Postoperative Pain In Dogs Research Articles

Transversus Abdominis plane block to manage post operative pain in canine mastectomy

The aim of this study was to assess effectiveness of transversus abdominis plane block as part of a multimodal anaesthetic protocol in controlling perioperative nociception/ pain in dogs that underwent mammary tumour excision. The study included twelve dogs belonging to different breeds and ages. The dogs were classified according to the American Society of Anaesthetists (ASA) classification of physical status, based on their pre-anaesthetic evaluations and were divided into two groups: I and II, each with six dogs. Dogs in both groups received dexmedetomidine for premedication and diazepam-propofol for induction. Group I dogs were subjected to Transversus abdominis plane (TAP) block and Group II dogs were given butorphanol. Pain score was assessed using the Glasgow Composite Measure Pain Scale (GCMPS-SF) at one hour post-operatively. The pain score was significantly lower in Group I. None of the dogs in Group I required rescue analgesia. TAP block proved beneficial in mitigating nociception and postoperative pain in dogs undergoing mammary tumour excision. Keywords: Mammary tumour resection, TAP block, post-operative pain

Surgical Site Infiltration with Comfort-in Device and Traditional Syringe in Dogs Undergoing Regional Mastectomy: Evaluation of Intra- and Postoperative Pain and Oxidative Stress.

The surgical site infiltration of a local anesthetic is defined as the direct injection of a drug. This study aimed to compare the effects of surgical site infiltration with 4 mg kg-1 lidocaine using a Comfort-in device and traditional syringe on oxidative status and intra- and postoperative pain in dogs undergoing regional mastectomy. Sixty adult female dogs divided into C (Comfort-in device), S (traditional syringe), and CTR (control) groups received 2 µg kg-1 dexmedetomidine and 4 mg kg-1 tramadol IM, 5 mg kg-1 tiletamine/zolazepam IV, and isoflurane. The physiological and anesthesiological parameters were measured. The assessment of intra- and postoperative responses to the surgical stimulus was performed using a cumulative pain scale (CPS score of 0-4) and the Colorado Pain Scale (CSU-CAPS score of 0-4). The hematological and biochemical parameters and inflammatory oxidative status were measured. The CPS scores showed no significant differences between the C and S groups (p = 0.236), while the comparison between the CTR, C, and S groups, respectively, showed a significant difference (p < 0.001). The postoperative analgesia scores were significantly lower in the C group compared to those of the S and CTR groups (p < 0.001). In the C group, no subject received rescue analgesia during the intra- and postoperative periods. The level of oxidative inflammatory stress was lower in group C than those in S and CTR groups, and no side effects were observed in all the groups.

Postoperative pain in dogs undergoing either laparoscopic or open ovariectomy

A prospective, quasi-experimental, clinical trial was performed to assess acute postoperative pain in healthy female dogs following elective ovariectomy by either laparoscopy (n=13) or laparotomy (n=14). Pain was assessed by both a veterinarian at the hospital, and by the owner once the patient was discharged. The Spanish version of the short form of the Glasgow Composite Measuring Pain Scale (CMPS-SF) was used. Pain scores were assessed by the veterinarian preoperatively and at 1, 2, 4, and 6 h after extubation, whilst owner-assessed scores were performed preoperatively and at postoperative days 0, 1, 2, 3, 5 and 7. Data were compared with Mann-Whitney-U test. Veterinarian-assessed CMPS-SF scores were different between both groups at all postoperative times but not at baseline, being below 6/24 in all dogs in the laparoscopy group, but equal to or greater than 6/24 in the laparotomy group at 1 h (n=12), and 4 h (n=4) (P<0.001 and P=0.029, respectively). There were also differences in pain scores between both groups at 2 h (P=0.012) and 6 h (P=0.007), being below 6/24 in all of them. However, there were no differences in owner assessments between groups. In conclusion, ovariectomy performed by laparoscopy induced lower pain scores that were below the pain threshold set by the CMPS-SF during the first 6 h postoperatively. After discharge, and up to one week later, ongoing owner-assessed scores suggest no pain was induced with neither of the techniques. Owners were proactive allowing real-time pain assessment to be reported. The development and validation of instruments for acute pain assessment by owners is warranted, as these tools are currently lacking.

