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Upchurch D, Lin KTT, KuKanich B. Two doses of subcutaneous methadone for postoperative analgesia in dogs undergoing tibial plateau levelling osteotomies. J Small Anim Pract 2024; 65:368-375. [PMID: 38594836 DOI: 10.1111/jsap.13728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/28/2024] [Accepted: 03/20/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVES To evaluate analgesia, sedation and adverse effects of two doses of subcutaneous methadone in dogs undergoing tibial plateau levelling osteotomy. MATERIALS AND METHODS Seventeen client-owned dogs undergoing unilateral tibial plateau levelling osteotomy were randomly allocated to receive either 0.25 mg/kg methadone (eight dogs) or 0.5 mg/kg methadone (nine dogs). All dogs were premedicated with methadone and 2 to 6 mcg/kg dexmedetomidine subcutaneously. They were induced and maintained on a standard protocol. All animals received a second dose of methadone subcutaneously 4 hours after premedication and a 4.4 mg/kg dose of carprofen subcutaneously at 8 hours after premedication. During surgery, blood pressure, heart rate and temperature were assessed every 5 minutes. Postoperatively, sedation scores, temperature, heart rate and Glasgow composite modified pain score - short form were assessed for 12 hours postoperatively. RESULTS One of 17 (5.9%) dogs had intraoperative hypotension, nine of 17 dogs had intra-operative bradyarrhythmias and 17 of 17 dogs had intra-operative hypothermia. No dogs required intra-operative rescue. Composite modified pain score - short form scores were below the threshold for intervention in 16 of 17 (94.1%) animals. Only one of 17 (5.9%) dogs required rescue analgesia. Median sedation score was 0 by the T8 time point. Adverse events were rare in both groups with only vocalisation and hypothermia reported commonly postoperatively. CLINICAL SIGNIFICANCE Two doses of methadone at either 0.25 or 0.5 mg/kg administered via subcutaneous injections pre-operatively and 4 hours later, along with 4.4 mg/kg carprofen subcutaneously 8 hours after the first methadone dose appear to provide sufficient pain control for up to 12 hours in dogs undergoing tibial plateau levelling osteotomy.
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Affiliation(s)
- D Upchurch
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, 66506, USA
| | - K T T Lin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, 48824, USA
| | - B KuKanich
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, 66506, USA
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Di Franco C, Evangelista F, Briganti A. Multiple uses of dexmedetomidine in small animals: a mini review. Front Vet Sci 2023; 10:1135124. [PMID: 37342619 PMCID: PMC10278766 DOI: 10.3389/fvets.2023.1135124] [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: 12/31/2022] [Accepted: 05/10/2023] [Indexed: 06/23/2023] Open
Abstract
Dexmedetomidine is an alpha-2 adrenergic agonist, which use had an exponential increase in human and veterinary medicine in the last 10 years. The aim of this mini review is to summarize the various uses of dexmedetomidine underlining its new applications and capabilities in the small animals' clinical activity. While this drug was born as sedative in veterinary medicine, some studies demonstrated to be effective as an analgesic both in single administration and in continuous infusion. Recent studies have also shown the role of dexmedetomidine as an adjuvant during locoregional anesthesia, increasing the duration of the sensitive block and consequently decreasing the demand for systemic analgesics. The various analgesic properties make dexmedetomidine an interesting drug for opioid-free analgesia. Some studies highlighted a potential neuroprotective, cardioprotective and vasculoprotective role of dexmedetomidine, thus conferring it a place in critical care medicine, such as trauma and septic patients. Dexmedetomidine has demonstrated to be a multitasking molecule and it is ready to face new challenges.
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Affiliation(s)
- Chiara Di Franco
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Flavia Evangelista
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
- Vet Hospital H24, Firenze, Italy
| | - Angela Briganti
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
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Di Bella C, Pennasilico L, Botto R, Salvaggio A, Galosi M, Staffieri F, Piccionello AP. Efficacy of dexmedetomidine as adjuvant to bupivacaine in femoral-sciatic nerve blocks in dogs undergoing tibial plateau levelling osteotomy (TPLO). Res Vet Sci 2023; 154:124-131. [PMID: 36584520 DOI: 10.1016/j.rvsc.2022.12.015] [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: 09/11/2022] [Revised: 12/18/2022] [Accepted: 12/24/2022] [Indexed: 12/28/2022]
Abstract
The aim of this randomized, prospective clinical study was to evaluate the efficacy of dexmedetomidine combined with bupivacaine on sciatic and femoral nerve blocks in dogs. Thirty dogs were selected for elective unilateral tibial plateau levelling osteotomy, and each subject was assigned randomly to receive perineural bupivacaine 0.5% (0.1 mL/kg) and intramuscular dexmedetomidine (0.5 μg/kg) in the BDs group, perineural bupivacaine 0.5% (0.1 mL/kg) plus dexmedetomidine (0.5 μg/kg) in the BDloc group, and perineural bupivacaine 0.5% (0.1 mL/kg) plus intramuscular administration of saline solution the in Bupi group. Nerve blocks were guided by electrolocation. The main intraoperative parameters were registered 10 min before the start of surgery (BASE) and during the skin incision (SKIN), the osteotomy (BONE) and the suture (SUTURE). At 2, 4, 6, 8, 10, 15, 20 and 24 h after blocks, the Glasgow Composite Pain scale (GPCs) was used to identify the degree of pain during the postoperative period. Patients with scores ≥5/20 received rescue analgesia and were excluded. Furthermore, heart rate, mean arterial pressure, footstep capacity, reaction to wound touch and femoral and sciatic skin sensitivity were registered. Parametric data were compared at each time point of the study with the one-way ANOVA for repeated measures and Fisher's test for yes/no variables analysis (p < 0.05). No subject required intraoperative rescue analgesia. In BDloc group, the GCPs score was <5/20 for all dogs at all times of the study, and 70% of dogs did not need systemic analgesia. In the Bupi and BDs groups, 100% of subjects achieved a score ≥ 5/20 between 8 and 10 h after the blocks, and 100% of subjects showed femoral and sciatic skin sensitivity and required rescue analgesia within 10 h. Our results showed that the addition of dexmedetomidine as an adjuvant to bupivacaine in SF blocks may prolong the sensory block and ensure sufficient analgesia for up to 24 h in dogs undergoing TPLO surgery.
