1
|
Wolfe KL, Hofmeister EH. Scoping review of quality of anesthetic induction and recovery scales used for dogs. Vet Anaesth Analg 2021; 48:823-840. [PMID: 34483039 DOI: 10.1016/j.vaa.2021.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/14/2021] [Accepted: 07/18/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To compare, describe and assess the level of validation of all instruments measuring quality of induction and recovery from anesthesia in dogs. DATABASES USED A search was performed using the electronic database PubMed to find articles containing an induction quality scale, a recovery quality scale or both in dogs. Articles not directly accessible through PubMed were obtained through the Auburn University Library website and Google Scholar. The phrases 'induction scoring systems dogs', 'recovery scoring systems dogs', 'anesthetic induction score dogs', and 'anesthetic recovery score dogs' were used for searches using the 'best match search' function. The time frame searched was from 1980 to May 2020. The search was conducted from March 2020 to May 2020. CONCLUSIONS A thoroughly tested and validated scale for measuring the quality of induction and recovery does not exist in the current veterinary literature. A large disagreement exists between studies on the use of induction and recovery scales, and many have reported inconsistent results with current instruments. It is recommended that an induction and recovery scale intended for wide-scale use be constructed and tested extensively for psychometric validation and reliability.
Collapse
Affiliation(s)
- Kathryn L Wolfe
- Department of Animal Sciences, Auburn University, Auburn, AL, USA
| | - Erik H Hofmeister
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA.
| |
Collapse
|
2
|
Hampton CE, Riebold TW, Mandsager RE. Recovery characteristics of dogs following anesthesia induced with tiletamine-zolazepam, alfaxalone, ketamine-diazepam, or propofol and maintained with isoflurane. J Am Vet Med Assoc 2020; 254:1421-1426. [PMID: 31149881 DOI: 10.2460/javma.254.12.1421] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare characteristics of recovery from isoflurane anesthesia in healthy nonpremedicated dogs after anesthetic induction by IV administration of tiletamine-zolazepam with those observed after induction by IV administration of alfaxalone, ketamine-diazepam, or propofol. DESIGN Prospective, randomized crossover study. ANIMALS 6 healthy adult hounds. PROCEDURES Each dog underwent the 4 treatments in random order with a ≥ 7-day washout period between anesthetic episodes. Anesthesia was induced by IV administration of the assigned induction drug or combination (each to effect in 25% increments of calculated dose) and maintained with isoflurane in oxygen for 60 minutes. Cardiorespiratory variables and end-tidal isoflurane concentration (ETISO) were measured just before isoflurane administration was discontinued. Dogs were observed and video recorded during recovery. Recovery characteristics were retrospectively scored from recordings by 3 raters. Interrater and intrarater reliability of scoring was assessed by intraclass correlation coefficient calculation. Linear and mixed ANOVAs were used to compare extubation times, recovery scores, and body temperature among treatments. RESULTS Most cardiorespiratory variables, body temperature, ETISO, and time to extubation did not differ between tiletamine-zolazepam and other induction treatments. Recovery scores were lower (indicating better recovery characteristics) with propofol or alfaxalone than with tiletamine-zolazepam but did not differ between tiletamine-zolazepam and ketamine-diazepam treatments. Anesthetic episode number and ETISO had no effect on extubation time or recovery score. Intrarater and interrater correlations for recovery scores were excellent. CONCLUSIONS AND CLINICAL RELEVANCE Recovery of healthy dogs from anesthesia with isoflurane after induction with tiletamine-zolazepam was uncomplicated and had characteristics comparable to those observed following induction with ketamine-diazepam. However, recovery characteristics were improved when anesthesia was induced with propofol or alfaxalone.
Collapse
|
3
|
Effects of fentanyl-lidocaine-ketamine versus sufentanil-lidocaine-ketamine on the isoflurane requirements in dogs undergoing total ear canal ablation and lateral bulla osteotomy. Vet Anaesth Analg 2020; 47:595-603. [PMID: 32792272 DOI: 10.1016/j.vaa.2020.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 12/30/2019] [Accepted: 04/05/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare the isoflurane-sparing effects of sufentanil-lidocaine-ketamine (SLK) and fentanyl-lidocaine-ketamine (FLK) infusions in dogs undergoing total ear canal ablation and lateral bulla osteotomy (TECA-LBO). STUDY DESIGN Randomized blinded clinical study. ANIMALS A group of 20 client-owned dogs undergoing TECA-LBO. METHODS Intravenous (IV) administration of lidocaine (3 mg kg-1) and ketamine (0.6 mg kg-1) with fentanyl (5.4 μg kg-1; n = 10; FLK group) or sufentanil (0.72 μg kg-1; n = 10; SLK group) was immediately followed by the corresponding constant rate infusion (CRI) (lidocaine 3 mg kg-1 hour-1; ketamine 0.6 mg kg-1 hour-1; either fentanyl 5.4 μg kg-1 hour-1 or sufentanil 0.72 μg kg-1 hour-1). Anaesthesia was induced with propofol 3-5 mg kg-1 IV and was maintained with isoflurane. End-tidal isoflurane concentration (Fe'Iso) was decreased in 0.2% steps every 15 minutes until spontaneous movements were observed (treated with propofol 1 mg kg-1 IV) or an increase of > 30% in heart rate or mean arterial pressure from baseline occurred (treated with rescue fentanyl or sufentanil). Quality of recovery and pain were assessed at extubation using the short-form Glasgow Composite Pain Scale (SF-GCPS), Colorado State University Canine Acute Pain scale (CSU-CAP), and visual analogue scale (VAS). Data were analysed with analysis of variance, t tests, Fisher test and Spearman coefficient (p < 0.05). RESULTS Fe'Iso decreased significantly in SLK group (45%; p = 0.0006) but not in FLK (15%; p = 0.1135) (p = 0.0136). SLK group had lower scores for recovery quality (p = 0.0204), SF-GCPS (p = 0.0071) and CSU-CAP (p = 0.0273) than FLK at extubation. Intraoperative rescue analgesia and VAS were not significantly different between groups. CONCLUSIONS AND CLINICAL RELEVANCE Compared with FLK infusion, CRI of SLK at these doses decreased isoflurane requirements, decreased pain scores and improved recovery quality at extubation in dogs undergoing TECA-LBO.
