Peer-reviewed veterinary case report
Pain relief options for kittens having spay surgery without opioids
By Malo, Annie et al.·Published in Journal of feline medicine and surgery·2023·Department of Clinical Sciences, Canada·View original on PubMed →
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Original publication title: Randomised, prospective, blinded, clinical trial of opioid-free injectable anaesthesia with or without multimodal analgesia in kittens undergoing ovariohysterectomy.
- Species:
- cat
Plain-English summary
A group of 29 healthy kittens, aged between 10 weeks and 6 months, underwent spaying surgery (ovariohysterectomy) using an opioid-free anesthesia method. Some kittens received additional pain relief through a combination of medications, while others did not. The kittens that received the extra pain relief had significantly lower pain scores after surgery and were able to eat more food shortly after the procedure compared to those who did not. This approach effectively managed pain with minimal need for additional medication, helping the kittens recover comfortably.
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Abstract
OBJECTIVES: This study compared an opioid-free injectable anaesthetic protocol with or without multimodal analgesia in kittens undergoing ovariohysterectomy. METHODS: In this prospective, randomised, blinded, clinical trial, 29 healthy kittens (mean ± SD weight 1.55 ± 0.46 kg; aged 10 weeks to 6 months) were included. Anaesthesia was performed with an intramuscular injection of ketamine (4 mg/kg), dexmedetomidine (40 μg/kg) and midazolam (0.25 mg/kg). In the multimodal group (MMG), cats (n = 14) received meloxicam (0.1 mg/kg SC) and intraperitoneal bupivacaine 0.25% (2 mg/kg), whereas the same volume of saline was administered in the control group (CG; n = 15). Atipamezole (0.4 mg/kg IM) was given 15 mins after ovariohysterectomy. Postoperative pain was assessed using the UNESP-Botucatu multidimensional feline pain assessment scale - short form. Rescue analgesia (buprenorphine 0.02 mg/kg IM in MMG/CG and meloxicam 0.1 mg/kg SC in CG) was administered if pain scores were ⩾4/12. Soft food intake (after 2 and 60 mins) was evaluated at specific time points postoperatively. Statistical analyses were performed with linear models and post-hoc pairwise comparison with Benjamini-Hochberg corrections (<0.05). RESULTS: The prevalence of rescue analgesia was higher in the CG (n = 15/15) than the MMG (n = 1/14;<0.001). Pain scores at 1 h, 2 h and 4 h postoperatively were higher in the CG (4.1 ± 2.8, 4.8 ± 3.0 and 5.3 ± 1.2, respectively) than in the MMG (1.6 ± 1.0, 1.1 ± 1.0 and 0.9 ± 0.8, respectively;<0.001). Food intake (%) at 1 h postoperatively was higher in the MMG after 2 and 60 mins (10.4 ± 9 and 71.9 ± 29, respectively) than in the CG (1.4 ± 2 and 13.9 ± 7, respectively;<0.001). CONCLUSIONS AND RELEVANCE: This opioid-free protocol using multimodal analgesia produced adequate postoperative pain relief, while almost eliminating the need for rescue analgesia in kittens undergoing ovariohysterectomy. Pain decreased food intake.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/36943182/