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Affiliation(s)
- Caterina Di Bella
- School of Bioscience and Veterinary Medicine, University of Camerino, Camerino, Italy.
| | - Luca Pennasilico
- School of Bioscience and Veterinary Medicine, University of Camerino, Camerino, Italy.
| | - Riccardo Botto
- School of Bioscience and Veterinary Medicine, University of Camerino, Camerino, Italy.
| | - Alberto Salvaggio
- School of Bioscience and Veterinary Medicine, University of Camerino, Camerino, Italy
| | - Margherita Galosi
- School of Bioscience and Veterinary Medicine, University of Camerino, Camerino, Italy.
| | - Francesco Staffieri
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantations, University of Bari, Bari, Italy.
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Caramalac SM, Albuquerque VB, Oliveira AR, Caramalac SM, Jardim PHDEA, Barbosa CF, Frazílio FDEO. Analgesic, cardiorespiratory effects and motor block characteristics of epidural levobupivacaine alone or in combination with methadone or dexmedetomidine in bitches undergoing unilateral total mastectomy. AN ACAD BRAS CIENC 2022; 94:e20210082. [PMID: 36477226 DOI: 10.1590/0001-3765202220210082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/17/2021] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to evaluate the latency, extent of analgesia, and duration of motor block of levobupivacaine alone and combined with methadone or dexmedetomidine after epidural administration during and after mastectomy in dogs. Twenty-four mature, mixed-breed female dogs were randomly divided into three experimental groups with eight animals each, according to the agents used in lumbosacral epidural analgesia: levobupivacaine 0.75% alone (1.5mg/kg - control group), levobupivacaine 0.75% (1.5 mg/kg) + methadone 1% (0.3 mg/kg), or levobupivacaine 0.75% (1.5 mg/kg) + dexmedetomidine 0.05% (3 µg/kg). During surgery, cardiorespiratory parameters were evaluated. Rescue analgesia was given when there were signs of nociception and was necessary in all three treatment groups. Since all animals received rescue analgesia during the surgery and immediately post-surgery, the duration of the sensitive block were not evaluated. The extent of sensory block was between the 12º and 13º thoracic vertebrae for the control group, 7º thoracic vertebra to 5º lumbar vertebra (methadone group), and 8º thoracic vertebra to 4º lumbar vertebra for the dexmedetomidine group. Methadone or dexmedetomidine combined with levobupivacaine increased the extent of the sensory block and the duration of the motor block in bitches when administered via the epidural route.
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Affiliation(s)
- Simone M Caramalac
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
| | - Veronica B Albuquerque
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
| | - Alice R Oliveira
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Faculdade de Medicina Veterinária e Zootecnia, Departamento de Anestesiologia de Medicina Veterinária, Campus Botucatu, Rua Prof. Doutor Walter Mauricio Correa, s/n, 18618-681 Botucatu, SP, Brazil
| | - Silvana M Caramalac
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
| | - Paulo Henrique DE A Jardim
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
| | - Carolynne F Barbosa
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
| | - Fabrício DE O Frazílio
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
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Local and Regional Anaesthetic Techniques in Canine Ovariectomy: A Review of the Literature and Technique Description. Animals (Basel) 2022; 12:ani12151920. [PMID: 35953908 PMCID: PMC9367435 DOI: 10.3390/ani12151920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/05/2022] [Accepted: 07/26/2022] [Indexed: 11/17/2022] Open
Abstract
Simple Summary This review stems from a general trend of increasing attention toward surgical nociception in the veterinary field. Indeed, veterinarian anaesthetists are becoming more careful in relieving perioperative nociception, improving the analgesic protocols and therefore optimising surgical outcomes. Canine ovariectomy is a common surgical procedure with a moderate level of pain. Therefore, intraoperative analgesia is very important because pain causes various systemic inflammatory effects that slow patient recovery. This review aims to collect all recent information about local and regional anaesthetic/analgesic techniques in a review of the literature describing the technique utilised. In addition, the present review aims to provide practical guidelines for veterinary practitioners to improve the anaesthetic techniques in canine neutering through an overview of the available literature. In fact, the methods described, considering the relative simplicity of execution, can be used in daily routine practice. Abstract Canine ovariectomy is an elective surgery with a moderate level of pain. Despite its relative simplicity, it requires surgical pain management. This study aimed to collect all recent information about local and regional anaesthetic/analgesic techniques in a review of the literature describing the technique utilised. The various procedures described in this review use local anaesthetics to improve analgesia in the routine systemic anaesthetic protocol. The approach described in this paper is called multimodal analgesia and is used in addition to the normal standard anaesthetic protocol. These techniques proved effective in minimising responses to the surgical stimulus and ensured adequate intraoperative and postoperative analgesia. The routine use of multimodal analgesia is considered a useful alternative for pain management in canine ovariectomy, in that it minimises patient suffering, improves the recovery of rescue analgesia, increases drug savings, and improves animal outcomes. In addition, the use of these local and regional techniques ensures satisfactory analgesic coverage that lasts for the first hours postoperatively.