Collapse
|
4
|
Tambella AM, Attili AR, Beribè F, Galosi M, Marchegiani A, Cerquetella M, Palumbo Piccionello A, Vullo C, Spaterna A, Fruganti A. Management of otitis externa with an led-illuminated gel: a randomized controlled clinical trial in dogs. BMC Vet Res 2020; 16:91. [PMID: 32192496 PMCID: PMC7083025 DOI: 10.1186/s12917-020-02311-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 03/11/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Canine otitis externa is a painful condition which can be challenging to treat due to difficulties in the administration of otic medication. This can be due to lack of owner compliance in the application of ear drops or due to the resentment that some dogs demonstrate when attempts are made to administer topical medication into a sensitive ear canal. The aim of the study was to assess the efficacy of a topical LED-illuminated gel (LIG) in canine otitis externa in comparison to standard of care therapy. Dogs with spontaneous otitis externa were randomly allocated in three groups: groups QW received LIG once weekly; BW received LIG twice weekly; group C received enrofloxacin and silver sulfadiazine twice daily. LIG consists of a topical application of a gel containing chromophores that, when illuminated by a LED lamp, re-emit fluorescent light which can stimulate physiological responses, promoting healing and controlling bacteria. The evaluation protocol (T0 to T5) considered clinical assessment (OTIS-3-index-scoring-system; pruritus-severity-scale; pain-severity-score; aural temperature), cytological scoring system, quali-quantitative bacteriologic assessment. RESULTS All groups (QW, n = 21; BW, n = 23; C, n = 20) showed improvement during the study (QW: P < 0.02 for cytological and pain scores, P < 0.003 for bacteriologic assessment, P < 10- 4 for pruritus, total OTIS-3 and temperature assessments; BW: P < 10- 4 for all clinical, cytological and bacteriologic assessments; C: P < 0.02 for all clinical and cytological assessments, P < 10- 4 for bacteriologic assessment). The highest clinical score reduction occurred in Group BW (P < 0.014 in T3; P < 0.001 in T4 and P < 10- 4 in T5). BW reached the clinically relevant effect level at T3 (- 3.26 ± 1.21 levels), QW reached it at T4 (- 3.24 ± 0.99), C did not reach it. No differences between groups were seen in the reduction of CFU/mL (T0-T5). CONCLUSIONS All treatment groups showed a positive clinical effect. LIG administered twice-a-week was the most favourable protocol of the study. LIG may be considered beneficial in the management of canine otitis externa; it seems to be effective in controlling the clinical condition, including the signs of inflammation and local pain, the bacterial growth, and it may help increasing treatment compliance.
Collapse
Affiliation(s)
- Adolfo Maria Tambella
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Anna Rita Attili
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Francesca Beribè
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Margherita Galosi
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Andrea Marchegiani
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Matteo Cerquetella
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Angela Palumbo Piccionello
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Cecilia Vullo
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Andrea Spaterna
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Alessandro Fruganti
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| |
Collapse
|
5
|
Efficacy of greater auricular and auriculotemporal nerve blocks performed in rabbits. Vet Anaesth Analg 2020; 47:567-573. [PMID: 32336591 DOI: 10.1016/j.vaa.2020.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 02/21/2020] [Accepted: 02/23/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the efficacy, duration and safety of greater auricular and auriculotemporal nerve blocks in rabbits. STUDY DESIGN Prospective, randomized, crossover, experimental study. ANIMALS A total of 11 healthy adult Dutch-belted rabbits. METHODS The rabbits underwent general anesthesia and injections of the greater auricular and auriculotemporal nerves using either bupivacaine (0.3 mL kg-1, 0.5%) or the same volume of saline. After anesthesia, the efficacy and duration of nerve blocks were assessed using analgesiometry forceps on the pinna and cotton-tipped applicators within the vertical ear canal. Rabbits were monitored for abnormal carriage of the ear and auriculopalpebral nerve block of the ipsilateral eye. Body weight, food intake, fecal output and fecal pellet diameter were measured daily for 6 days after the nerve blocks were performed and compared with baseline to assess short-term effects. RESULTS The greater auricular nerve was successfully blocked in 12/16 (75%) ears for mean ± standard deviation duration of 88 ± 52 minutes. In successfully blocked ears, altered ear position was noted in five/16 (31%) cases. The auriculotemporal nerve was blocked in one/16 ears for 120 minutes. The auriculopalpebral nerve was inadvertently blocked in three/16 ears. Food intake and fecal output decreased significantly during the treatment day but returned to pretreatment values after 24 hours. There was no change in body weight or fecal pellet diameter for either treatment. CONCLUSIONS AND CLINICAL RELEVANCE The results suggest that duration of the greater auricular nerve block with 0.5% bupivacaine was short-lived in the live rabbit. Auriculotemporal nerve block was only achieved in one ear; therefore, further studies are warranted to evaluate the contribution of these blocks in the pain management of rabbits undergoing auricular surgery.
Collapse
|
6
|
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: 31] [Impact Index Per Article: 7.8] [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).
Collapse
|
7
|
Injection techniques for auricular nerve blocks in the rabbit cadaver. Vet Anaesth Analg 2019; 47:274-279. [PMID: 32029354 DOI: 10.1016/j.vaa.2019.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/28/2019] [Accepted: 11/26/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To describe the landmarks for localization and to determine the methodology and volume of methylene blue dye to adequately stain the auricular nerves in rabbit cadavers. STUDY DESIGN Prospective, randomized, cadaveric study. ANIMALS A total of 26 rabbit cadavers (Dutch-Belted and New Zealand White breeds). METHODS Part I: anatomical dissections were performed to identify the sensory auricular nerves and to establish the ideal injection approach and volume of dye required for nerve staining. Part II: a single injection technique using 0.1 mL kg-1 dye was evaluated for staining the greater auricular nerve and two techniques (perpendicular and angled needle approaches) using 0.075 mL kg-1 dye were evaluated for the auriculotemporal nerve. Dye spread was evaluated through cadaveric dissections and nerve staining graded using a 0-2 point scale. Injections were considered successful if the nerve was stained circumferentially. Cadavers were assessed for staining of the mandibular nerve owing to the close proximity to the auriculotemporal nerve. Fisher's exact test and mixed effects logistic regression model were used for statistical analysis. RESULTS The greater auricular nerve was stained in 24/27 (88.9%) injections. The auriculotemporal nerve was stained in 7/12 injections (58.3%) with the perpendicular needle approach; staining success increased to 80% (12/15 injections) with the angled needle approach; however, this difference was not statistically significant (p = 0.228). Mandibular nerve staining occurred on seven auriculotemporal injections with no statistically significant difference in the incidence of nerve staining between techniques. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that the auricular nerves in rabbit cadavers can be successfully located and stained using anatomic landmarks and the described injection techniques.
Collapse
|
8
|
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: 13] [Impact Index Per Article: 2.6] [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.
