Analgesia in Dogs After Intercostal Thoracotomy: A Clinical Trial Comparing Intravenous Buprenorphine and Interpleural Bupivacaine |
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| Authors: | MG CONZEMIUS dvm DJ BROCKMAN bvsc mrcvs LG KING MVB MRCVS Diplomate ACVIM Diplomate ACVECC SZ PERKOWSKI VMD PhD |
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| Institution: | Departments of Surgery and the Center for Veterinary Critical Care, Veterinary Hospital at the University of Pennsylvania, Philadelphia, PA. |
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| Abstract: | We prospectively studied 26 dogs that presented for intercostal thoracotomy. Dogs were pre-medicated with oxymorphone, induced with diazepam and etomidate, and anesthesia was maintained with isoflurane in oxygen. Preoperatively, animal patients were randomly assigned to one of two groups. Group 1 (n = 13) received buprenorphine (10 μg/kg intravenously IV]) every 6 hours for 24 hours starting 10 minutes before tracheal extubation. Group 2 (n = 13) received 0.5% bupivacaine (1.5 mg/kg) administered interpleural (IP) by slow injection through a pediatric feeding tube fixed to the most dorsal aspect of the thoracotomy incision. Interpleural injections were administered with each dog placed in lateral recumbency with the incision positioned ventrally; IP injections were administered every 4 hours for 24 hours starting 10 minutes before tracheal extubation. All cases were monitored in the intensive care unit for 24 hours postoper-atively. The analgesic efficacy of each regimen was evaluated using a pain scoring system that included a subjective pain score, heart rate, and respiratory rate. Arterial blood pressure, arterial blood gases, oxygen saturation, body temperature, and changes in the electrocardiogram or neurological status were also noted. Significant increases in mean heart rate, respiratory rate, and total pain score occurred after surgery in dogs in the buprenorphine group. In contrast, dogs in the bupivacaine group had no significant changes when compared with their preoperative values. Dogs in the bupivacaine group had significantly decreased total pain scores and better PaO2 and oxygen saturation values when compared with the dogs receiving buprenorphine. Hypoventilation did not occur in either group. |
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