Abstract
ObjectiveTo assess the effect of continuous wound infusion (CWI) with preperitoneal ropivacaine on postoperative analgesia and compare it with the epidural administration of ropivacaine and morphine in bitches undergoing ovariohysterectomy. Study designA parallel, randomized, clinical, prospective and nonblinded study. AnimalsA group of 38 Greyhound bitches. MethodsIn the catheter group (CathG), CWI with ropivacaine 1% (1 mg kg–1 + 0.8 mg kg–1 hour–1) was applied to the preperitoneal space over the surgical incision. In the epidural group (EpiG), ropivacaine 0.5% (1.3 mg kg–1) and morphine (0.1 mg kg–1) were epidurally administered. Occipital-coccygeal length was used to calculate the volume for the epidural. Pain was scored using a dynamic interactive visual analogue scale (DIVAS) and Glasgow composite measure pain scale–short form (CMPS-SF) before anaesthesia and at 2, 4, 6, 18, 21 and 24 hours after extubation. Incisional sensitivity using a dynamometer (MWTs-incision) was evaluated simultaneously. Plasma ropivacaine and cortisol concentrations, degree of sedation, motor blockade and response to interdigital clamping were measured or assessed. A two-way mixed analysis of variance and a Mann–Whitney U test were used to analyse data; p < 0.05. ResultsNo differences were detected in the DIVAS (p = 0.301), CMPS-SF (p = 0.600) scores, MWTs-incision measurements (p = 0.257) and cortisol values (p = 0.878) between the groups. Rescue analgesia was required in two dogs, one in each group, at 2 hours. Sedation, motor blockade and negative response to interdigital clamping were detected in EpiG at 2, 4 and 6 hours. Mean plasma ropivacaine values were higher in CathG (0.475 ± 0.164 ng mL–1) than in EpiG (0.184 ± 0.213 ng mL–1; p = 0.001). Conclusion and clinical relevanceCompared with epidural ropivacaine and morphine, CWI with preperitoneal ropivacaine is an effective analgesic technique for postoperative pain management in bitches undergoing ovariohysterectomy without motor blockade.
Highlights
Epidural anaesthesia allows postoperative pain management with the use of different drugs, such as opioids, local anaesthetics or a2-adrenoceptor agonists (DeRossi et al 2016; Steagall et al 2017; Garcia-Pereira 2018)
No differences were detected in the dynamic interactive visual analogue scale (DIVAS) (p 1⁄4 0.301), composite measure pain scaleeshort form (CMPS-SF) (p 1⁄4 0.600) scores, mechanical wound thresholds (MWTs)-incision measurements (p 1⁄4 0.257) and cortisol values (p 1⁄4 0.878)
Three animals in epidural group (EpiG) and seven in catheter group (CathG) needed fentanyl, no significant differences were detected between groups (p 1⁄4 0.141)
Summary
Epidural anaesthesia allows postoperative pain management with the use of different drugs, such as opioids, local anaesthetics or a2-adrenoceptor agonists (DeRossi et al 2016; Steagall et al 2017; Garcia-Pereira 2018). It is a commonly used technique, complications such as hypotension, bradycardia, ventilatory depression or urinary retention have been reported (Jones 2001; Cerasoli et al 2017). To the authors’ knowledge, this type of study has not been performed in veterinary medicine
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