Comparison of analgesic efficacy of epidural methadone or ropivacaine/methadone with or without pre‐operative oral tepoxalin in dogs undergoing tuberositas tibiae advancement surgery |
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| Authors: | Tim Bosmans Koen Piron Maarten Oosterlinck Frank Gasthuys Luc Duchateau Tim Waelbers Yves Samoy Delphine Van Vynckt Ingeborgh Polis |
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| Institution: | 1. Department of Medicine and Clinical Biology of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium;2. Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium;3. Department of Physiology and Biometrics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium;4. Department of Medical Imaging and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium |
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| Abstract: | ObjectiveTo investigate the clinical efficacy of four analgesia protocols in dogs undergoing tibial tuberosity advancement (TTA).Study designProspective, randomized, blinded study.AnimalsThirty-two client owned dogs undergoing TTA-surgery.MethodsDogs (n= 8 per treatment) received an oral placebo (PM and PRM) or tepoxalin (10 mg kg?1) tablet (TM and TRM) once daily for 1 week before surgery. Epidural methadone (0.1 mg kg?1) (PM and TM) or the epidural combination methadone (0.1 mg kg?1)/ropivacaine 0.75% (1.65 mg kg?1) (PRM and TRM) was administered after induction of anaesthesia. Intra-operative fentanyl requirements (2 μg kg?1 IV) and end-tidal isoflurane concentration after 60 minutes of anaesthesia (Fe′ISO60) were recorded. Post-operative analgesia was evaluated hourly from 1 to 8 and at 20 hours post-extubation with a visual analogue scale (VAS) and the University of Melbourne Pain Scale (UMPS). If VAS > 50 and/or UMPS > 10, rescue methadone (0.1 mg kg?1) was administered IV. Analgesic duration (time from epidural until post-operative rescue analgesia) and time to standing were recorded. Normally distributed variables were analysed with an F-test (α = 0.05) or t-test for pairwise inter-treatment comparisons (Bonferonni adjusted α = 0.0083). Non-normally distributed data were analysed with the Kruskall–Wallis test (α = 0.05 or Bonferonni adjusted α = 0.005 for inter-treatment comparison of post-operative pain scores).ResultsMore intra-operative analgesia interventions were required in PM 2 (0–11)] median (range)] and TM 2 (1–2)] compared to PRM (0) and TRM (0). Fe′ISO60 was significantly lower in (PRM + TRM) compared to (PM + TM). Analgesic duration was shorter in PM (459 ± 276 minutes) (mean ± SD) and TM (318 ± 152 minutes) compared to TRM (853 ± 288 minutes), but not to PRM (554 ± 234 minutes). Times to standing were longer in the ropivacaine treatments compared to TM.Conclusions and clinical relevanceInclusion of epidural ropivacaine resulted in reduction of Fe′ISO60, avoidance of intra-operative fentanyl administration, a longer duration of post-operative analgesia (in TRM) and a delay in time to standing compared to TM. |
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| Keywords: | dogs epidural methadone ropivacaine tepoxalin tibial tuberosity advancement |
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