EVALUATION OF THE POSTOPERATIVE ANALGESIC EFFECTS OF TUNING ELEMENT RELIEF PATCHES IN DOGS UNDERGOING OVARIOHYSTERECTOMY

Ovariohysterectomy (OHE) is a common surgical procedure in small animals that causes significant postoperative pain. Tuning Element Relief Patches (TERPs) are silicone patches containing titanium salts, believed to relieve pain by resonating pain-related ion channels. In this experiment, 12 dogs undergoing OHE surgery received subcutaneous robenacoxib (group R, [Formula: see text]) injection or two sheets of TERPs (group T, [Formula: see text]) as postoperative analgesia to assess the analgesic effect of TERPs. The results demonstrated no significant differences in physiological parameters, pain scores and mechanical nociceptive thresholds (MNTs) between groups postoperatively, indicating that the TERPs provide comparable results to robenacoxib in managing postoperative pain in dogs undergoing OHE. While this study provides evidence of the pain-relieving effects of TERPs, further studies are required to evaluate their long-term safety and efficacy in various clinical conditions.

Influence of intravenous fentanyl or dexmedetomidine infusions, combined with lidocaine and ketamine, on cardiovascular response, sevoflurane requirement and postoperative pain in dogs anesthetized for unilateral mastectomy

ObjectiveTo compare the effects of constant rate infusions (CRI) of fentanyl or dexmedetomidine, combined with lidocaine and ketamine, on cardiovascular response during surgery, sevoflurane requirement and postoperative pain in dogs undergoing mastectomy. Study designProspective, randomized, blinded, clinical trial. AnimalsA total of 29 female dogs with mammary tumors. MethodsPremedication consisted of intramuscular acepromazine and morphine. General anesthesia was induced with intravenous propofol and maintained with sevoflurane. Dogs were randomized to be administered intravenous DLK [dexmedetomidine 1 μg kg–1 loading dose (LD) and 1 μg kg–1 hour–1; lidocaine 2 mg kg–1 LD and 3 mg kg–1 hour–1; ketamine 1 mg kg–1 LD and 0.6 mg kg–1 hour–1; n = 14] or FLK (fentanyl 5 μg kg–1 LD and 9 μg kg–1 hour–1; same doses of lidocaine and ketamine; n = 15) during anesthesia. Cardiorespiratory variables and end-tidal sevoflurane (Fe′Sevo) were recorded during surgery. The number of dogs administered ephedrine to treat arterial hypotension [mean arterial pressure (MAP) < 60 mmHg] was recorded. Meloxicam was administered to both groups. Postoperative pain and rescue analgesia requirement were assessed for 24 hours using the short form of the Glasgow Composite Measure Pain Scale. Data were compared using a mixed effects model or a Mann–Whitney test. ResultsMore dogs required ephedrine in FLK than in DLK (67% versus 7%). Heart rate was not significantly different between groups, whereas lower values of MAP (p ≤ 0.01) and Fe′Sevo (p = 0.018) were observed in FLK than in DLK. Rescue analgesia was administered to 2/15 dogs in FLK and 0/14 dogs in DLK. Conclusions and clinical relevanceBased on the cardiovascular response during surgery, intraoperative infusions of FLK and DLK provided adequate antinociception. Infusion of DLK provided greater stability of blood pressure. Both protocols resulted in minimal need for additional analgesia within 24 hours postoperatively.

Postoperative pain in dogs after intraperitoneal and incisional ropivacaine

Postoperative pain in dogs after intraperitoneal and incisional ropivacaine

Comparison between the Effect of Lidocaine or Ropivacaine Hematoma Block and of Different Timings of Administration on Post-Operative Pain in Dogs Undergoing Osteosynthesis of Long-Bone Fractures.