Collapse
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
| |
Collapse
|
9
|
Layne EA, de Miguel Garcia C. Clinical techniques in Veterinary Dermatology: Regional anaesthesia of the canine ear. Vet Dermatol 2019; 30:470-e138. [PMID: 31515861 DOI: 10.1111/vde.12792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Video otoscopy is a valuable tool for the diagnosis and treatment of otitis externa (OE) and otitis media (OM) in dogs. Procedures performed by video otoscopy often are painful and it can be challenging to maintain steady anaesthetic depth and provide smooth anaesthetic recovery. A multimodal approach to analgesia and anaesthesia is ideal to minimize complications associated with high doses of anaesthetic drugs while providing the patient with adequate analgesia. HYPOTHESIS/OBJECTIVE To describe a technique for regional anaesthesia of the canine ear. ANIMALS One canine cadaver, obtained as part of a teaching laboratory class for other clinical techniques, with institutional approval, was used for illustration purposes. RESULTS Clinical technique for regional anaesthesia of the canine ear. CONCLUSIONS AND CLINICAL IMPORTANCE Nerve blocks for regional anaesthesia are an important aspect of a multimodal anaesthetic approach. A technique for blocking the two major sensory nerves to the canine ear is described.
Collapse
Affiliation(s)
- Elizabeth A Layne
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI, 53706, USA
| | - Cristina de Miguel Garcia
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI, 53706, USA
| |
Collapse
|
10
|
Castejón-González AC, Reiter AM. Locoregional Anesthesia of the Head. Vet Clin North Am Small Anim Pract 2019; 49:1041-1061. [PMID: 31521406 DOI: 10.1016/j.cvsm.2019.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Locoregional (local and regional) anesthesia is used routinely during surgical procedures of the head. The goal of this article is to provide a practical guide for the clinician to safely perform different techniques in dogs and cats and to minimize the risk of complications associated with locoregional anesthesia.
Collapse
Affiliation(s)
- Ana C Castejón-González
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA.
| | - Alexander M Reiter
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA
| |
Collapse
|
11
|
Pascal M, Kaartinen J. Suspected exaggerated reaction to dopamine infusion in a cat with increased intracranial pressure. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2018-000698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
12
|
Stathopoulou TR, Pinelas R, Haar GT, Cornelis I, Viscasillas J. Description of a new approach for great auricular and auriculotemporal nerve blocks: A cadaveric study in foxes and dogs. Vet Med Sci 2018; 4:91-97. [PMID: 29851309 PMCID: PMC5979758 DOI: 10.1002/vms3.90] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Otitis externa is a painful condition that may require surgical intervention in dogs. A balanced analgesia protocol should combine systemic analgesic agents and local anaesthesia techniques. The aim of the study was to find anatomical landmarks for the great auricular and the auriculotemporal nerves that transmit nociceptive information from the ear pinna and to develop the optimal technique for a nerve block. The study consisted of two phases. In phase I, one fox cadaver was used for dissection and anatomical localization of the auricular nerves to derive landmarks for needle insertion. Eight fox cadavers were subsequently used to evaluate the accuracy of the technique by injecting methylene blue bilaterally. In phase II findings from phase I were applied in four Beagle canine cadavers. A block was deemed successful if more than 0.6 cm of the nerve's length was stained. Successful great auricular nerve block was achieved by inserting the needle superficially along the wing of the atlas with the needle pointing towards the jugular groove. For the auriculotemporal nerve block the needle was inserted perpendicular to the skin at the caudal lateral border of the zygomatic arch, close to the temporal process. The overall success rate was 24 out of 24 (100%) and 22 out of 24 (91%) for the great auricular and the auriculotemporal nerves, respectively, while the facial nerve was stained on three occasions. Our results suggest that it is feasible to achieve a block of the auricular nerves, based on anatomical landmarks, without concurrently affecting the facial nerve.
Collapse
Affiliation(s)
- Thaleia-Rengina Stathopoulou
- Department of Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, United Kingdom
| | - Rui Pinelas
- North Downs Specialist Referrals, 3 & 4 The Brewerstreet Dairy Business Park, Redhill, United Kingdom
| | - Gert Ter Haar
- Anicura, Medisch Centrum voor Dieren, Amsterdam, Netherlands
| | - Ine Cornelis
- Department of Medicine and clinical biology of small animals, University of Ghent, Merelbeke, Belgium
| | - Jaime Viscasillas
- Department of Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, United Kingdom
| |
Collapse
|
13
|
Enomoto M, Lascelles BDX, Gerard MP. Defining local nerve blocks for feline distal pelvic limb surgery: a cadaveric study. J Feline Med Surg 2017; 19:1215-1223. [PMID: 28186424 PMCID: PMC11104168 DOI: 10.1177/1098612x17690652] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Objectives Anatomical and methodological detail is lacking regarding local anesthetic peripheral nerve block techniques for distal pelvic limb surgery in cats. The aim of this study was to develop, describe and test nerve block methods based on cadaveric dissections and dye injections. Methods Ten pairs of feline pelvic limbs (n = 20) were dissected and the tibial nerve (T n.), common fibular (peroneal) nerve (CF n., and its two branches, the superficial fibular [peroneal] nerve [SpF n.] and the deep fibular [peroneal] nerve [DpF n.]) and the saphenous nerve (Sa n.) were identified. Based on these dissections, a 'distal crus block' (selective blockade of the CF n., T n. and Sa n.) and a 'distal pes block' (selective blockade of the SpF n., DpF n., T n. and Sa n.) were developed for surgical procedures in two different regions of the distal pelvic limb. Techniques were tested using new methylene blue (NMB) dye injections in feline pelvic limbs (n = 12). Using a 25 G × 5/8 inch needle and 1 ml syringe, 0.1 ml/kg of NMB dye solution was injected at the site of the CF n., and 0.05 ml/kg was injected at the sites of the SpF n., DpF n., Sa n. and T n. The length and circumference (fully or partially stained) of each stained nerve were measured. Results Positive staining of nerves was observed in 12/12 limbs. The lengths stained for the CF n., DpF n., SpF n., Sa n. and T n. were 27.19 ± 7.13, 20.39 ± 5.57, 22.82 ± 7.13, 30.89 ± 6.99 and 25.16 ± 8.09 mm, respectively. The nerves were fully stained in 12, 12, 10, 11 and 11 out of 12 limbs, respectively. Conclusions and relevance These two, three-point injection methods may be an effective perioperative analgesia technique for feline distal pelvic limb procedures.
