneously in all cats after intubation. After the abdominal incision, the cats were administered one of three treatments (15 cats in each treatment): IP instillation of 0.9% saline solution (group Control), 0.25% ropivacaine (1 mg kg-1, group ROP) or ropivacaine and dexmedetomidine (4 μg kg-1, group ROP-DEX). During anesthesia, heart rate (HR), electrocardiography, noninvasive systolic arterial pressure (SAP) and respiratory variables were monitored. Sedation and pain were assessed preoperatively and at various time points up to 24 hours after extubation using sedation scoring, an interactive visual analog scale, the UNESP-Botucatu multidimensional composite pain scale (MCPS) and mechanical nociceptive thresholds (MNT; von Frey anesthesiometer). Rescue analgesia (morphine, 0.1 mg kg-1) IM was administered if the MCPS ≥6. Data were analyzed using the chi-square test, Tukey test, Kruskal-Wallis test and Friedman test (p < 0.05). RESULTS HR was significantly lower in ROP-DEX compared with Control (p = 0.002). The pain scores, MNT, sedation scores and the postoperative rescue analgesia did not differ statistically among groups. CONCLUSIONS AND CLINICAL RELEVANCE As part of a multimodal pain therapy, IP ropivacaine-dexmedetomidine was associated with decreased HR intraoperatively; however, SAP remained within normal limits. Using the stated anesthetic protocol, neither IP ropivacaine nor ropivacaine-dexmedetomidine significantly improved analgesia compared with IP saline in cats undergoing ovariohysterectomy.
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Affiliation(s)
- Isabela Pga Nicácio
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of Western São Paulo, São Paulo, Brazil
| | - Ana Beatriz F Stelle
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of Western São Paulo, São Paulo, Brazil
| | - Tatiane S Bruno
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of Western São Paulo, São Paulo, Brazil
| | - Gabriel M Nicácio
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of Western São Paulo, São Paulo, Brazil
| | - José S Costa
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of Western São Paulo, São Paulo, Brazil
| | - Renata N Cassu
- Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of Western São Paulo, São Paulo, Brazil.
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Grubb T, Lobprise H. Local and regional anaesthesia in dogs and cats: Descriptions of specific local and regional techniques (Part 2). Vet Med Sci 2020; 6:218-234. [PMID: 31965749 PMCID: PMC7196680 DOI: 10.1002/vms3.218] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 07/27/2019] [Accepted: 10/27/2019] [Indexed: 11/30/2022] Open
Abstract
Pain management in veterinary patients is a crucial component of appropriate patient care. Local anaesthetic drugs used in local and regional blockade can completely block the transmission of nociceptive impulses, decreasing both intra‐operative nociception and postoperative pain, while decreasing the potential incidence of adverse effects that can be associated with systemic boluses of drugs. For efficacy and safety, this class of drugs is recommended as part of the analgesic protocol in the majority of surgical procedures and traumatic injuries. Numerous local and regional blocks are proven effective in dogs and cats, thus providing the clinician with ample opportunity to include these blocks in practice. This manuscript, Part 2 of a two‐part instalment, focuses on brief descriptions of select commonly used local/regional anaesthesia techniques for dogs and cats that cover a multitude of painful surgeries/injuries and that can be implemented in any practice. In Part 1 of this topic, detailed information on local anaesthetic drugs commonly used in small animal practice was reviewed (Grubb & Lobprise, 2020).
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Steagall PVM, Benito J, Monteiro B, Lascelles D, Kronen PW, Murrell JC, Robertson S, Wright B, Yamashita K. Intraperitoneal and incisional analgesia in small animals: simple, cost-effective techniques. J Small Anim Pract 2019; 61:19-23. [PMID: 31737915 DOI: 10.1111/jsap.13084] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 08/26/2019] [Accepted: 09/30/2019] [Indexed: 11/27/2022]
Abstract
The World Small Animal Veterinary Association Global Pain Council (WSAVA-GPC) has recently published its first "capsule review" by Monteiro et al. These are short articles that present a brief assessment of the scientific evidence and practical recommendations on important, and sometimes controversial, subjects in pain management. The capsules will be published regularly in the Journal of Small Animal Practice, the official journal of the WSAVA. This second article discusses the use of intraperitoneal and incisional analgesia in small animal practice, including their limitations and recommendations by the authors.