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Camargo J, Teixeira L, Trindade-Gerardi A, Dos Santos B, Da Rosa M, Paim M, Contesini E. LARYNGEAL PARALYSIS FOLLOWING ENDOTRACHEAL INTUBATION IN A DOG: A CASE REPORT. Top Companion Anim Med 2022; 48:100635. [DOI: 10.1016/j.tcam.2022.100635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 10/19/2022]
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Viilmann I, Klöppel H, Wringe E, Vettorato E. Success Rate and Perioperative Complications of Lumbosacral Extradural Anaesthesia in Dogs Undergoing Total Hip Replacement: A Double-Centre Retrospective Study. Vet Comp Orthop Traumatol 2021; 35:81-89. [PMID: 34560807 DOI: 10.1055/s-0041-1736194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The aim of this study was to retrospectively evaluate the success rate and perioperative complications of lumbosacral extradural anaesthesia in dogs undergoing total hip replacement. STUDY DESIGN Records of dogs undergoing total hip replacement in which lumbosacral extradural anaesthesia with 0.5% levo- or bupivacaine combined with either morphine or buprenorphine were retrieved. Success rate was defined as intraoperative fentanyl consumption <1 μg/kg/h with no intravenous infusion of other analgesic drugs and no additional morphine/methadone within the first 3 hours from premedication. Prevalence of intraoperative anaesthetic and postoperative surgical complications was calculated. RESULTS Overall, 206 dogs were included in the study. Success rate was 88.7%. Hypercapnia (75.2%), hypotension (46.1%), hypothermia (27.7%) and regurgitation (6.3%) were recorded during anaesthesia. Within 24 hours post-surgery, urinary retention (17.8%), vomiting/regurgitation/diarrhea (8.2%) and sciatic neurapraxia of the operated limb (5.8%) were recorded. Luxation of the operated hip occurred at 48 and 72 hours after surgery in two dogs and one dog respectively. One dog had cardiopulmonary arrest at 52 hours after surgery. CONCLUSION While hypercapnia, hypotension and hypothermia might develop intraoperatively, the high success rate and the relatively low prevalence of postoperative surgical complications directly associated with lumbosacral extradural anaesthesia justify its use in dogs undergoing total hip replacement.
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Affiliation(s)
- Inga Viilmann
- Dick White Referrals, Six Mile Bottom, Cambridgeshire, United Kingdom
| | - Heide Klöppel
- Davies Veterinary Specialists, Higham Gobion, Hertfordshire, United Kingdom
| | - Elliot Wringe
- Davies Veterinary Specialists, Higham Gobion, Hertfordshire, United Kingdom
| | - Enzo Vettorato
- Dick White Referrals, Six Mile Bottom, Cambridgeshire, United Kingdom
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Santos MA, Lucera TM, Horr M, Santana IN, Mattos-Junior E. Comparative study on epidural administration of dexmedetomidine, dexmedetomidine-lidocaine or lidocaine in conscious rabbits. Lab Anim 2021; 55:341-349. [PMID: 33588626 DOI: 10.1177/0023677221993156] [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] [Indexed: 11/17/2022]
Abstract
The aim of this study was to compare the cardiorespiratory, arterial blood gas and antinociceptive effects of dexmedetomidine (D), dexmedetomidine-lidocaine (DL) or lidocaine (L) administered epidurally on conscious rabbits. Eight six-month-old male New Zealand rabbits were randomly distributed into three treatments: D (2.5 μg/kg); DL (2.5 μg/kg; 2 mg/kg); and L (2 mg/kg). The drugs were injected epidurally via a catheter. Cardiorespiratory, arterial blood gas and antinociceptive variables were recorded before administration, 5 and 10 min after drug administration, then every 10 min until the animals presented a positive response to nociceptive stimulation of perineal dermatomes. Two animals had permanent paralysis after DL treatment due to hemorrhage and congestion with neuron necrosis in spinal cord segments. There was a reduction in mean arterial pressure in treatment L at 5 and 10 min, compared with the baseline, and in treatment DL at 10-30 min. Increases in pH were observed in treatment D at 5 and 10 min, and in DL at all the times evaluated, compared with the baseline. No alterations were observed in other blood gas or electrolyte variables. Antinociceptive effects were evaluated in the perineal, sacral and lumbar regions, and were restricted to the perineal region following D and L treatment. The antinociceptive effects following DL were greater than D and L alone in all of the regions. L and D promotes short-term antinociceptive effects for up to 15 min and, when used in combination with D, increased the duration and extent of sensory block by up to 45 min.