We aimed to compare the efficacy of intra-operative lidocaine hematoma block (HB) to ropivacaine HB and to compare the efficacy of different timings of ropivacaine HB in controlling post-operative pain in dogs undergoing the osteosynthesis of long-bone fractures. We conducted a randomized, blinded, prospective clinical study. Forty-eight dogs with long-bone fractures were included and were randomly allocated to four groups: lidocaine (L), ropivacaine (Rmid), ropivacaine pre- (Rpre) and ropivacaine post- (Rpost) groups. The dogs in group L (n = 14) and in group Rmid (n = 11) received a lidocaine or ropivacaine HB, respectively, after fracture reduction and before osteosynthesis material placement. Rpre dogs (n = 11) received ropivacaine HB before fracture reduction, and Rpost dogs (n = 12) received ropivacaine HB after osteosynthesis material placement. Eight post-operative pain assessments were performed using the University of Melbourne Pain Scale (UMPS) and an algometer. Rescue analgesia was administered based on UMPS scoring. For data analysis, the Shapiro-Wilk test of normality, chi-square, Student t test and Split Plot analysis were used. The level of significance was set at α = 0.05. Rescue analgesia was administered to one dog in group L, one in group Rmid and one in group Rpost, with no significant differences detected. Compared to group Rmid, group L dogs exhibited significantly higher mean mechanical pain thresholds (p = 0.049) and lower mean UMPS scores (p = 0.001). Group Rpost dogs had statistically significantly higher mean pain thresholds compared to group Rmid (p = 0.009). When performed after fracture reduction and before osteosynthesis material placement, lidocaine HB seems to be more effective than ropivacaine HB in controlling post-operative pain in dogs undergoing osteosynthesis of long-bone fractures. The administration of ropivacaine HB after osteosynthesis material placement seems to be more effective than administration after fracture reduction and before osteosynthesis material placement or administration before fracture reduction in controlling post-operative pain in dogs undergoing osteosynthesis of long-bone fractures.

Evaluation of lidocaine administration into the ovarian pedicle for the control of intraoperative and early postoperative pain during ovariohysterectomy in dogs

ObjectiveTo evaluate effects of lidocaine 2% administration into the ovarian pedicle on intraoperative nociception and early postoperative pain in dogs undergoing ovariohysterectomy. Study designProspective, randomized, blinded clinical study. AnimalsA total of 20 healthy adult female dogs of different breeds. MethodsDogs were premedicated with acepromazine (0.02 mg kg–1) and morphine (0.5 mg kg–1) intramuscularly, anesthesia induced with propofol and maintained with isoflurane. Dogs were randomly assigned to be administered 2 mL of saline (group S) or lidocaine 2% (group L) into the mesovarium (1 mL each side). Heart rate (HR) and noninvasive systemic arterial pressure were recorded before surgery (T0), before (T1) and during ligation of the right ovarian pedicle (T2), before (T3) and during ligation of the left ovarian pedicle (T4). Rescue treatment (propofol) was administered if HR or systolic arterial pressure (SAP) increased by 20% compared with the previous time point. Pain, assessed with the Glasgow Composite Measure Pain Scale-Short Form (CMPS-SF) was recorded before premedication (baseline) and after extubation. Administration of postoperative rescue analgesia was recorded. ResultsIn group S, HR was higher at T2 than T1 (112 ± 18 versus 89 ± 21 beats minute–1, p = 0.001) There were no significant differences between treatments at any time. SAP was higher at T2 than T1 in group S (110 ± 12 versus 100 ± 10 mmHg, p = 0.031). SAP was higher in group S than group L at T3 (113 ± 12 and 91 ± 10 mmHg, respectively, p = 0.001). No dogs required propofol intraoperatively. All dogs required postoperative rescue analgesia. Compared with baseline, CMPS-SF increased 60 minutes after extubation (group S; p = 0.019, group L; p = 0.043). Conclusions and clinical relevanceAdministration of lidocaine 2% into the mesovarium did not reduce intraoperative nociception and did not improve postoperative analgesia.

Evaluation of the Analgesic Efficacy of Undiluted Intraperitoneal and Incisional Ropivacaine for Postoperative Analgesia in Dogs after Major Abdominal Surgery.

Recommendations for intraperitoneal (IP) and incisional (INC) administration of local anaesthetics after visceral surgery exist, but evidence is scarce. This prospective, randomized, blinded, controlled, clinical trial compared postoperative pain in dogs undergoing major abdominal surgery. Sixteen client-owned dogs were anaesthetized with a standardized balanced protocol including opioids and received either 2 mg/kg ropivacaine IP (0.27 mL/kg) and a 1 mg/kg INC splash (0.13 mL/kg) or equal volumes of saline. Influence of the treatment on heart rate (HR) and postoperative pain was assessed using the Short Form of the Glasgow Composite Pain Scale (GCPS-SF), a dynamic interactive visual analogue scale (DIVAS) and mechanical nociceptive threshold testing (MNT). Data was tested with mixed ordinal regression and log linear mixed models for 0.5, 1, 2, 3, 4, 6, 8, 10 and 12 h after extubation. Rescue analgesia was given to 3/8 dogs after ropivacaine and 0/8 dogs after saline. GCPS-SF and MNT were not different between groups. DIVAS was slightly higher after ropivacaine (odds increased by 5.44 (confidence interval (CI) 1.17-9.96, p = 0.012)), and HR after ropivacaine was 0.76 * that after saline (CI 0.61-0.96, p = 0.02) with no effect of time (p = 0.1). Undiluted ropivacaine IP and INC was not beneficial for postoperative analgesia.

