Peer-reviewed veterinary case report
Pain relief after tibial surgery in dogs using methadone and tepoxalin
By Bosmans, Tim et al.·Published in Veterinary anaesthesia and analgesia·2012·Department of Medicine and Clinical Biology of Small Animals·View original on PubMed →
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Original publication title: Comparison of analgesic efficacy of epidural methadone or ropivacaine/methadone with or without pre-operative oral tepoxalin in dogs undergoing tuberositas tibiae advancement surgery.
- Species:
- dog
Plain-English summary
A group of 32 dogs undergoing knee surgery (tibial tuberosity advancement) received different pain relief methods to see which worked best. Some dogs got a combination of epidural pain relief with ropivacaine and methadone, while others received just methadone or a placebo. The dogs that received the ropivacaine had less need for additional pain medication during surgery and experienced longer-lasting pain relief afterward. However, those treated with ropivacaine took longer to stand up after surgery compared to those who received only methadone.
People also search for: dog knee surgery pain relief · epidural pain management for dogs · ropivacaine methadone for dogs
Abstract
OBJECTIVE: To investigate the clinical efficacy of four analgesia protocols in dogs undergoing tibial tuberosity advancement (TTA). STUDY DESIGN: Prospective, randomized, blinded study. ANIMALS: Thirty-two client owned dogs undergoing TTA-surgery. METHODS: Dogs (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'ISO(60) ) 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). RESULTS: More 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'ISO(60) 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 RELEVANCE: Inclusion of epidural ropivacaine resulted in reduction of Fe'ISO(60) , 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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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/22726277/