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Affiliation(s)
- Maria Aap Santos
- Veterinary Science Graduate Program, University of Franca, Brazil
| | - Tiago Mc Lucera
- Veterinary Science Graduate Program, University of Franca, Brazil
| | - Mônica Horr
- Veterinary Science Graduate Program, University of Franca, Brazil
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Reader RC, McCarthy RJ, Schultz KL, Volturo AR, Barton BA, O'Hara MJ, Abelson AL. Comparison of liposomal bupivacaine and 0.5% bupivacaine hydrochloride for control of postoperative pain in dogs undergoing tibial plateau leveling osteotomy. J Am Vet Med Assoc 2020; 256:1011-1019. [PMID: 32301662 DOI: 10.2460/javma.256.9.1011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare liposome-encapsulated bupivacaine (LEB) and (nonliposomal) 0.5% bupivacaine hydrochloride (0.5BH) for control of postoperative pain in dogs undergoing tibial plateau leveling osteotomy (TPLO). ANIMALS 33 client-owned dogs. PROCEDURES In a randomized clinical trial, dogs undergoing TPLO received LEB (5.3 mg/kg [2.4 mg/lb]) or 0.5BH (1.5 mg/kg [0.68 mg/lb]) by periarticular soft tissue injection. All dogs received carprofen (2.2 mg/kg [1 mg/lb], SC, q 12 h) beginning at extubation. Signs of pain were assessed at extubation and predetermined times up to 48 hours later with the Colorado State University-Canine Acute Pain Scale and Glasgow Composite Pain Scale-Short Form. A pressure nociceptive threshold device was used at the affected stifle joint before surgery and at 5 postoperative time points. Methadone (0.1 mg/kg [0.05 mg/lb], IV) was administered if the Colorado State University pain scale score was ≥ 2 (scale, 0 to 4). Surgical variables; pain scores; pressure nociceptive thresholds; times to first administration of rescue analgesic, first walk, and first meal consumption; and total opioid administration were compared between treatment groups. RESULTS 28 dogs completed the study. Dogs administered LEB were less likely to require rescue analgesia and received lower amounts of opioids than dogs administered 0.5BH. There were no significant intergroup differences in other measured variables. CONCLUSIONS AND CLINICAL RELEVANCE The LEB appeared to provide adequate analgesia after TPLO with lower requirements for opioid treatments, which may allow dogs to be discharged from the hospital earlier than with traditional pain management strategies.
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Louro LF, Milner PI, Bardell D. Epidural administration of opioid analgesics improves quality of recovery in horses anaesthetised for treatment of hindlimb synovial sepsis. Equine Vet J 2020; 53:682-689. [PMID: 32852063 DOI: 10.1111/evj.13338] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/17/2020] [Accepted: 08/15/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Opioid epidural analgesia has been shown to provide effective analgesia in horses. There is a lack of evidence regarding the effect of opioid epidural analgesia on quality of recovery in horses. OBJECTIVES Identify whether opioid epidural analgesia influences quality of recovery in horses undergoing general anaesthesia required for management of hindlimb synovial sepsis. STUDY DESIGN Single-centre retrospective cross-sectional study. METHODS Data were obtained from the clinical records of horses which had undergone arthroscopic or tenoscopic surgery for management of hindlimb synovial sepsis over a 9-year period in a referral hospital population. Multivariable logistic regression analysis was used to identify the perioperative factors that impact on quality of recovery. RESULTS Records from 149 horses, undergoing 170 general anaesthetics were included. Multivariable logistic regression analysis showed that opioid epidural analgesia (OR 3.0, 95% CI 1.2 to 7.2, P = .02) was associated with good quality of recovery, whereas Cob breeds (OR 0.16, 95% CI 0.06 to 0.46, P = .001), age (in years) (OR 0.90, 95% CI 0.83 to 0.97, P = .004) increasing intraoperative dosages (in mg/kg) of thiopental (OR 0.64, 95% CI 0.46 to 0.90, P = .01) or ketamine (OR 0.42, 95% CI 0.18 to 0.98, P = .04) were associated with poor quality of recovery. MAIN LIMITATIONS Certain variables that may influence quality of recovery, such as patient temperament and hindlimb orthopaedic co-morbidities were not recorded. The clinical prediction model obtained is only applicable to the specific facilities, population and perianaesthetic management practiced at our institution. CONCLUSIONS Opioid epidural analgesia is significantly associated with good quality of recovery in horses undergoing general anaesthesia required for management of hindlimb synovial sepsis. Other risk factors, such as increasing age, cob breed, use of higher intraoperative dosages (in mg/kg) of ketamine and/or thiopental, were associated with poor quality of recovery.