Collapse
Affiliation(s)
- Masataka Enomoto
- Comparative Pain Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - B Duncan X Lascelles
- Comparative Pain Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
- Center for Pain Research and Innovation, University of North Carolina, School of Dentistry, Chapel Hill, NC, USA
- Center for Translational Pain Research, Department of Anesthesiology, Duke University, Durham, NC, USA
| | - Mathew P Gerard
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| |
Collapse
|
14
|
Becker WM, Mama KR, Rao S, Palmer RH, Egger EL. Prevalence of Dysphoria after Fentanyl in Dogs Undergoing Stifle Surgery. Vet Surg 2015; 42:302-7. [DOI: 10.1111/j.1532-950x.2012.01080.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Willem M. Becker
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins CO
| | - Khursheed R. Mama
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins CO
| | - Sangeeta Rao
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins CO
| | - Ross H. Palmer
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins CO
| | - Erick L. Egger
- Department of Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Colorado State University; Fort Collins CO
| |
Collapse
|
15
|
Enomoto M, Lascelles BDX, Gerard MP. Defining the local nerve blocks for feline distal thoracic limb surgery: a cadaveric study. J Feline Med Surg 2015; 18:838-45. [PMID: 26250858 PMCID: PMC5661698 DOI: 10.1177/1098612x15597967] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives Though controversial, onychectomy remains a commonly performed distal thoracic limb surgical procedure in cats. Peripheral nerve block techniques have been proposed in cats undergoing onychectomy but evidence of efficacy is lacking. Preliminary tests of the described technique using cadavers resulted in incomplete staining of nerves. The aim of this study was to develop nerve block methods based on cadaveric dissections and test these methods with cadaveric dye injections. Methods Ten pairs of feline thoracic limbs (n = 20) were dissected and superficial branches of the radial nerve (RSbr nn.), median nerve (M n.), dorsal branch of ulnar nerve (UDbr n.), superficial branch of palmar branch of ulnar nerve (UPbrS n.) and deep branch of palmar branch of ulnar nerve (UPbrDp n.) were identified. Based on these dissections, a four-point block was developed and tested using dye injections in another six pairs of feline thoracic limbs (n = 12). Using a 25 G × 5/8 inch needle and 1 ml syringe, 0.07 ml/kg methylene blue was injected at the site of the RSbr nn., 0.04 ml/kg at the injection site of the UDbr n., 0.08 ml/kg at the injection site of the M n. and UPbrS n., and 0.01 ml/kg at the injection site of the UPbrDp n. The length and circumference of each nerve that was stained was measured. Results Positive staining of all nerves was observed in 12/12 limbs. The lengths stained for RSbr nn., M n., UDbr n., UPbrS n. and UPbrDp n. were 34.9 ± 5.3, 26.4 ± 4.8, 29.2 ± 4.0, 39.1 ± 4.3 and 17.5 ± 3.3 mm, respectively. The nerve circumferences stained were 93.8 ± 15.5, 95.8 ± 9.7, 100 ± 0.0, 100 ± 0.0 and 93.8 ± 15.5%, respectively. Conclusions and relevance This described four-point injection method may be an effective perioperative analgesia technique for feline distal thoracic limb procedures.
Collapse
Affiliation(s)
- Masataka Enomoto
- Comparative Pain Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - B Duncan X Lascelles
- Comparative Pain Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA Center for Comparative Medicine and Translational Research, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA Center for Pain Research and Innovation, UNC School of Dentistry, Chapel Hill, NC, USA
| | - Mathew P Gerard
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| |
Collapse
|
16
|
Albuquerque V, Araújo M, Ferreira G, Fonseca M, Abimussi C, Ferreira J, Oliva V. Epidural levobupivacaine alone or combined with different morphine doses in bitches under continuous propofol infusion. ARQ BRAS MED VET ZOO 2015. [DOI: 10.1590/1678-4162-7661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to assess the cardiopulmonary, analgesic, adverse effects, serum concentration of cortisol and plasma levels of levobupivacaine and morphine in bitches undergoing propofol anesthesia and epidural analgesia with levobupivacaine alone or combined with morphine. This was a randomized 'blinded' prospective clinical study using 32 adult bitches weighing 9.8±4.1kg that were admitted for elective ovariohysterectomy. Twenty minutes after administration of acepromazine and midazolam, anesthesia was induced with propofol (4mg kg-1) and maintained by a continuous rate infusion (CRI). Each animal was randomly assigned to one of four epidural groups: GL = levobupivacaine alone (0.33mg kg-1); GLM0.1 = levobupivacaine and morphine (0.1mg kg-1); GLM0.15 = levobupivacaine and morphine (0.15mg kg-1); and GLM0.2 = levobupivacaine and morphine (0.2mg kg-1). Variables obtained during anesthesia were heart rate, respiratory rate, systolic, mean and diastolic arterial blood pressures, oxyhemoglobin saturation, inspired oxygen fraction, end-tidal carbon dioxide tension, blood gases, serum cortisol, and plasma levels of levobupivacaine and morphine. The onset and duration times of the blockade were recorded. Arterial pressures were significantly increased in all groups at the times of ovarian pedicle clamping. There was a decrease in pH, together with an increase in both PaO2and PaCO2 over time. Serum cortisol levels were increased in TESu compared to TB, T30 and TR. Limb spasticity, muscle tremors, opisthotonos and diarrhea were observed in some animals during propofol infusion and ceased with the end of CRI. Reactions happened at different moments and lasted for different periods of time in each individual. Epidural with levobupivacaine alone or combined with morphine allowed for ovariohysterectomy to be performed under low propofol infusion rates, with minimal changes in cardiovascular variables and in serum cortisol levels. Adverse effects were observed in very few animals in each group.
Collapse
|
17
|
Chow DWY, Wong MY, Westermeyer HD. Comparison of two bupivacaine delivery methods to control postoperative pain after enucleation in dogs. Vet Ophthalmol 2015; 18:422-8. [DOI: 10.1111/vop.12259] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Derek W. Y. Chow
- Veterinary Specialty Hospital; 1/F, 165 Wanchai Road Wan Chai Hong Kong
| | - Man Yu Wong
- Department of Mathematics; The Hong Kong University of Science & Technology; Clear Water Bay Kowloon Hong Kong
| | - Hans D. Westermeyer
- NC State College of Veterinary Medicine1060 William Moore Drive; North Carolina State University; Raleigh NC 27606 USA
| |
Collapse
|
18
|
Ploog CL, Swinger RL, Spade J, Quandt KM, Mitchell MA. Use of lidocaine-bupivacaine–infused absorbable gelatin hemostatic sponges versus lidocaine-bupivacaine retrobulbar injections for postoperative analgesia following eye enucleation in dogs. J Am Vet Med Assoc 2014; 244:57-62. [DOI: 10.2460/javma.244.1.57] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
19
|
Hansen B, Lascelles BDX, Thomson A, DePuy V. Variability of performance of wound infusion catheters. Vet Anaesth Analg 2013; 40:308-15. [PMID: 23406507 DOI: 10.1111/vaa.12016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 02/27/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the distribution of flow from two commercial and one handmade multihole wound infusion catheters. STUDY DESIGN Open label experimental measurement of flow distribution in a bench top apparatus of handmade (n = 10) and two commercial (n = 10 each) wound infusion catheters with 5-6'' (12-15.2 cm) long diffusion surfaces. METHODS The distribution of 6 mL of distilled water injected at three different injection speeds (0.5, 5, and 120 minutes) through individual triangular pieces of felt cloth fitted over six contiguous regions of the diffusion surface of each catheter was measured in triplicate. RESULTS The distribution of flow through the six regions was significantly more uniform at the two faster injection speeds. Ninety two per cent of the 120 minute infusion trials resulted in one or more regions producing negligible flow (<5% of total output), and in 16% of the 120 minute trials all the flow came from just one or two regions. CONCLUSIONS Constant-rate infusions of 3 mL hour(-1) provide erratic distribution of flow from wound infusion catheters in a bench top apparatus. Commercial catheters did not outperform handmade catheters. CLINICAL RELEVANCE Uneven distribution of flow at low infusion speeds may contribute to inconsistent or unsatisfactory pain relief in patients treated with continuous wound infusions of local anesthetics.
