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Effect of 4 Analgesic Protocols on Comfort and Sedation of Dogs for 24 hours after Stifle Surgery

Lewis, Kerrie Anne
http://rave.ohiolink.edu/etdc/view?acc_num=osu1366606136

Abstract Details

2013, Master of Science, Ohio State University, Veterinary Clinical Sciences.
Peri-operative and long-term pain management is essential for dogs undergoing TPLO. Combination analgesic techniques may be superior to individual techniques in dogs after stifle surgery. Pain and sedation scores were evaluated for 24 hours post-operatively in dogs undergoing TPLO surgery and assigned to 4 separate analgesia protocols. All dogs presented were chronically receiving an NSAID and NSAID administration continued post-operatively. Thirty-four dogs presented for tibia plateau leveling osteotomy (same surgeon) were randomly assigned to one of four groups (four group repeated measure ANOVA): 1) Co-infusion of morphine (0.24 mg/kg/hr), lidocaine (3 mg/kg/hr), ketamine (0.6 mg/kg/hr) (MLK) begin at induction; 2) Lumbosacral epidural containing morphine (0.2 mg/kg) and ropivacaine (0.2 mg/kg) (LE) administered post-induction and pre-surgically; 3) MLK plus LE; 4) No additional analgesic drug administration after morphine premedication. All dogs received acepromazine (0.02 – 0.1 mg/kg) and morphine (0.4 mg/kg) intramuscularly (pre-medication), propofol, and isoflurane in oxygen (depth controlled by adjusting vaporizer setting). Indices of cardiorespiratory function and isoflurane requirement were recorded at 5-minute intervals during anesthesia which included heart rate (HR), respiratory rate (RR), blood pressure, end-tidal carbon dioxide (ETCO2), end-tidal isoflurane concentration (ETISO), and vaporizer percentage of isoflurane (ISO%). Co-infusion was discontinued at the end of surgery. A validated Sedation Scoring System and the Modified Glasgow Composite Measure Pain Score were used by two blinded evaluators to assess comfort and sedation after extubation and 98°F, at 60 minute intervals for 4 hours then every 4 hours for 24 hours. Dogs with pain scores greater than 6 were given morphine rescue analgesia (0.4 mg/kg, IM). No differences in any intra-operative value; including, HR, RR, SAP, ETCO2, ETIso, and Vaporizer % were detected among groups. No differences in pain score, rescue analgesia requirement, or time to first rescue analgesia were detected. Values (mean ± SD) for groups 1,2,3 and 4 were (respectively): Pain score: 2.6 ± 1.9, 2.6 ± 1.6, 2.8 ± 1.6, and 2.8 ± 2.0. Sedation score: 6.1 ± 4.3, 5.2 ± 4.3, 7.8 ± 4.5, and 6.3 ± 4.2 Rescue analgesia was administered to 4 of 12, 4 of 12, 5 of 12, and 3 of 12 dogs in each group for groups 1,2,3, and 4, respectively. In conclusion, we found pain scores were similar among groups, and that all 4 groups had similar rescue analgesia requirements and had similar times to first rescue analgesia requirements. Because time to first rescue analgesia varied with each group we conclude that dogs undergoing TPLO surgery benefit from interval assessment of pain status throughout the 24 hour post-operative period.
richard bednarski, DVM (Advisor)
jonathan dyce, DVM (Committee Member)
turi aarnes, DVM (Committee Member)
john hubbell, DVM (Committee Member)
120 p.
Veterinary Services
TPLO; pain; dogs; pain scoring; analgesia; anesthesia; veterinary

Recommended Citations

Citations

  • Lewis, K. A. (2013). Effect of 4 Analgesic Protocols on Comfort and Sedation of Dogs for 24 hours after Stifle Surgery [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1366606136

    APA Style (7th edition)

  • Lewis, Kerrie. Effect of 4 Analgesic Protocols on Comfort and Sedation of Dogs for 24 hours after Stifle Surgery. 2013. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1366606136.

    MLA Style (8th edition)

  • Lewis, Kerrie. "Effect of 4 Analgesic Protocols on Comfort and Sedation of Dogs for 24 hours after Stifle Surgery." Master's thesis, Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1366606136

    Chicago Manual of Style (17th edition)

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This open access ETD is published by The Ohio State University and OhioLINK.