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Affiliation(s)
- Luís F Louro
- Institute of Veterinary Science, University of Liverpool, Neston, UK
| | - Peter I Milner
- Institute of Veterinary Science, University of Liverpool, Neston, UK
| | - David Bardell
- Institute of Veterinary Science, University of Liverpool, Neston, UK.,Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, Liverpool, UK
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Clinical evaluation of postoperative analgesia, cardiorespiratory parameters and changes in liver and renal function tests of paracetamol compared to meloxicam and carprofen in dogs undergoing ovariohysterectomy. PLoS One 2020; 15:e0223697. [PMID: 32059002 PMCID: PMC7021320 DOI: 10.1371/journal.pone.0223697] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/21/2020] [Indexed: 12/23/2022] Open
Abstract
Background In veterinary medicine, the administration of nonsteroidal anti-inflammatory analgesics (NSAIDs) for the control of postsurgical pain in dogs and cats is common given the anti-inflammatory, analgesic, and antipyretic effects of these drugs. This study compared the serum biochemical changes and postoperative analgesic effects of paracetamol, meloxicam, and carprofen in bitches submitted to an ovariohysterectomy using the Dynamic Interactive Visual Analog Scale (DIVAS) and Pain Scale of the University of Melbourne (UMPS) scoring systems. Methods Thirty bitches of different breeds underwent elective ovariohysterectomies and were randomly assigned to one of three treatment groups: a paracetamol group [15 mg kg-1 intravenous (IV)], a carprofen group (4 mg kg-1 IV), and a meloxicam group (0.2 mg kg-1 IV). All treatments were administered 30 minutes prior to surgery. Paracetamol was administered every 8 hours postoperatively for 48 hours total, while carprofen and meloxicam were intravenously administered every 24 hours. An evaluation of post-surgical pain was done with the DIVAS and the UMPS. The first post-surgical pain measurement was performed 1 hour after surgery and then 2, 4, 6, 8, 12, 16, 20, 24, 36, and 48 hours after surgery. Results All groups exhibited a gradual reduction in pain throughout the postoperative period in both scales; however, neither scale significantly differed between the three treatment groups (P > 0.05) during the 48 postoperative hours. Conclusions Paracetamol was as effective as meloxicam and carprofen for post-surgical analgesia in bitches subjected to elective ovariohysterectomy. The present study demonstrates that paracetamol may be considered a tool for the effective treatment of acute perioperative pain in dogs. Furthermore, this drug led to no adverse reactions or changes in the parameters assessed in the present study, indicating its safety.
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Hernandez-Avalos I, Mota-Rojas D, Mora-Medina P, Martínez-Burnes J, Casas Alvarado A, Verduzco-Mendoza A, Lezama-García K, Olmos-Hernandez A. Review of different methods used for clinical recognition and assessment of pain in dogs and cats. Int J Vet Sci Med 2019; 7:43-54. [PMID: 31819890 PMCID: PMC6882480 DOI: 10.1080/23144599.2019.1680044] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/07/2019] [Accepted: 10/09/2019] [Indexed: 12/28/2022] Open
Abstract
In light of the need to perform surgical techniques and the importance of animal welfare because of acute pain, the objectives of the veterinary anaesthetists are to manage muscle relaxation and adequate analgesia in order to conserve a balance in the autonomic nervous system, enhance the action of the parasympathetic system in the face of the emerging action of the sympathetic portion provoked by the surgeon, and maintain a balance among them. The aim of the present review is to describe different evaluation criteria for acute pain using unidimensional and multidimensional scales, correlating these findings to parasympathetic tone activity (PTA) and bispectral index (BIS) assessment, to conduct an objective evaluation of pain that patients (dog or cat) perceives, in order to administrate an adequate analgesic treatment in each case. In conclusion, this integral, objective evaluation will allow veterinarians – especially anaesthesiologists – to improve the management of pain in the patients.
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Affiliation(s)
| | - Daniel Mota-Rojas
- Neurophysiology of Pain, Behavior and Assessment of Welfare in Domestic Animals, DPAA, Universidad Autónoma Metropolitana (UAM), Mexico City, Mexico
| | - Patricia Mora-Medina
- Livestock Science Department, Universidad Nacional Autónoma de México (UNAM), FESC, Mexico
| | - Julio Martínez-Burnes
- Graduate and Research Department, Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma de Tamaulipas, Victoria City, Tamaulipas, Mexico
| | - Alejandro Casas Alvarado
- Neurophysiology of Pain, Behavior and Assessment of Welfare in Domestic Animals, DPAA, Universidad Autónoma Metropolitana (UAM), Mexico City, Mexico
| | - Antonio Verduzco-Mendoza
- Departamento Bioterio y Cirugía Experimental, Instituto Nacional de Rehabilitación-Luis Guillermo Ibarra Ibarra (INR-LGII), Mexico City, Mexico
| | - Karina Lezama-García
- Neurophysiology of Pain, Behavior and Assessment of Welfare in Domestic Animals, DPAA, Universidad Autónoma Metropolitana (UAM), Mexico City, Mexico
| | - Adriana Olmos-Hernandez
- Departamento Bioterio y Cirugía Experimental, Instituto Nacional de Rehabilitación-Luis Guillermo Ibarra Ibarra (INR-LGII), Mexico City, Mexico
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Valverde A, Skelding AM. Alternatives to Opioid Analgesia in Small Animal Anesthesia: Alpha-2 Agonists. Vet Clin North Am Small Anim Pract 2019; 49:1013-1027. [PMID: 31481257 DOI: 10.1016/j.cvsm.2019.07.010] [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
Alpha-2 agonists have potent analgesic effects, in addition to their sedative actions. Alpha-2 agonists provide analgesia through any of several routes of administration, including parenteral, oral, epidural or intrathecal and intraarticular, because of spinal and supraspinal actions. Systemic doses are short acting, whereas local administration at the site of action result in longer analgesic effects. The potent cardiovascular and respiratory effects of alpha-2 agonists should be considered when used as analgesics.