Collapse
Affiliation(s)
- Bernie Hansen
- Comparative Pain Research Laboratory, North Carolina State University College of Veterinary Medicine, Raleigh, NC 27607, USA.
| | | | | | | |
Collapse
|
20
|
Mastrocinque S, Almeida TF, Tatarunas AC, Imagawa VH, Otsuki DA, Matera JM, Fantoni DT. Comparison of Epidural and Systemic Tramadol for Analgesia Following Ovariohysterectomy. J Am Anim Hosp Assoc 2012; 48:310-9. [DOI: 10.5326/jaaha-ms-5795] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The objective of the study was to compare epidural and systemic tramadol for postoperative analgesia in bitches undergoing ovariohysterectomy. Twenty animals, randomly divided into two groups, received either epidural (EPI) or intramuscular (IM) tramadol (2 mg/kg) 30 min before anesthetic induction. Analgesia, sedation, cardiorespiratory parameters, end-tidal isoflurane, blood catecholamines and cortisol, and arterial blood gases were measured at different time points up to 24 hr after agent administration. There were no differences between the two groups regarding cardiorespiratory parameters, end-tidal isoflurane, and pain scores. Two dogs in the IM and one in the EPI group required supplemental analgesia. Cortisol was increased (P<0.05) at 120 min (3.59 μg/dL and 3.27μg/dL in the IM and EPI groups, respectively) and 240 min (2.45 μg/dL and 2.54μg/dL in the IM and EPI groups, respectively) compared to baseline. Norepinephrine was also increased (P<0.05) at 120 min in both groups compared to baseline values. Epinephrine values were higher (P<0.05) in the IM group compared with the EPI group at 50 min, 120 min, and 1,440 min after tramadol administration. Epidural tramadol is a safe analgesic, but does not appear to have improved analgesic effects compared with IM administration.
Collapse
Affiliation(s)
- Sandra Mastrocinque
- Department of Surgery, School of Veterinary Medicine and Animal Sciences, (S.M., T.A., A.T., J.M., D.F.) and Department of Surgery, School of Medicine (V.I., D.O.), University of São Paulo, São Paulo, Brazil
| | - Tatiana F. Almeida
- Department of Surgery, School of Veterinary Medicine and Animal Sciences, (S.M., T.A., A.T., J.M., D.F.) and Department of Surgery, School of Medicine (V.I., D.O.), University of São Paulo, São Paulo, Brazil
| | - Angélica C. Tatarunas
- Department of Surgery, School of Veterinary Medicine and Animal Sciences, (S.M., T.A., A.T., J.M., D.F.) and Department of Surgery, School of Medicine (V.I., D.O.), University of São Paulo, São Paulo, Brazil
| | - Viviani H. Imagawa
- Department of Surgery, School of Veterinary Medicine and Animal Sciences, (S.M., T.A., A.T., J.M., D.F.) and Department of Surgery, School of Medicine (V.I., D.O.), University of São Paulo, São Paulo, Brazil
| | - Denise A. Otsuki
- Department of Surgery, School of Veterinary Medicine and Animal Sciences, (S.M., T.A., A.T., J.M., D.F.) and Department of Surgery, School of Medicine (V.I., D.O.), University of São Paulo, São Paulo, Brazil
| | - Julia M. Matera
- Department of Surgery, School of Veterinary Medicine and Animal Sciences, (S.M., T.A., A.T., J.M., D.F.) and Department of Surgery, School of Medicine (V.I., D.O.), University of São Paulo, São Paulo, Brazil
| | - Denise T. Fantoni
- Department of Surgery, School of Veterinary Medicine and Animal Sciences, (S.M., T.A., A.T., J.M., D.F.) and Department of Surgery, School of Medicine (V.I., D.O.), University of São Paulo, São Paulo, Brazil
| |
Collapse
|
21
|
Neves CS, Balan JAO, Pereira DR, Stevanin H, Cassu RN. A comparison of extradural tramadol and extradural morphine for postoperative analgesia in female dogs undergoing ovariohysterectomy. Acta Cir Bras 2012; 27:312-7. [DOI: 10.1590/s0102-86502012000400006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 02/22/2012] [Indexed: 11/21/2022] Open
Abstract
PURPOSE: To compare the postoperative analgesic effects of the extradural tramadol or morphine in female dogs undergoing ovariohysterectomy. METHODS: Sixteen female dogs were randomly assigned to two groups of eight animals each and received morphine (0.1mg kg-1 M group) or tramadol (2mg kg-1 T group). The pre-anesthetic medication was intravenously (iv) acepromazine (0.05mg kg-1). Anesthesia was induced with propofol (4mg kg-1iv) and maintained with isoflurane. The degree of analgesia was evaluated using a numerical rating scale that included physiologic and behavior variables. Dogs were scored at one, three, six and 12 hours after surgery by one blinded observer. Dogs were treated with morphine (0.5mg kg-1) if their scores were >6. Serum cortisol was measured before the pre-anesthetic medication was administered (basal), at the time of the ovarian pedicle clamping (T0), and at 1 (T1), 6 (T6) and 12 (T12) hours postoperative. RESULTS: The pain score did not differ between morphine and tramadol treatments. Rescue analgesia was administered to one dog in the T treatment group. Serum cortisol did not differ between treatments. CONCLUSION: The extradural administration of morphine or tramadol is a safe and effective method of inducing analgesia in female dogs undergoing ovariohyterectomy.
Collapse
|
22
|
Smeak DD. Management of complications associated with total ear canal ablation and bulla osteotomy in dogs and cats. Vet Clin North Am Small Anim Pract 2011; 41:981-94, vii. [PMID: 21889696 DOI: 10.1016/j.cvsm.2011.05.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Total ear canal ablation combined with bulla osteotomy is a salvage procedure recommended primarily for end-stage inflammatory ear canal disease but also for neoplasia and severe traumatic injuries. Due to the complexity of the procedure and the poor exposure associated with the surgical approach, there is significant risk for a variety of complications. This review discusses intraoperative, early postoperative, and late postoperative complications reported in large retrospective studies, the causes for these complications, and recommendations about how to prevent them.
