Abstract
ObjectiveThe aim of this study was to determine whether lumbosacral epidural administration of magnesium sulphate added to ropivacaine prolongs and improves perioperative analgesia, without adverse effects on motor block duration or hind limb neurological function, in dogs undergoing hip arthroplasty. Study designInvestigator-blind, controlled, randomized, prospective clinical trial. AnimalsA group of 20 client-owned dogs undergoing hip arthroplasty were allocated randomly to either group C (control, 1 mg kg−1epidural ropivacaine) or group M (magnesium, epidural injection of 1 mg kg−1 ropivacaine and 2 mg kg−1magnesium sulphate). MethodsAll dogs were premedicated with intramuscular acepromazine. General anaesthesia was induced with propofol and maintained with isoflurane in oxygen. Intraoperatively, nociception was assessed based on changes in heart rate, respiratory rate and mean arterial pressure above baseline values. Postoperatively, pain was evaluated with a Sammarco pain score, a Glasgow pain scale and a visual analogue scale (VAS). Tarlov’s scale was used to quantify motor block. All dogs were evaluated at recovery and then 1, 2, 3, 4, 5 and 24 hours after that. Rescue analgesia was provided during surgery with fentanyl and, postoperatively, with buprenorphine. Groups were compared using one-way repeated-measure analysis of variance followed by the Holm–Sidak method for multiple comparison or nonparametric tests when appropriate. ResultsThe two treatment groups did not differ (p > 0.05) with respect to intraoperative physiological variables, rescue analgesia, postoperative pain scores (Sammarco q = 1.00; Glasgow q = 3.10; VAS q = 0.50) and duration of the motor block (Tarlov’s q = 2.40). Conclusions and clinical relevanceThe addition of epidural magnesium to ropivacaine did not improve or prolong the analgesia provided by ropivacaine alone. Further studies are needed to determine whether an epidural magnesium dose of >2 mg kg−1 would exert better analgesia, without causing adverse effects, in dogs undergoing orthopaedic surgery.
Highlights
Total hip replacement is an innovative and invasive surgery used in dogs to treat hip dysplasia and other pathological conditions affecting the coxofemoral joint
The aim of this study was to determine whether the addition of magnesium sulphate to epidural ropivacaine would result in better perioperative analgesia, defined as longer duration and decreased rescue analgesia requirement, than ropivacaine alone, in client[82] owned dogs anaesthetised for elective hip arthroplasty
Twenty client-owned dogs scheduled for hip arthroplasty between March 2014 and February 2016 were recruited for this study
Summary
Total hip replacement is an innovative and invasive surgery used in dogs to treat hip dysplasia and other pathological conditions affecting the coxofemoral joint. Providing adequate perioperative analgesia during invasive orthopaedic procedures is an ethical obligation for the veterinarian, and plays a crucial role in the outcome of the surgery itself (Conzemius et al 2005). Effective prevention and treatment of pain has been shown to significantly improve dogs’ attitude, as well as limb’s use and function in dogs undergoing major orthopaedic surgery Epidural administration of analgesics is traditionally regarded as safer and easier to perform than the spinal route. Practicality and ease of performance, single epidural injection is usually preferred to constant rate infusion of analgesics via this route, which can only be accomplished after insertion of an epidural catheter. Single epidural injections may provide analgesia of insufficient duration when invasive and potentially long surgeries are performed
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