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Affiliation(s)
- P V M Steagall
- Department of Clinical Sciences, Université de Montréal, Montreal, Quebec, J2S 2M2, Canada
| | - J Benito
- Department of Clinical Sciences, Université de Montréal, Montreal, Quebec, J2S 2M2, Canada
| | - B Monteiro
- Department of Clinical Sciences, Université de Montréal, Montreal, Quebec, J2S 2M2, Canada
| | - D Lascelles
- Translational Research in Pain Program, Comparative Pain Research and Education Center, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, 27606, USA
| | - P W Kronen
- Veterinary Anaesthesia Service - International, Winterthur, 8400, Switzerland
| | - J C Murrell
- Highcroft Veterinary Referrals, Whitchurch, Bristol, BS14 9BE, UK
| | - S Robertson
- Lap of Love Veterinary Hospice, Lutz, Florida, 33549, USA
| | - B Wright
- Mistral Vet, Fort Collins, Colorado, 80534, USA
| | - K Yamashita
- Small Animal Clinical Sciences, Rakuno Gakuen University, Ebetsu, Hokkaido, 069-8501, Japan
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19
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Benito J, Evangelista MC, Doodnaught GM, Watanabe R, Beauchamp G, Monteiro BP, Steagall P. Analgesic Efficacy of Bupivacaine or Bupivacaine-Dexmedetomidine After Intraperitoneal Administration in Cats: A Randomized, Blinded, Clinical Trial. Front Vet Sci 2019; 6:307. [PMID: 31572740 PMCID: PMC6753169 DOI: 10.3389/fvets.2019.00307] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 08/29/2019] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to compare the analgesic efficacy of intraperitoneal bupivacaine vs. bupivacaine-dexmedetomidine in combination with intramuscular buprenorphine in cats undergoing ovariohysterectomy. Sixty healthy adult cats (2.8 ± 0.7 kg; n = 30/group) were included in a randomized, prospective, blinded, clinical trial after owners' written consent. After premedication with acepromazine (0.02 mg/kg) and buprenorphine (0.02 mg/kg) intramuscularly, anesthesia was induced with propofol to effect (6.2 ± 1.4 mg/kg) and maintained with isoflurane. Bupivacaine 0.25% alone (BG; 2 mg/kg) or bupivacaine (same dose) with dexmedetomidine (BDG; 1 μg/kg) were instilled/splashed over the ovarian pedicles and caudal aspect of uterus before ovariohysterectomy. Final injectate volume was standardized between groups. Sedation was evaluated using a five-point simple descriptive scale. Pain was evaluated using the short-form UNESP-Botucatu composite pain scale (SF-CPS) before, and at 0.5, 1, 2, 3, 4, 6, 8, 12, and 24 h after surgery. Rescue analgesia was provided with buprenorphine (0.02 mg/kg intravenously) and meloxicam (0.2 mg/kg subcutaneously) when SF-CPS ≥ 4. The Mantel-Haenszel chi-square test was used for analyzing ordinal variables (e.g., SF-CPS pain scores). The effect of time in SF-CPS scores was assessed with the Cochran-Mantel-Haenszel test for repeated measures. The alpha level for each contrast was adjusted downward with the sequential Benjamini-Hochberg procedure. The number of cats receiving rescue analgesia was analyzed using χ2 test (p < 0.05). The prevalence of rescue analgesia was the same for the two treatments (p = 1.000) [BG, n = 6, 20%; BDG, n = 6, 20%] and similar for timing of rescue analgesia (p = 0.16). The SF-CPS scores were significantly increased between 1 and 12 h in BG, and between 0.5 and 8 h in BDG when compared with baseline values. Median (interquartile range) pain scores were higher in BG [1 (1-2)] than BDG [1 (0-1)] at 12 h (p = 0.023). Sedation scores were not significantly different between groups throughout the study. In terms of prevalence of rescue analgesia, but not duration of action, the analgesic efficacy of bupivacaine-dexmedetomidine was similar to bupivacaine alone after intraperitoneal administration in cats receiving buprenorphine.
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Affiliation(s)
- Javier Benito
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Marina C Evangelista
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Graeme M Doodnaught
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Ryota Watanabe
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Guy Beauchamp
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Beatriz P Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Paulo Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
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