Collapse
Affiliation(s)
- Daniel D Smeak
- Department of Veterinary Clinical Sciences, Colorado State University, College of Veterinary Medicine and Biomedical Sciences, Veterinary Teaching Hospital, 300 West Drake Road, Fort Collins, CO 80523, USA.
| |
Collapse
|
23
|
Pharmacokinetics, intraoperative effect and postoperative analgesia of tramadol in cats. Res Vet Sci 2011; 90:503-9. [DOI: 10.1016/j.rvsc.2010.07.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2009] [Revised: 07/12/2010] [Accepted: 07/20/2010] [Indexed: 11/19/2022]
|
24
|
Myrna KE, Bentley E, Smith LJ. Effectiveness of injection of local anesthetic into the retrobulbar space for postoperative analgesia following eye enucleation in dogs. J Am Vet Med Assoc 2010; 237:174-7. [DOI: 10.2460/javma.237.2.174] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
25
|
Vettorato E, Zonca A, Isola M, Villa R, Gallo M, Ravasio G, Beccaglia M, Montesissa C, Cagnardi P. Pharmacokinetics and efficacy of intravenous and extradural tramadol in dogs. Vet J 2010; 183:310-5. [DOI: 10.1016/j.tvjl.2008.11.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2008] [Revised: 10/24/2008] [Accepted: 11/02/2008] [Indexed: 11/26/2022]
|
26
|
MAEDA K, SAKONJU I, KUMAKURA A, TOMIZAWA Z, KAKUTA T, SHIMAMURA S, OKANO S, TAKASE K. Effects of Lidocaine Hydrochloride on Canine Granulocytes, Granulocyte CD11b Expression and Reactive Oxygen Species Production. J Vet Med Sci 2010; 72:141-7. [DOI: 10.1292/jvms.09-0157] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Iwao SAKONJU
- School of Veterinary Medicine, Kitasato University
| | | | | | | | | | - Shozo OKANO
- School of Veterinary Medicine, Kitasato University
| | | |
Collapse
|
27
|
Abstract
The biggest challenge to the use of analgesic agents in animals is the determination of the efficacy of these agents. In humans, the verbal communication of the alleviation of pain is fundamental to the effective use of analgesics. In animals, the lack of verbal communication not only confounds the diagnosis and characterisation of the experience of pain, but also challenges the evaluation of the analgesic therapy. As animals possess the same neuronal pathways and neurotransmitter receptors as humans, it seems reasonable to expect that their perceptions of painful stimuli will be similar, and this is a basis for the use of laboratory animals for screening of analgesics for human use. However, as the evaluation in the laboratory animal tests is based mainly on behavioural responses, and although some physiological responses do occur, it is often difficult to separate these from stress responses. The use of behavioural responses to evaluate analgesics in a range of species is complicated by the fact that different species show different behaviours to a similar pain stimulus, and different pain stimuli produce different pain responses in the same species. Thus behaviours may be species- and pain-specific and this can complicate analgesic evaluation. As most animals possess similar neuronal mechanisms to humans for pain perception, it is not surprising that the standard human pain control strategies can be applied to animals. For instance, local anaesthetics, opioids, non-steroidal anti-inflammatory drugs (NSAIDs), as well as other analgesics used in humans are all found to be effective for animal use. Differences in metabolism and distribution between various species, as well as financial considerations in larger animals can affect efficacy and thus limit their use. In addition, the use of any drug in a species that may be intended for human consumption will be limited by residue considerations. The treatment of pain in animals presents many challenges, but the increasing public concerns regarding animal welfare will ensure that studies into the nature and control of animal pain will continue to have a high profile.
Collapse
Affiliation(s)
- Alex Livingston
- Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK S7N5B4, Canada.
| |
Collapse
|
28
|
Laing S, Paul V, Murison PJ. The effects of nitrous oxide on recovery from isoflurane anaesthesia in dogs. J Small Anim Pract 2009; 50:82-6. [DOI: 10.1111/j.1748-5827.2008.00689.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
29
|
Hansen B. Analgesia for the critically ill dog or cat: an update. Vet Clin North Am Small Anim Pract 2009; 38:1353-63, vii. [PMID: 18954688 DOI: 10.1016/j.cvsm.2008.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Acute pain reliably accompanies severe illness and injury, and when sufficiently severe, it can complicate the recovery of critically ill patients. Because acute pain is closely tied to the neurologic process of nociception, pharmacologic therapy is often essential and effective. This update focuses on two methods of treatment of acute pain-local anesthetic infusion and continuous intravenous infusion of multimodal agents-that can be layered on top of standard care with other drugs.
Collapse
Affiliation(s)
- Bernie Hansen
- Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, 4700 Hillsborough Street, Raleigh, NC 27606, USA.
| |
Collapse
|
30
|
BUBENIK LORETTA, HOSGOOD GISELLE, BARKER STEVEN, HICKS MERRIN, SERRA VERNA, STOUT RHETT. Estimated Plasma Bupivacaine Concentration After Single Dose and Eight-Hour Continuous Intra-Articular Infusion of Bupivacaine in Normal Dogs. Vet Surg 2007; 36:783-91. [DOI: 10.1111/j.1532-950x.2007.00337.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
31
|
Wolfe TM, Bateman SW, Cole LK, Smeak DD. Evaluation of a local anesthetic delivery system for the postoperative analgesic management of canine total ear canal ablation--a randomized, controlled, double-blinded study. Vet Anaesth Analg 2007; 33:328-39. [PMID: 16916355 DOI: 10.1111/j.1467-2995.2005.00272.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine if a constant rate local anesthetic delivery system is more effective than continuous intravenous (IV) morphine infusion for postoperative analgesia. ANIMALS Twenty client-owned dogs undergoing total ear canal ablation. METHODS Dogs were randomly assigned to the lidocaine group (LID) or the morphine group (MOR). The LID group received a constant rate infusion of lidocaine locally and a continuous IV infusion of saline, while the MOR group received a constant rate infusion of saline locally and a continuous IV infusion of morphine. The primary investigator evaluated each patient and determined a hospital behavior score, anesthesia recovery score, preoperative pain score, and serial postoperative pain and sedation scores over 38 hours. Pain and sedation observations were videotaped and scored by three additional evaluators. Evaluators were blinded to treatment assignments. RESULTS There were no significant differences in age, weight, hospital behavior scores or anesthesia recovery scores. The primary investigator's pain scores were not significantly different, but sedation scores were significantly lower for the LID group. Sedation and pain scores by the video evaluators were not significantly different between groups. Kappa agreement between observers was poor, but better agreement was noted between sedation scores than pain scores. Drug-related complications were significantly lower in the LID group (n = 0) compared with the MOR group (n = 5). Wound complications were not significantly different (LID = 4, MOR = 4). Intravenous delivery complications occurred in 12 (60%) patients. Local delivery complications occurred in five (25%) dogs. Delivery complications were not significantly different between groups. CONCLUSIONS AND CLINICAL RELEVANCE Continuous incisional lidocaine delivery was an equipotent and viable method of providing postoperative analgesia compared with IV morphine. Lidocaine delivery resulted in a trend toward lower pain scores, significantly lower sedation scores, and no dogs requiring analgesic rescue. Wound complications secondary to local infusion were minor and self-limiting. Drug-related complications occurred only in the MOR group.