Premedication with acetazolamide: Is its use for postoperative pain and stress control after laparoscopic ovariectomy in dogs ruled out?

Studies in human medicine have concluded that acetazolamide reduces pain associated with carbon dioxide insufflation during laparoscopic surgery. However, there are no published reports regarding the use of acetazolamide for this purpose in companion animals, despite the increasing popularity of laparoscopic techniques in veterinary medicine due to their advantages over open surgeries. Thirty mixed-breed female dogs were included in the study and randomly assigned to one of three groups: OVE (median celiotomy ovariectomy; n = 10), OVEL (laparoscopic ovariectomy, n = 10) and OVELA (laparoscopic ovariectomy with acetazolamide preoperative administration; n = 10). Experienced surgeons performed all procedures, and the anaesthetic and analgesic protocols were identical for all animals. Acetazolamide was administered orally (at a dose of 25 mg/kg) 2 h prior to induction in the OVELA group. Postoperative pain was evaluated using serum cortisol, salivary cortisol, and the University of Melbourne Pain Scale (UMPS) Score. Any statistical differences were observed in the UMPS scores when the OVELA group was compared to the OVEL group at 1 h after surgery (p = 0.515), 12 h (p = 0.375) and 24 h (p = 0.242). Animals undergoing open surgery (OVE group) had significantly higher pain scores at all times after surgery when compared with OVEL and OVELA groups. A high positive correlation (r = 0.792; p = 0.01) was found between serum and saliva cortisol concentrations. Mean saliva cortisol concentration was not significantly lower for the OVELA group compared to the other groups. This study found evidence that preoperative administration of acetazolamide may be beneficial in managing postoperative pain in dogs after laparoscopic surgeries. However, further research with a larger sample size is needed to confirm this and to determine if acetazolamide should be included in a multimodal postoperative analgesia protocol for laparoscopic ovariectomy in dogs.

Evaluation of the efficacy of a cannabidiol and cannabidiolic acid rich hemp extract for pain in dogs following a tibial plateau leveling osteotomy.

To determine the impact of a cannabidiol (CBD) and cannabidiolic acid (CBDA) rich hemp product on acute post-operative pain in dogs following a tibial plateau leveling osteotomy (TPLO), and to evaluate for changes in early bone healing, serum chemistry profiles, and complete blood counts. In this randomized, placebo controlled, blinded clinical trial, 44 client-owned dogs were assigned to receive either a CBD/CBDA product dosed at 2-2.5 mg/kg PO every 12 h or a placebo for 4 weeks following a TPLO. Variables evaluated before (week 0), and at 2 and 4 weeks post-operatively included standardized veterinary assessments for pain score, weight-bearing, and lameness, the Canine Brief Pain Inventory (pain interference score-PIS, pain severity score-PSS), and serum biochemistry. Complete blood counts were performed at weeks 0 and 4. Additionally, orthogonal radiographs evaluating the degree of healing were taken at week 4. A mixed model analysis, analyzing changes of variables of interest from enrollment baseline to all other time points was utilized, with a p-value ≤ 0.05 considered significant. Of the 44 enrolled patients, 3 were lost to follow up and excluded from analysis. No significant differences were noted between placebo (n = 19) and CBD/CBDA (n = 22) groups at any point in pain score, degree of lameness, degree of weight-bearing, PIS, PSS, or radiographic healing of the osteotomy. A significant finding of elevation of ALP above normal reference range in the treatment group was identified (p = 0.02) and eosinophil count was affected by treatment (p = 0.01), increasing from baseline in placebo and decreasing in treatment groups. Finally, a significant difference (p = 0.03) was noted at 2 weeks post-operatively where 4 patients in the placebo group and no treatment patients received trazodone to facilitate activity restrictions. Use of a CBD/CBDA rich hemp product dosed at 2-2.5 mg/kg PO every 12 h did not have a significant impact on pain or delay early bone healing. A statistically significant increase in ALP, decrease in eosinophils, and reduced use of trazodone was identified in the treatment group.

