Abstract
Objective
Intraperitoneal (IP) bupivacaine provides postoperative analgesia in dogs undergoing
ovariohysterectomy (OHE) alone or in combination with incisional (INC) bupivacaine.
This study investigated whether the combination of INC and IP bupivacaine is superior
to IP bupivacaine alone.
Study design
Prospective, randomized, blinded clinical study.
Animals
Thirty-nine privately owned dogs undergoing OHE, aged 25 ± 23 months and weighing
11.8 ± 5.7 kg.
Methods
Dogs were premedicated with acepromazine (0.05 mg kg−1) and morphine (0.5 mg kg−1) intramuscularly (IM); anaesthesia was induced with propofol and maintained with
isoflurane in oxygen. Carprofen (4 mg kg−1) was administered subcutaneously (SC) after intubation. Bupivacaine (3 mg kg−1) IP was administered before complete closure of the linea alba to all dogs. Dogs
were randomly assigned into two groups: group B received bupivacaine (n = 20; 1 mg kg−1) and group S received saline (n = 19; 0.2 mL kg−1) INC as a subcutaneous ‘splash’ before skin closure. Postoperative analgesia was
assessed with a dynamic interactive visual analogue scale, the short form of the Glasgow
Composite Pain Scale, and mechanical nociceptive threshold (MNT) measurement at 0.5,
1, 2, 4, 6, 8, 12 and 20 hours after surgery by one blinded observer. Parametric data
were tested using t-test; nonparametric data were analysed using the two-sample Wilcoxon test (p < 0.05).
Results
There was no significant difference between groups with regard to age, weight, surgical
and anaesthetic duration, incision length, sedation and pain scores. MNT values decreased
in both groups at all time points as compared with the baseline. No dog required rescue
analgesia. No postoperative complications were observed.
Conclusion and clinical relevance
Bupivacaine IP and carprofen SC after morphine IM did provide satisfactory postoperative
analgesia in dogs undergoing OHE with the anaesthetic protocol used. There appears
to be no clinical advantage to adding bupivacaine INC. Neither protocol could prevent
the development of primary hyperalgesia.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Veterinary Anaesthesia and AnalgesiaAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Challenges of pain assessment in domestic animals.J Am Vet Med Assoc. 2002; 220: 313-319
- Pharmacokinetics, pharmacodynamics, and analgesic effects of morphine after rectal, intramuscular, and intravenous administration in dogs.Am J Vet Res. 2000; 61: 24-28
- Local anesthetics.in: Miller RE 8th edn. Miller's Anesthesia. vol. 1. Churchill Livinsgston, USA2014: 1028-1054
- Analgesia.in: Clarke KW Trim CM Hall LW Veterinary Anaesthesia. 11th edn. Saunders Elsevier, UK2014: 115-123
- Cut‐off point for rescue analgesia of uni‐dimensional scales used to assess postoperative pain in cats.in: Proceedings of the AVA Autumn Meeting. 2013 (London, UK)
- Anaesthetic sparing effect of local anaesthesia of the ovarian pedicle during ovariohysterectomy in dogs.Vet Anaesth Analg. 2008; 35: 537-542
- Effect of intraperitoneal or incisional bupivacaine on pain and the analgesic requirement after ovariohysterectomy in dogs.Vet Anaesth Analg. 2012; 39: 426-430
- Evaluation of intraperitoneal and incisional lidocaine or bupivacaine for analgesia following ovariohysterectomy in the dog.Vet Anaesth Analg. 2004; 31: 46-52
- Correlation between subjective and objective measures used to determine severity of postoperative pain in dogs.J Am Vet Med Assoc. 1997; 210: 1619-1622
- Comparative systemic toxicity of convulsant and supraconvulsant doses of intravenous ropivacaine, bupivacaine, and lidocaine in the conscious dog.Anesth Analg. 1989; 69: 794-801
- Effects of infiltration of the incision site with bupivacaine on postoperative pain and incisional healing in dogs undergoing ovariohysterectomy.J Am Vet Med Assoc. 2010; 237: 395-401
- Lidocaine increases the ventricular fibrillation threshold during bupivacaine‐induced cardiotoxicity in pigs.Br J Anaesth. 1998; 80: 218-222
- Acute pain management: a case‐based approach.in: Gaynor JS Muir WWI Handbook of Veterinary Pain Management. 3rd edn. Elsevier, USA2014: 444-446
- Pharmacological options for intra‐operative and early postoperative analgesia: an update.J Small Anim Pract. 2012; 53: 377-386
- Preoperative wound infiltration with bupivacaine reduces early and late opioid requirement after hysterectomy.Anesth Analg. 1996; 83: 376-381
- Pharmacokinetics of morphine and plasma concentrations of morphine‐6‐glucuronide following morphine administration to dogs.J Vet Pharmacol Ther. 2005; 28: 371-376
- Efficacy and kinetics of carprofen, administered preoperatively or postoperatively, for the prevention of pain in dogs undergoing ovariohysterectomy.Vet Surg. 1998; 27: 568-582
- Cardiotoxicity of local anesthetics – the plot thickens.Anesthesiology. 1984; 60: 3-5
- The challenge of evaluating pain and a pre‐incisional local anesthetic block.PeerJ. 2014; 2: e341
- Effect of surgeon experience on postoperative plasma cortisol and C‐reactive protein concentrations after ovariohysterectomy in the dog: a randomised trial.Aust Vet J. 2012; 90: 474-478
- A qualitative systematic review of incisional local anaesthesia for postoperative pain relief after abdominal operations.Br J Anaesth. 1998; 81: 377-383
- Application of a scaling model to establish and validate an interval level pain scale for assessment of acute pain in dogs.Am J Vet Res. 2005; 66: 2154-2166
- I: Intraperitoneal administration of analgesia: is this practice of any utility?.Br J Anaesth. 2002; 89: 535-537
- The analgesic effects of intraperitoneal and incisional bupivacaine with epinephrine after total abdominal hysterectomy.Anesth Analg. 2002; 95: 158-162
- Development of the short‐form Glasgow Composite Measure Pain Scale (CMPS‐SF) and derivation of an analgesic intervention score.Anim Welf. 2007; 16: 97-104
- Intraperitoneal versus interpleural morphine or bupivacaine for pain after laparoscopic cholecystectomy.Anesthesiology. 1995; 82: 634-640
- Comparison between analgesic effects of buprenorphine, carprofen, and buprenorphine with carprofen for canine ovariohysterectomy.Vet Anaesth Analg. 2008; 35: 69-79
- Multimodal analgesia for postoperative pain relief.In Pract. 2008; 30: 208-212
- The analgesic efficacy of patient‐controlled bupivacaine wound instillation after total abdominal hysterectomy with bilateral salpingo‐oophorectomy.Anesth Analg. 2001; 93: 482-487
Article Info
Publication History
Accepted:
June 10,
2015
Received:
February 25,
2015
Identification
Copyright
© 2016 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Inc. All rights reserved.