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Affiliation(s)
- Alexander Valverde
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1, Canada.
| | - Alicia M Skelding
- Toronto Animal Health Partners Emergency and Specialty Hospital, Toronto, Ontario M3B 2R2, Canada
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Floriano D, Sahagian MJ, Chiavaccini L. Impact of epidural bupivacaine on perioperative opioid requirements, recovery characteristics, and duration of hospitalization in dogs undergoing cystotomy: A retrospective study of 56 cases. Vet Surg 2019; 48:1330-1337. [PMID: 31328291 DOI: 10.1111/vsu.13290] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 06/03/2019] [Accepted: 06/22/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare perioperative opioid consumption and duration of hospitalization (DOH) in anesthetized dogs receiving opioid-based analgesia (OBA) vs those receiving bupivacaine epidural-based analgesia (EPID) during cystotomy. STUDY DESIGN Retrospective cross-sectional study. ANIMALS Fifty-six client-owned dogs undergoing cystotomy. METHODS Clinical records of dogs undergoing cystotomy between January 2015 and December 2017 were reviewed. Demographic data, duration of anesthesia and surgery, anesthetic management, perioperative opioid consumption expressed in morphine equivalents (ME), perioperative use of adjuvant analgesics, time to first micturition, time to eat, time to ambulate, and DOH were recorded. Opioid consumption and DOH were compared with a Wilcoxon rank-sum test, followed by linear regression analysis as appropriate. Time to first micturition, time to eat, and time to walk unassisted were modeled with Cox-proportional hazard models. RESULTS Dogs treated with EPID during surgery required 1.5 mg/kg ME less compared with those treated with OBA (P = .04) during surgery. Three of 19 dogs treated with EPID vs 15 of 37 dogs receiving OBA required intraoperative adjuvant analgesics (P = .06). Dogs treated with EPID regained motor function slower than dogs treated with OBA (P = .01); however, there was no difference in time to urinate, time to eat, or DOH between treatments. CONCLUSION Perioperative lumbosacral epidural with bupivacaine reduced intraoperative opioid consumption in dogs anesthetized for cystotomy. CLINICAL SIGNIFICANCE The use of epidural bupivacaine in dogs undergoing cystotomy may reduce intraoperative opioid requirements without affecting return of bladder function or DOH.
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Affiliation(s)
- Dario Floriano
- Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael J Sahagian
- Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ludovica Chiavaccini
- Department of Molecular and Biomedical Sciences, North Carolina State University, Raleigh, North Carolina
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Kamal MM, Talaat SM. Comparative study of epidural morphine and epidural dexmedetomidine used as adjuvant to levobupivacaine in major abdominal surgery. EGYPTIAN JOURNAL OF ANAESTHESIA 2019. [DOI: 10.1016/j.egja.2013.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Manal M. Kamal
- Dept. of Anesthesiology, Intensive Care and Pain Management , Faculty of Medicine , Ain Shams University , Cairo, Egypt
| | - Sahar M. Talaat
- Dept. of Anesthesiology, Intensive Care and Pain Management , Faculty of Medicine , Ain Shams University , Cairo, Egypt
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Garcia-Pereira F. Epidural anesthesia and analgesia in small animal practice: An update. Vet J 2018; 242:24-32. [PMID: 30503540 DOI: 10.1016/j.tvjl.2018.09.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 09/05/2018] [Accepted: 09/07/2018] [Indexed: 11/15/2022]
Abstract
Epidural anesthesia is a commonly performed technique in both human and veterinary medicine. The technique is relatively simple following appropriate training and provides anesthesia and analgesia for acute and chronic pain. Several drug combinations have been administered by this route with variable success and duration. Multiple techniques to guide or confirm correct epidural needle placement are discussed in this article, as well as anatomical features of the epidural space, effect of drug volume and concentration, and adverse effects of the technique in small animal practice. This article is not an exhaustive review of the literature, but an update of some new findings over the last decade.
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Affiliation(s)
- F Garcia-Pereira
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610 USA.
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Schäffer DPH, de Araujo NLLC, Otero AR, Dórea Neto FDA, Barbosa VF, Martins Filho EF, Oriá AP. Cardiorespiratory effects of epidural anesthesia using lidocaine with morphine or dexmedetomidine in capuchin monkeys (Sapajussp.) undergoing bilateral tubal ligation surgery, anesthetized with isoflurane. J Med Primatol 2017; 46:311-319. [DOI: 10.1111/jmp.12304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2017] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Ana Rosa Otero
- School of Veterinary Medicine and Zootechny; Federal University of Bahia UFBA; Salvador Brazil
| | | | - Vivian Fernanda Barbosa
- School of Veterinary Medicine and Zootechny; Federal University of Bahia UFBA; Salvador Brazil
| | | | - Arianne Pontes Oriá
- School of Veterinary Medicine and Zootechny; Federal University of Bahia UFBA; Salvador Brazil
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Steagall PVM, Simon BT, Teixeira Neto FJ, Luna SPL. An Update on Drugs Used for Lumbosacral Epidural Anesthesia and Analgesia in Dogs. Front Vet Sci 2017; 4:68. [PMID: 28553642 PMCID: PMC5427076 DOI: 10.3389/fvets.2017.00068] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 04/20/2017] [Indexed: 12/20/2022] Open
Abstract
This review aims to report an update on drugs administered into the epidural space for anesthesia and analgesia in dogs, describing their potential advantages and disadvantages in the clinical setting. Databases searched include Pubmed, Google scholar, and CAB abstracts. Benefits of administering local anesthetics, opioids, and alpha2 agonists into the epidural space include the use of lower doses of general anesthetics (anesthetic “sparing” effect), perioperative analgesia, and reduced side effects associated with systemic administration of drugs. However, the potential for cardiorespiratory compromise, neurotoxicity, and other adverse effects should be considered when using the epidural route of administration. When these variables are considered, the epidural technique is useful as a complementary method of anesthesia for preventive and postoperative analgesia and/or as part of a balanced anesthesia technique.