Comparison of the Transdermal and Intravenous Administration of Buprenorphine in the Management of Intra- and Postoperative Pain in Dogs Undergoing a Unilateral Mastectomy.

The aim of this prospective clinical study was to evaluate the effectiveness of transdermal patches of buprenorphine as an alternative route for the management of perioperative pain in dogs undergoing a unilateral mastectomy. Our hypothesis was that the transdermal route would allow the obtainment of an analgesic plan comparable to that of the injectable administration. Twelve dogs were divided in two groups. In the BupreP group (six dogs), buprenorphine patches were applied 40 h before the start of the surgery, guaranteeing a dosage of 5-6 μg/kg/h. In the BupreI group (six dogs), 20 μg/kg of buprenorphine was administered intravenously 30 min before the induction of anesthesia, and this was repeated every 6 h for 24 h. The main physiological parameters, sedation scores (0 = no sedation; 11 = deep sedation), and pain scores were monitored from 30 min before the surgery to 24 h after the end of anesthesia. All p values &lt; 0.05 were defined as statistically significant. Thirty minutes before the surgery, the sedation scores were higher in BupreI (score = 10) compared to the BupreP group (score = 1). Moreover, during the mastectomy, the mean arterial pressure significantly increased in both groups even if nobody required additional analgesia. In the postoperative period, the pain scores did not show statistically significant differences between the two groups, maintaining values below the pain threshold at all times of the study. In conclusion, the transdermal administration of buprenorphine could guarantee an analgesic quality equal to that of the injectable route.

Usefulness of Pain Scales for Postoperative Pain in Dogs

Usefulness of Pain Scales for Postoperative Pain in Dogs

Retrospective assessment of the relationship between intraoperative nociception and postoperative analgesia requirements in dogs undergoing thoracic surgery.

The analgesia management of thoracic surgery can be challenging and debate exists regarding the efficacy of pre-emptive analgesia and its relationship with postoperative pain. The aim of this study was to assess the relationship between intraoperative nociception and postoperative pain in dogs undergoing thoracic surgery. If proven, effective prevention of intraoperative nociception could imply prospective lower postoperative analgesia requirements. The study was retrospective and observational. Clinical records from dogs undergoing thoracic surgery (2015-2019) were reviewed and cases were allocated to one of two groups: NOCI-FREE - dogs with no evidence of intraoperative nociception; NOCI - dogs that required intraoperative rescue analgesia to address a nociceptive response. Pre-anaesthetic medication, locoregional analgesia, intraoperative infusions and rescue analgesia were used. Additionally, postoperative pain scores and analgesia plans were registered and compared between groups. Our study failed to identify a difference in the postoperative pain scores and analgesia requirements between dogs having signs of intraoperative nociception and those without. Additionally, the use of postoperative analgesic preventive infusions and rescue analgesia was similar for both NOCI and NOCI-FREE. Being on an intraoperative infusion of opioids, dexmedetomidine or lidocaine was identified as a protective factor for nociception [OR=11; (4.15-29.7)]. In the population studied, it appears that dogs showing signs of nociception intraoperatively do not necessarily show higher pain scores nor do they need additionally pain relief in the postoperative period.

Opioid requirements after locoregional anaesthesia in dogs undergoing tibial plateau levelling osteotomy: a pilot study

