Peer-reviewed veterinary case report
Pain relief options with epidural drugs for dogs having mastectomy
By Herrera Becerra, José R et al.·Published in Veterinary anaesthesia and analgesia·2022·Faculty of Veterinary Medicine, Brazil·View original on PubMed →
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Original publication title: Epidural administration of combinations of ropivacaine, morphine and xylazine in bitches undergoing total unilateral mastectomy: a randomized clinical trial.
- Species:
- dog
Plain-English summary
A group of 22 female dogs undergoing surgery to remove a mammary tumor received different combinations of pain relief through an epidural injection. The treatments included ropivacaine with morphine, ropivacaine with xylazine, or a combination of both. While all treatments helped manage pain during surgery, those receiving ropivacaine and morphine had better pain control afterward and were able to stand sooner than those given ropivacaine with xylazine. The study suggests that using ropivacaine with morphine is the most effective option for pain relief in these surgeries, as xylazine may slow recovery.
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Abstract
OBJECTIVE: To investigate the epidural administration of combinations of ropivacaine, morphine and xylazine in bitches undergoing unilateral mastectomy. STUDY DESIGN: Prospective, randomized, blinded, clinical study. ANIMALS: A total of 22 bitches scheduled to undergo unilateral mastectomy for mammary tumor excision. METHODS: Dogs were anesthetized with acepromazine (0.02 mg kg) and morphine (0.3 mg kg) intramuscularly, propofol intravenously (IV) and isoflurane. Prior to the beginning of surgery, dogs were randomly administered one of three epidural treatments: ropivacaine (0.75 mg kg) with morphine (0.1 mg kg) (group RM, n = 7); ropivacaine with xylazine (0.1 mg kg) (group RX, n = 8); or ropivacaine with morphine and xylazine (group RMX, n = 7). Cardiopulmonary variables and the expired concentration of isoflurane (Fe'Iso) were recorded intraoperatively. Meloxicam (0.1 mg kg) was administered IV during skin closure. Postoperative pain scores were evaluated with the Glasgow composite measure pain scale short form for 24 hours, and rescue analgesia with morphine (0.5 mg kg) was administered intramuscularly when pain scores were ≥ 6/24. RESULTS: Fe'Iso was significantly higher in group RM than in groups RX and RMX. Heart rate decreased significantly in groups RX and RMX, but blood pressure remained within acceptable values. The number of dogs administered rescue analgesia within 24 hours was significantly higher in group RX (seven dogs, 87.5%) than in groups RM (one dog, 14.3%; p = 0.01) and RMX (two dogs, 28.6%; p = 0.04). Time to standing was significantly longer in group RX than in group RM. CONCLUSIONS AND CLINICAL RELEVANCE: All epidural treatments provided adequate antinociception with minimal cardiovascular adverse effects during mastectomy. The inclusion of morphine (groups RM and RMX) provided the best postoperative analgesia. Owing to the undesirable effect of xylazine on ambulation, the combination ropivacaine-morphine appeared to provide greater benefits in bitches undergoing unilateral mastectomy.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/34742648/