Peer-reviewed veterinary case report
Opioid use after knee surgery in dogs with or without epidural pain
By Scaglione, Jessie & Carver, Jacqueline·Published in BMC veterinary research·2023·Surgery Department, United States·View original on PubMed →
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Original publication title: Incidence of postoperative administration of opioids in dogs undergoing a tibial plateau leveling osteotomy after intra-operative liposomal bupivacaine administration with or without morphine epidural.
- Species:
- dog
Plain-English summary
A group of 174 dogs with torn knee ligaments underwent a surgical procedure called tibial plateau leveling osteotomy (TPLO) to help with their injuries. Some of these dogs received a special pain relief method that included an epidural and a local anesthetic, while others only received the local anesthetic. The dogs that had the epidural needed significantly fewer opioid pain medications after surgery—about 36% less—compared to those who did not have the epidural. This suggests that using an epidural along with the local anesthetic can effectively reduce the need for stronger pain relief after surgery.
People also search for: dog TPLO surgery pain management · dog knee surgery recovery · epidural for dog pain relief
Abstract
OBJECTIVE: To determine the influence of two intraoperative pain management protocols on the need for additional opioids in patients receiving an epidural and periarticular liposomal bupivacaine (PLB) vs. PLB alone in the 12-24 h period after undergoing a TPLO. STUDY DESIGN: Retrospective study. ANIMALS: One hundred seventy-four dogs with cranial cruciate ligament tears presenting for TPLO. METHODS: Medical records of dogs presenting for a unilateral or bilateral cranial cruciate ligament tear who had a TPLO performed were reviewed for signalment, weight, body condition score, and peri-operative pain management protocol. Dogs were divided into two groups: those who received an epidural and PLB, and those who received only PLB. Post-operative opioid administration was recorded for each group. RESULTS: Patients who received an epidural and PLB received fewer postoperative opioids. There were 36% fewer opioid injections administered to dogs who received epidurals compared to dogs who did not receive epidurals (IRR) (95% CI) = 0.64 (0.45-0.92), P = 0.02). BCS was not a significant predictor of the post-operative opioid requirement (IRR (95% CI) = 1.3 (0.75-2.4), P = 0.38). When adjusting for BCS as a possible confounder, there were 39% fewer opioid injections in dogs who received epidurals than dogs without (IRR (95% CI) = 0.61 (0.42-0.88), P = 0.009). CONCLUSIONS: The incidence of postoperative opioid administration was significantly diminished in patients receiving both an epidural and PLB. CLINICAL SIGNIFICANCE: Administration of an epidural in addition to infiltration of PLB significantly decreased the incidence of postoperative opioid administration in dogs undergoing a TPLO.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/37525246/