ObjectiveTo determine the intraoperative and early postoperative opioid requirement after ultrasound-guided sciatic and/or femoral nerve block or epidural anaesthesia in dogs undergoing tibial plateau levelling osteotomy (TPLO). Study designProspective, masked, pilot, randomized, clinical trial. AnimalsA total of 40 client-owned dogs undergoing TPLO. MethodsEach dog was randomly assigned to group SF (combined sciatic and femoral nerve block), group S (sciatic nerve block), group F (femoral nerve block) or group E (epidural anaesthesia). A total of 0.3 mL kg–1 of ropivacaine 0.5% was administered to each nerve or in the epidural space. Intraoperatively, fentanyl (2 μg kg–1) was administered intravenously when heart rate, mean arterial pressure or respiratory rate increased by >30% compared with baseline values. Postoperatively, a visual analogue scale (VAS) and a modified German version of the French pain scale (4AVet) were used to assess pain every 30 minutes for 150 minutes and again once the morning after surgery. Methadone (0.1 mg kg–1) was administered intravenously if the VAS was ≥ 4 cm [maximal value 10 cm; median (interquartile range)] or the composite pain score was ≥5 [maximal value 15; median (interquartile range)]. Significance was defined as p ≤ 0.05. ResultsGroups SF and E required less total intraoperative and early postoperative opioid doses compared with groups S and F (p = 0.031). No dogs in group SF had a block failure or required postoperative methadone. A reduced methadone requirement was found in group SF compared with all the other groups up to 150 minutes after recovery (p = 0.041). Conclusions and clinical relevanceCombined sciatic and femoral nerve block and epidural anaesthesia lead to less cumulative consumption of perioperative opioids than single nerve blockade. Sciatic or femoral nerve block alone might be insufficient to control nociception and early postoperative pain in dogs undergoing TPLO.

Uso de la Escala de dolor de la Universidad de Melbourne para evaluar dos protocolos de analgesia posquirúrgica en perras sometidas a mastectomía

Breast tumors in dogs comprise about 52% of neoplasms in dogs. Complete surgical removal, called mastectomy, is considered the treatment of choice. Postoperative pain for this procedure can be classified as moderate to severe, therefore requiring treatment with drugs that minimize pain. Preemptive analgesia is a method that consists of administering medications before painful stimulus and, thus, has stood out among analgesic protocols. Scales capable of evaluating pain in animals arose in view of the difficulty in its recognition in Veterinary Medicine. The pain scale of the University of Melbourne (UMPS) consists of the assessment of specific physiological and behavioral parameters related to pain, increasing its sensitivity and specificity. Therefore, the present study aimed to evaluate the effectiveness of two different preemptive analgesia protocols in controlling postoperative pain in dogs undergoing mastectomy, using UMPS. For this, the research included 16 female patients who were randomly divided into two groups (G1 and G2). The G1 group regarding the preemptive analgesia protocol with firocoxib associated with the transdermal fentanyl patch, was composed of 8 females. Thus, the remaining 8 females constituted the G2 group receiving preemptive analgesia with carprofen associated with transdermal fentanyl. In the postoperative period, patients were evaluated by applying the UMPS in 5 stages (T1, T2, T3, T12 and T24). The analgesic rescue was only carried out when the evaluation reached a score higher than 13. Therefore, among the 16 female dogs who participated in the research, 11 of them (68.75%) demonstrated adequate pain control, therefore, there was no need for rescue, 4 patients (25%) required analgesic rescue and 1 patient (6.25%) was disqualified from the research. However, it is concluded that the Pain Scale at the University of Melbourne is a good method for assessing the degree of pain in dogs and that transdermal fentanyl patch (Durogesic®) demonstrated good performance in pain control in association with both anti-inflammatory drugs , as long as it is in total adherence to the skin surface.

Postoperative Analgesic Effects of Laserpuncture and Meloxicam in Bitches Submitted to Ovariohysterectomy.

Background: This prospective, randomised and blind study investigated the efficacy of laserpuncture for postoperative pain management in dogs. Method: Sixteen bitches were sedated with acepromazine and randomly treated before ovariohysterectomy with meloxicam 0.2 mg·kg−1 intramuscular or laserpuncture (wavelength 904 mm, frequency 124 Hz, potency 10 Joules, 100 s in each acupoint). Anaesthesia was performed with propofol, isoflurane/O2, and fentanyl. The Glasgow Composite Measure Pain Scale (GCMPS) and Dynamic Interactive Visual Analog Scale (DIVAS) were used to evaluate postoperative pain before and for 24 h after surgery. Morphine was administrated as rescue analgesia when pain scores were ≥3.33 (GCMPS). Differences between treatments, time points, and amount of rescue analgesia between groups were investigated by the Mann–Whitney test and the area under the curve (AUC) for GCMPS, Friedman, and Chi-squared tests, respectively (p < 0.05). Results: Dogs treated with laserpuncture presented lower GCMPS AUC for 24 h and lower GCMPS scores at 2 and 4 h postoperatively (p = 0.04). Three dogs treated with meloxicam required postoperatively rescue analgesia against none treated with laserpuncture. Conclusions: In this preliminary study, laserpuncture mitigated postoperative pain in dogs following ovariohysterectomy, and the technique is a promising adjunct to perioperative pain management in dogs undergoing soft tissue surgery.

