Postoperative comparison of four perioperative analgesia protocols in dogs undergoing stifle joint surgery

• Published in: Journal of the American Veterinary Medical Association Vol. 244; no. 9; pp. 1041 - 1046
• Main Authors: Lewis, Kerrie A, Bednarski, Richard M, Aarnes, Turi K, Dyce, Jonathan, Hubbell, John A E
• Format: Journal Article
• Language: English
• Published: United States 01-05-2014
• Subjects: Amides - administration & dosage; Amides - therapeutic use; Analgesia - methods; Analgesia - veterinary; Analgesics - administration & dosage; Analgesics - therapeutic use; Anesthetics, Local - administration & dosage; Anesthetics, Local - therapeutic use; Animals; Dog Diseases - prevention & control; Dogs; Female; Ketamine - administration & dosage; Ketamine - therapeutic use; Lidocaine - administration & dosage; Lidocaine - therapeutic use; Male; Morphine - administration & dosage; Morphine - therapeutic use; Pain, Postoperative - prevention & control; Pain, Postoperative - veterinary; Stifle - surgery
• ISSN: 0003-1488; 1943-569X
• DOI: 10.2460/javma.244.9.1041

To compare 4 analgesic protocols in dogs undergoing stifle joint surgery.
Randomized, blinded, prospective clinical trial. Animals-48 client-owned dogs that underwent stifle joint surgery.
Dogs undergoing tibial plateau leveling osteotomy were randomly assigned to receive a constant rate infusion of a combination of morphine, lidocaine, and ketamine; a lumbosacral epidural with morphine and ropivacaine; both treatments (ie, constant rate infusion and lumbosacral epidural); or only IM premedication with morphine. Indices of cardiorespiratory function and isoflurane requirement were recorded at 5-minute intervals during anesthesia. A validated sedation scoring system and the modified Glasgow composite measure pain score were used to assess comfort and sedation after surgery and anesthesia once the swallowing reflex returned and a body temperature of ≥ 36.7°C (98.1°F) was attained. Pain and sedation scores were acquired at 60-minute intervals for 4 hours, then at 4-hour intervals for 24 hours. Dogs with a postoperative pain score > 5 of 24 were given morphine as rescue analgesia.
No differences in heart rate, respiratory rate, systolic arterial blood pressure, end-tidal Pco2, end-tidal isoflurane concentration, and vaporizer setting were detected among groups. No differences in pain score, sedation score, rescue analgesia requirement, or time to first rescue analgesia after surgery were detected.
Pain scores were similar among groups, and all 4 groups had similar rescue analgesia requirements and similar times to first administration of rescue analgesia. All 4 analgesic protocols provided acceptable analgesia for 24 hours after stifle joint surgery.