Collapse
Affiliation(s)
- Tina M Wolfe
- Cincinnati Animal Referral and Emergency Center, Cincinnati, OH 45249, USA.
| | | | | | | |
Collapse
|
32
|
Rasmussen LM, Lipowitz AJ, Graham LF. Controlled, clinical trial assessing saphenous, tibial and common peroneal nerve blocks for the control of perioperative pain following femoro-tibial joint surgery in the nonchondrodystrophoid dog. Vet Anaesth Analg 2006; 33:49-61. [PMID: 16412132 DOI: 10.1111/j.1467-2995.2005.00235.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine whether bupivacaine peripheral nerve block of the saphenous, tibial and common peroneal nerves proximal to the femoro-tibial joint reduces peri-operative pain following extracapsular surgical stabilization of cranial cruciate ligament rupture in the nonchondrodystrophoid dog. ANIMALS Forty-one dogs with naturally acquired femoro-tibial joint instability. Study design Randomized, controlled, clinical trial. METHODS Dogs diagnosed with suspected cranial cruciate ligament injury based on physical and radiographic evidence were randomly assigned to treatment (bupivacaine) or control (saline) nerve blocks before femoro-tibial joint surgery. Pain scores, skin sensation, pain threshold to incisional pressure, time to first systemic 'rescue' opioid analgesic and total analgesic dose were evaluated for 24 hours. p < 0.05 was considered significant. RESULTS Treatment dogs had a significantly longer period of cutaneous desensitization than control dogs. There were no significant differences between treatment and control groups for pain score, pain threshold to incisional pressure, or time to first-rescue analgesic. The treatment group received significantly more supplemental analgesics than the control group. CONCLUSIONS These peripheral nerve blocks were easy to perform and resulted in significant desensitization of the associated nerve autonomous zones, but did not improve post-operative analgesia. CLINICAL RELEVANCE Clinical benefit was not detected when using this technique for peri-operative pain management following extracapsular cranial cruciate ligament surgical stabilization.
Collapse
Affiliation(s)
- Lara M Rasmussen
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA, USA.
| | | | | |
Collapse
|
33
|
Radlinsky MG, Mason DE, Roush JK, Pineda R. Use of a continuous, local infusion of bupivacaine for postoperative analgesia in dogs undergoing total ear canal ablation. J Am Vet Med Assoc 2005; 227:414-9. [PMID: 16121607 DOI: 10.2460/javma.2005.227.414] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether addition of a continuous, local infusion of bupivacaine would improve postoperative analgesia in dogs undergoing total ear canal ablation. DESIGN Randomized controlled trial. ANIMALS 16 dogs undergoing total ear canal ablation (12 unilaterally and 4 bilaterally with > 1 month between procedures). PROCEDURE Dogs were randomly allocated to receive morphine (0.25 mg/kg [0.11 mg/lb]) at the end of the procedure (10 procedures) or morphine and a continuous, local infusion of bupivacaine (0.13 to 0.21 mg/kg/h [0.06 to 0.1 mg/lb/h]; 10 procedures). Dogs were observed for 48 hours after surgery. Additional doses of morphine were administered up to every 4 hours in dogs with signs of severe pain. RESULTS Temperament, sedation, analgesia, and cumulative pain scores were not significantly different between groups any time after surgery. Recovery score was significantly higher for dogs that received bupivacaine than for control dogs 2 hours after extubation but not at any other time. Serum cortisol concentration was not significantly different between groups at any time but, in both groups, was significantly increased at the time of extubation, compared with all other observation times. Total number of additional doses of morphine administered was not significantly different between groups. Bupivacaine was not detected in the plasma of any of the dogs that received the local bupivacaine infusion. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that addition of a continuous, local infusion of bupivacaine did not significantly increase the degree of postoperative analgesia in dogs that underwent total ear canal ablation and were given morphine at the end of surgery.
Collapse
Affiliation(s)
- MaryAnn G Radlinsky
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506-5606, USA
| | | | | | | |
Collapse
|
34
|
Romans CW, Gordon WJ, Robinson DA, Evans R, Conzemius MG. Effect of postoperative analgesic protocol on limb function following onychectomy in cats. J Am Vet Med Assoc 2005; 227:89-93. [PMID: 16013541 DOI: 10.2460/javma.2005.227.89] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the analgesic effects of topical administration of bupivacaine, i.m. administration of butorphanol, and transdermal administration of fentanyl in cats undergoing onychectomy. DESIGN Prospective study. ANIMALS 27 healthy adult cats. PROCEDURE Cats were randomly assigned to 1 of 3 treatment groups, and unilateral (left forefoot) onychectomy was performed. Gait analysis was performed before and 1, 2, 3, and 12 days after surgery. All forces were expressed as a percentage of the cat's body weight. RESULTS On day 2, peak vertical force (PVF) was significantly decreased in cats treated with bupivacaine, compared with cats treated with butorphanol or fentanyl. The ratio of left forelimb PVF to PVF of the other 3 limbs was significantly lower on day 2 in cats treated with bupivacaine than in cats treated with fentanyl. No significant differences in vertical impulse (VI) were found between groups on any day. Values for PVF, VI, and the PVF ratio increased progressively following surgery. However, for all 3 groups, values were still significantly decreased, compared with baseline values, 12 days after surgery. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that limb function following onychectomy is significantly better in cats treated with fentanyl transdermally or butorphanol i.m. than in cats treated with bupivacaine topically. Regardless of the analgesic regimen, limb function was still significantly reduced 12 days after surgery, suggesting that long-term analgesic treatment should be considered for cats undergoing onychectomy. Irrigation of the surgical incisions with bupivacaine prior to wound closure cannot be recommended as the sole method for providing postoperative analgesia in cats undergoing onychectomy.
Collapse
Affiliation(s)
- Cory W Romans
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011, USA
| | | | | | | | | |
Collapse
|
35
|
Abstract
There are several disease processes of the ear and pinna that warrant surgical intervention. This article reviews surgical anatomy and common surgical procedures of the ear and pinna, including aural hematomas, lateral wall resection, vertical ear canal resection, total ear canal ablation and lateral bulla osteotomy, partial pinna resection, and feline inflammatory polyps. The clinical signs, diagnosis, and surgical treatment along with potential complications for each disease process are discussed.