Utilização da escala composta Glasgow short form para avaliação de dois diferentes protocolos de analgesia pós-cirúrgica em cadelas submetidas à mastectomia

The concern with the treatment of postoperative pain is based on the prevention of unnecessary suffering of the patient, in addition to providing many physiological benefits. Post-surgical pain can be minimized more easily when preemptive analgesia is applied, that is, the administration of analgesics before tissue damage occurs. However, the association of non-steroidal anti-inflammatory drugs with opioids in anti-pain protocols is seen as a way to reduce the doses of each medication and ensure a greater coverage of inflammatory mediators. The modified Glasgow Scale (Short Form of the Glasgow Composite Pain Scale -CMPS-SF), allows the assessment of six behavioral categories. In view of this, the present study aims to evaluate and compare, by applying the modified Glasgow Scale, the effectiveness of two different preemptive analgesia protocols using transdermal fentanyl patch associated with two non-steroidal anti-inflammatory drugs (firocoxib and carprofen) for the control of postoperative pain in dogs undergoing mastectomy surgery. Thus, 16 bitches participated in the research and were randomly divided into two groups with 8 females constituting the 1 group and receiving preemptive analgesia with firocoxib associated with transdermal fentanyl patch and another 8 females constituting the 2 group receiving analgesia preemptive with carprofen associated with transdermal fentanyl. Postoperatively, patients were evaluated using the Glasgow Modified Scale in 5 steps (T1, T2, T3, T15 and T24). The analgesic rescue was only performed when the assessment exceeded 6 points on the scale. Among the 16 patients who participated in the research, 11 of them (68.75%) demonstrated adequate pain control, therefore, there was no need for rescue, 4 patients (25%) needed analgesic rescue and 1 patient (6.25%) was disqualified from the search. It was concluded that there was no difference in analgesic control with both protocols. The Glasgow Modified Scale is a useful method for assessing the degree of pain in bitches undergoing mastectomy. Transdermal fentanyl has demonstrated good performance in pain control simultaneously associated with both anti-inflammatory drugs, however it is of utmost importance that the patch is correctly attached to the skin for proper release of the active ingredient.

Comparison of liposomal bupivacaine and 0.5% bupivacaine hydrochloride for control of postoperative pain in dogs undergoing tibial plateau leveling osteotomy

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). 33 client-owned dogs. 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. 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. 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.

The effect of neuraxial morphine on postoperative pain in dogs after extrahepatic portosystemic shunt attenuation

ObjectiveTo investigate the analgesic effect of epidural morphine after surgical extrahepatic portosystemic shunt (EHPSS) attenuation. Study designRandomized clinical trial. AnimalsA total of 20 dogs with a congenital EHPSS. MethodsDogs were randomly allocated to be given either a single epidural dose of 0.2 mg kg–1 preservative-free morphine (group M) or not (group C) before surgery. All dogs were administered 0.3 mg kg–1 methadone intravenously (IV) as preanaesthetic medication. Pain scores were determined every 2 hours for the first 24 hours postoperatively using the short-form Glasgow Composite Measure Pain Scale (GCMPS-SF). Dogs with a GCMPS-SF pain score >4/20 or >5/24 received 0.1 mg kg–1 methadone IV as rescue analgesia and were reassessed 30 minutes later. If more than three doses of methadone were administered in a 2 hour period, alternative pain relief was provided and a treatment failure recorded. The GCMPS-SF pain scores and number of rescue analgesia injections were analysed over 24 hours. The last observation carried forward method was applied in case of treatment failure. Food consumption and time to first urination were recorded. Data were analysed using a Mann–Whitney U test and presented as median (minimum–maximum range), with significance set at p < 0.05. ResultsGroup M showed lower GCMPS-SF pain scores [15 (11–41) versus 31 (11–86); p = 0.023] and lower postoperative methadone requirements [0 (0–0.2) versus 0.25 (0–0.5) mg kg–1; p = 0.029] than group C. There were three treatment failures in group C only. Food consumption and time to first urination did not differ between groups. Conclusions and clinical relevanceEpidural morphine reduced the requirement for postoperative analgesia in this study population.