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Affiliation(s)
- Paulo V M Steagall
- Faculty of Veterinary Medicine, Department of Clinical Sciences, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Bradley T Simon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Francisco J Teixeira Neto
- Faculty of Veterinary Medicine and Animal Science, Department of Veterinary Surgery and Anaesthesiology, Universidade Estadual Paulista (UNESP), Botucatu, Brazil
| | - Stelio P L Luna
- Faculty of Veterinary Medicine and Animal Science, Department of Veterinary Surgery and Anaesthesiology, Universidade Estadual Paulista (UNESP), Botucatu, Brazil
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Murdoch AP, Michou JN. The effect of loco-regional anaesthesia on motor activity induced by direct stimulation of the sciatic nerve in dogs. Vet J 2016; 209:139-43. [PMID: 26831173 DOI: 10.1016/j.tvjl.2015.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 11/30/2015] [Accepted: 12/05/2015] [Indexed: 11/27/2022]
Abstract
A prospective, randomised, blinded, case-controlled clinical study was designed using client-owned dogs undergoing unilateral pelvic limb orthopaedic surgery, to determine the effect on induced motor activity by electrical stimulation of the sciatic nerve distal to the site of local anaesthetic administration. Dogs were administered 0.5% bupivacaine either extradurally or via a femoral and transgluteal sciatic electrolocation-guided nerve block prior to pelvic limb surgery. Motor response to electrical stimulation of branches of the sciatic nerve was tested and the minimum current required to induce muscle twitch was recorded prior to bupivacaine administration. Provided sensory blockade had been deemed successful intraoperatively, testing was repeated postoperatively, with each dog acting as its own control. Paired t-tests were performed to compare pre- and postoperative minimum currents. Eleven dogs administered extradural and 11 dogs administered femoral and sciatic perineural bupivacaine were eligible for post-operative testing. All dogs displayed normal motor response to electrical stimulation of the sciatic nerve at both sites tested before and after bupivacaine administration. There was no significant difference in the minimum current required to induce muscle twitch between pre- and post-operative testing (P = 0.31 sciatic site, P = 0.36 peroneal site), nor between the two groups using different loco-regional anaesthetic techniques (minimum P = 0.13). This study shows that stimulation of the sciatic nerve distal to the site of bupivacaine administration induces motor activity, despite adequate sensory blockade. This is relevant in surgical cases where mechanical stimulation of the sciatic nerve might be expected and needs to be recognised to avoid postoperative neurapraxia.
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Affiliation(s)
- A P Murdoch
- The Queen's Veterinary School Hospital, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK.
| | - J N Michou
- Pride Veterinary Centre, Riverside Road, Derby DE24 8HX, UK
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Wang YL, Zeng C, Xie DX, Yang Y, Wei J, Yang T, Li H, Lei GH. Single-dose intra-articular bupivacaine plus morphine after knee arthroscopic surgery: a meta-analysis of randomised placebo-controlled studies. BMJ Open 2015; 5:e006815. [PMID: 26078306 PMCID: PMC4480015 DOI: 10.1136/bmjopen-2014-006815] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To evaluate the efficacy and safety of single-dose intra-articular bupivacaine plus morphine after knee arthroscopic surgery. DESIGN Meta-analysis. DATA SOURCES AND STUDY ELIGIBILITY CRITERIA A comprehensive literature search, using Medline (1966-2014), the Cochrane Central Register of Controlled Trials and Embase databases, was conducted to identify randomised placebo-controlled trials that used a combination of single-dose intra-articular bupivacaine and morphine for postoperative pain relief. RESULTS 12 articles were included in this meta-analysis. The mean visual analogue scale (VAS) scores of the bupivacaine plus morphine group were significantly lower than those of the placebo group (weighted mean difference (WMD) -1.75; 95% CI -2.16 to -1.33; p<0.001). The VAS scores at the last follow-up time point (last VAS scores) of the bupivacaine plus morphine group were also significantly lower than those of the placebo group (WMD -1.46; 95% CI -1.63 to -1.29; p<0.001). The number of patients requiring supplementary analgesia was also significantly reduced (RR 0.60; 95% CI 0.39 to 0.93; p=0.02), while there was no significant difference in the time to first analgesic request (WMD 3.46; 95% CI -1.81 to 8.72; p=0.20) or short-term side effects (RR 1.67; 95% CI 0.65 to 4.26; p=0.29). CONCLUSIONS The administration of single-dose intra-articular bupivacaine plus morphine after knee arthroscopic surgery is effective for pain relief, and its short-term side effects remain similar to saline placebo.