Collapse
Affiliation(s)
- Otto I Lanz
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College.
| | | |
Collapse
|
36
|
Doyle RS, Skelly C, Bellenger CR. Surgical management of 43 cases of chronic otitis externa in the dog. Ir Vet J 2004; 57:22-30. [PMID: 21851652 PMCID: PMC3113813 DOI: 10.1186/2046-0481-57-1-22] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Over a seven-year period, chronic otitis externa was surgically managed in 43 dogs at the University Veterinary Hospital of University College Dublin. Lateral ear canal resection (LECR) was undertaken in nine of the 43 dogs: results were unsatisfactory, with a failure of the surgery in five of eight dogs and one dog lost to follow-up. Once end-stage otitis externa, with or without otitis media, is diagnosed, total ear canal ablation and lateral bulla osteotomy (TECA/LBO) is the best treatment option. In this series, 37 of 43 dogs underwent TECA/LBO and of the 29 dogs for which follow-up results were obtained 27 (93%) had an excellent or improved outcome to surgery. Complications following all procedures were most common in cases with a concurrent dermatopathy; therefore, definitive diagnosis and medical treatment for skin and ear disease is essential.
Collapse
Affiliation(s)
- Ronan S Doyle
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
| | | | | |
Collapse
|
37
|
Abstract
Hundreds of thousands of animals are presented to US veterinarians annually for surgery or for evaluation of painful disease. This large population offers the opportunity for clinical research of both acute and chronic pain syndromes. Although there is growing interest by veterinary clinical specialists to explore the nature of animal pain and how best to treat it, this resource is relatively unknown to the pain research community. Computer-assisted collection of behavioral data has created new opportunities for characterizing the pain experience in animal species for the benefit of both animals and humans. This review describes the current state of veterinary clinical pain studies in dogs and an application of computer-assisted behavioral analysis.
Collapse
Affiliation(s)
- Bernie D Hansen
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| |
Collapse
|
38
|
Abstract
Local anesthetics have the unique ability to produce complete blockade of sensory nerve fibers and prevent or pre-empt the development of secondary (central) sensitization to pain. For this reason, local and regional anesthetic techniques are often used with opioids, alpha 2-receptor agonists, dissociatives, and anti-inflammatory drugs as part of a multimodal strategy to manage pain. Lidocaine and bupivacaine are the local anesthetics used most commonly in dogs and cats. Lidocaine has a fast onset (10-15 min) and an intermediate duration of action (60-120 min), and is used for short diagnostic and surgical procedures. Bupivacaine has a slow onset (20-30 min) and a long duration of action (240-360 min), and is used to control pain both preoperatively and postoperatively. Local anesthetics are relatively safe if they are administered correctly. Administration of an excessive dose and accidental intravenous administration are probably the most common causes of systemic toxicity in small animals. Doses of local anesthetics, especially those for cats and small dogs, should always be calculated carefully. In many animals, the most simple and elegant way to control pain perioperatively is to perform a local or regional anesthetic block. Veterinarians should not hesitate to incorporate local and regional anesthetic techniques into their pain management strategies for dogs and cats.
Collapse
Affiliation(s)
- K A Lemke
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Canada
| | | |
Collapse
|
39
|
Abstract
We encounter patients with acute pain many times each day, and few aspects of veterinary practice offer such an opportunity to help so many in such a profoundly rewarding way. As emphasized here and elsewhere, we now have excellent tools with which to help these animals, and the biggest impediment to optimal treatment of their pain is often our own difficulty in recognizing its presence. Perhaps the single most important aspect of treating acute pain is to cultivate an ability to see past our personal biases and expectations which may limit treatment and to rediscover the common sense we had about pain before we entered the profession. By rededicating ourselves to seeking out, preventing, and relieving pain, we not only perform a vital service for our patients but also elevate our profession even as we reap financial and spiritual rewards for our efforts. What could be better?
Collapse
Affiliation(s)
- B Hansen
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, USA
| |
Collapse
|
40
|
Abstract
There has been a substantial increase in the use of analgesics for pain management in the last 10 years. Traditionally, veterinarians have not been trained in the identification of or monitoring of patients that are in pain, even though an evaluation of pain is inherent in assessing improvement in many medical and surgical diseases. Until recently, the physiology and pharmacology of opioids, NSAIDs, local anesthetics, and alpha 2 agonists were taught, but the therapeutic role of these drugs was generally believed to be related to restraint, anesthesia, or control of inflammation rather than to pain management.
Collapse
Affiliation(s)
- G L Carroll
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station, USA
| |
Collapse
|
41
|
Hansen B. Through a glass darkly: using behavior to assess pain. SEMINARS IN VETERINARY MEDICINE AND SURGERY (SMALL ANIMAL) 1997; 12:61-74. [PMID: 9159063 DOI: 10.1016/s1096-2867(97)80003-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Behavior assessment is crucial to the process of evaluation of pain and discomfort in veterinary patients. Behavioral responses to pain and other stressors are a function of the interaction between the individual and its environment, and are influenced by many factors including species, breed, age, sex, source of pain, and coexisting disease. Behavioral changes associated with acute postoperative pain typically peak within 24 hours and wane progressively thereafter. The intensity and duration of postoperative pain correlate with the location and extent of tissue injury, but there is much inter-patient variation of each characteristic. Published methods of systematic evaluation of pain in animals include objective measures of physiologic responses to experimental pain, subjective or semi-objective assessment of postoperative behavior, and quantitative measures of postoperative behavior and physiology. The techniques of quantitative measures of behavior are similar to pain-rating instruments developed for use in young children. Although objective assessment tools are difficult to develop and time consuming to apply, their methodological rigor and objectivity allow evaluation of behavior with minimal observer bias. Until objective assessment tools become widely used clinically, the best approach is to actively seek out evidence of pain in our patients, assuming its presence whenever there is tissue injury or inflammation.
Collapse
Affiliation(s)
- B Hansen
- North Carolina State University, College of Veterinary Medicine, Department of Companion Animal and Special Species Medicine, Raleigh 27606, USA
| |
Collapse
|
42
|
Pascoe P. Local and regional anesthesia and analgesia. SEMINARS IN VETERINARY MEDICINE AND SURGERY (SMALL ANIMAL) 1997; 12:94-105. [PMID: 9159066 DOI: 10.1016/s1096-2867(97)80006-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Many benefits can be obtained from the use of drugs applied locally or regionally when treating dogs and cats that are in pain or will be in pain because of surgical trauma. These techniques often use less medication than for systemic administration with a reduction in the likelihood of toxic effects from these compounds. Complete relief of pain can be achieved by blocking nerves originating from the site of injury by using local anesthetics, but this may entail loss of all sensation and motor paralysis. Other drugs, such as the opioids, may decrease the nociceptive input with minimal effect on motor activity. This report discusses the use of local anesthetics and other drugs for analgesia of the skin, mucous membranes, joints, pleura, and peritoneum, and the application of these drugs for regional blocks of peripheral nerves and epidural/intrathecal injection.
Collapse
Affiliation(s)
- P Pascoe
- School of Veterinary Medicine, Department of Surgery, University of California, Davis 95616, USA
| |
Collapse
|