Abstract

Simple SummaryBone substitutes are commonly used when bone grafts are necessary in human craniofacial surgery. To study the properties and biologic behaviour of those substitutes, they can be implanted in experimental animals. A frequently used model involves the creation of critical-sized defects (defects that are too large to heal by themselves) in the rabbits calvaria (the top part of the skull). The procedure was initially described in 1989 and the authors considered and reported that post-operative analgesia was not necessary. In our experience, this procedure is invasive and can result in severe postoperative pain. The anaesthetic management of rabbits undergoing this procedure is challenging. Most of the recent publications using this model fail to provide sufficient information on perioperative animal management. With this report we have aimed to document a possible practical and simple anaesthetic and postoperative management of rabbits undergoing this procedure. Particular emphasis has been placed on postoperative pain assessment, duration and treatment.Calvarial bone surgery on rabbits is frequently performed. This report aims to document a simple and practical anaesthetic and perioperative management for this procedure. Fourteen male New Zealand white rabbits were included in the study. Subcutaneous (SC) dexmedetomidine, ketamine and buprenorphine ± isoflurane vaporized in oxygen administered through a supraglottic airway device (V-gel®) provided clinically suitable anaesthesia. Supplemental oxygen was administered throughout recovery. Monitoring was clinical and instrumental (pulse-oximetry, capnography, invasive blood pressure, temperature, arterial blood gas analysis). Lidocaine was infiltrated at the surgical site and meloxicam was injected subcutaneously as perioperative analgesia. After surgery, pain was assessed five times daily (composite behavioural pain scale and grimace scale). Postoperative analgesia included SC meloxicam once daily for four days and buprenorphine every 8 h for three days (unless both pain scores were at the lowest possible levels). Rescue analgesia (buprenorphine) was administered in case of the score > 3/8 in the composite pain scale, >4/10 on the grimace scale or if determined necessary by the caregivers. Airway management with a V-gel® was possible but resulted in respiratory obstruction during the surgery in two cases. Hypoventilation was observed in all rabbits. All rabbits experienced pain after the procedure. Monitoring, pain assessments and administration of postoperative analgesia were recommended for 48 h.

Highlights

  • Rabbits are a standardized animal model applied in the research of biomaterials used in bone regenerative medicine [1,2,3]

  • Ethical concerns on the lack of analgesia in experimental rabbits undergoing surgery have already been raised [26] and analgesia recommendations for this surgical model were not found in the literature

  • That rabbit had a smaller head compared to the others and the R4 V-gel® was too large to be advanced smoothly so a R3 V-Gel® was placed

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Summary

Introduction

Rabbits are a standardized animal model applied in the research of biomaterials used in bone regenerative medicine [1,2,3]. An early description of this surgery stated that “postoperative analgesia was not considered necessary” [9] Recent publications using this model fail to provide sufficient information on perioperative animal management [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24] and do not comply with ARRIVE It is possible that many experimental rabbits undergoing this procedure receive inappropriate perioperative analgesia In our experience, this procedure is invasive and can result in severe postoperative pain. Ethical concerns on the lack of analgesia in experimental rabbits undergoing surgery have already been raised [26] and analgesia recommendations for this surgical model were not found in the literature

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