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Affiliation(s)
- Yi-lun Wang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Chao Zeng
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Dong-xing Xie
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Ye Yang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Jie Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan Province, China
| | - Tuo Yang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Hui Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Guang-hua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan Province, China
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Barletta M, Young CN, Quandt JE, Hofmeister EH. Agreement between veterinary students and anesthesiologists regarding postoperative pain assessment in dogs. Vet Anaesth Analg 2015; 43:91-8. [PMID: 25920011 DOI: 10.1111/vaa.12269] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 01/10/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the levels of agreement among first- and second-year veterinary students and experienced anesthesiologists in assessing postoperative pain in dogs from video-recordings. STUDY DESIGN Cross-sectional study. SUBJECTS Twenty-seven veterinary students, five anesthesiologists and 13 canine clinical patients. METHODS Prior to their enrolment in a core anesthesia course, veterinary students volunteered to watch 13 90 second videos of dogs. Dogs were hospitalized in an intensive care unit after a variety of surgical procedures. Students were asked to score the level of the dogs' pain using the Dynamic Interactive Visual Analog Scale and the Short Form of the Glasgow Composite-Measure Pain Scale. The same videotapes were scored by five board-certified anesthesiologists. The differences and agreement between the ratings of anesthesiologists and students, and first- and second-year students were determined with Mann-Whitney U-tests and Fleiss' or Cohen's kappa, respectively. RESULTS Pain scores assigned by students and anesthesiologists differed significantly (p < 0.01). Students assigned higher pain scores to dogs that were given low pain scores by anesthesiologists, and lower pain scores to dogs deemed to be in more pain by anesthesiologists. On average, students assigned higher scores on both scales. CONCLUSIONS AND CLINICAL RELEVANCE Veterinary students early in their training assigned pain scores to dogs that differed from scores assigned by experienced anesthesiologists.
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Affiliation(s)
- Michele Barletta
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Courtni N Young
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Jane E Quandt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Erik H Hofmeister
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
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McKune CM, Pascoe PJ, Lascelles BDX, Kass PH. The challenge of evaluating pain and a pre-incisional local anesthetic block. PeerJ 2014; 2:e341. [PMID: 24765575 PMCID: PMC3994627 DOI: 10.7717/peerj.341] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 03/23/2014] [Indexed: 11/20/2022] Open
Abstract
Background. Our objective was to test the effectiveness of a local anesthetic line block administered before surgery in reducing postoperative pain scores in dogs undergoing ovariohysterectomy (OVHX). Methods. This study is a prospective, randomized, blinded, clinical trial involving 59 healthy female dogs. An algometric pressure-measuring device was used to determine nociceptive threshold, and compared to three subjective pain scales. Group L/B received a line block of lidocaine (4 mg/kg) and bupivacaine (1 mg/kg) subcutaneously in the area of the incision site and saline subcutaneously as premedication; group L/BM (positive control) received a similar block and morphine (0.5 mg/kg) subcutaneously for premedication; and group SS (negative control) received a saline line block and saline premedication. Criteria for rescue analgesia were defined before the study. Dogs were assessed prior to surgery, at extubation (time 0) and at 2, 4, 6, 8 and 24 h post-recovery. The data were analyzed with one-way ANOVA, and a Split Plot Repeated Measures ANOVA with one grouping factor and one repeat factor (time). P < 0.05 was considered statistically significant. Results. Approximately 33% of dogs required rescue analgesia at some point during the study, with no significant difference between groups. There was no significant difference between treatment groups with any assessment method. Conclusions. As there were no statistically significant differences between positive and negative controls, the outcome of this technique cannot be proven.
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Affiliation(s)
- Carolyn M McKune
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California , Davis, CA , USA
| | - Peter J Pascoe
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California , Davis, CA , USA
| | - B Duncan X Lascelles
- Comparative Pain Research Laboratory, Department of Clinical Sciences & Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University , Raleigh, NC , USA
| | - Philip H Kass
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California , Davis, CA , USA
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Aarnes TK, Hubbell JAE, Hildreth BE. Use of sedation and ropivacaine-morphine epidural for femoral head and neck ostectomy in a dog. J Small Anim Pract 2014; 55:334-6. [PMID: 24602054 DOI: 10.1111/jsap.12202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2014] [Indexed: 11/28/2022]
Abstract
A five-year-old male German shepherd dog presented with traumatic craniodorsal luxation of the right coxofemoral joint with pre-existing moderate hip dysplasia. A femoral head and neck ostectomy was performed. The patient was sedated with acepromazine and morphine administered intramuscularly. A lumbosacral epidural was performed using a combination of morphine and ropivacaine. Intraoperatively, an infusion of medetomidine, morphine, lidocaine, and ketamine was administered intravenously, and oxygen was administered via facemask. Heart rate, respiratory rate and oscillometric arterial blood pressures were monitored. Postoperatively, carprofen was administered once subcutaneously. On the day of hospital discharge, carprofen and tramadol were administered orally every 12 hours. Twenty-one days later, the dog was doing well and the surgical staples were removed. Sedation with acepromazine and morphine, administration of an epidural containing morphine and ropivacaine, and intraoperative sedation with medetomidine, morphine, lidocaine and ketamine were suitable for femoral head and neck ostectomy.
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Affiliation(s)
- T K Aarnes
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA
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