Electroanalgesia for the postoperative control pain in dogs (original) (raw)

Acupuncture and pharmacopuncture are as effective as morphine or carprofen for postoperative analgesia in bitches undergoing ovariohysterectomy

Acta cirúrgica brasileira / Sociedade Brasileira para Desenvolvimento Pesquisa em Cirurgia, 2015

To investigate the analgesic effect of acupuncture (AP) or micro-dose pharmacopuncture (PA), using carprofen or morphine, in bitches undergoing ovariohysterectomy (OHE). Thirty five dogs were randomly assigned to five groups after sedation with acepromazine IM: AP, 0.5 mg.kg-1 of morphine subcutaneously (SC), 4 mg.kg-1 of carprofen SC, and PA with 0.05 mg.kg-1 of morphine or 0.4 mg.kg-1 of carprofen. Anaesthesia was induced with propofol and maintained with isoflurane. Pain was assessed after OHE by a blind observer for 24h, by dynamic visual analogue scale (DIVAS), Glasgow (CMPS-SF), Melbourne (UMPS) and Colorado University pain scale (CSU). Animals reaching 33% of the UMPS score received rescue analgesia with morphine IM. Non parametric data were analysed by Kruskal-Wallis or Friedman tests where applicable, followed by Dunn´s test. Parametric data were analysed by two way ANOVA, followed by Tukey test. There were no differences among groups in number of rescue analgesia. Except f...

Electroacupuncture versus morphine for the postoperative control pain in dogs

Acta Cirurgica Brasileira, 2011

PROPOSE: To compare the postoperative analgesic effects of electroacupuncture, morphine or sham acupuncture in dogs undergoing mastectomy. METHODS: Thirty client-owed dogs undergoing to mastectomy were randomly assigned to three groups of 10 animals each and received either morphine (T-M), the electroacupuncture (T-EA) or sham procedure (T-Sham). Pre-anesthetic medication was acepromazine (0.05 mg kg-1, IM). Anesthesia was induced with propofol (4 to 5 mg kg-1, IV) and maintained with isoflurane. Postoperatively pain degree was assessed using a numerical rating scale. Dogs were scored at 1, 3, 6 and 12 hours post-extubation. If the pain score was ≥6, supplemental morphine was administered. Serum cortisol concentration was measured before pre-anesthetic medication, at 45 minutes after the anesthetic induction, and at 1, 3 and 6 hours post-extubation. RESULTS: The pain score did not differ among the treatments, but rescue analgesia was lower in the T-EA group (2 of 10 dogs), when comp...

A systematic review of analgesia practices in dogs undergoing ovariohysterectomy

Veterinary World, 2018

Aim: This was a systematic review conducted to evaluate the analgesic drugs and techniques used in the management of pain in dogs undergoing ovariohysterectomy. Materials and Methods: Systematic searches in PubMed, Google Scholar, and ScienceDirect were conducted for peer-reviewed articles written in English and published from 1995 to 2015. The key search words were dogs, ovariohysterectomy, pain, and analgesics. This was followed by a manual search of the references within the primary data sources. Inclusion and exclusion of studies and data extraction were performed independently by two reviewers. All randomized studies evaluating the effects of analgesics during ovariohysterectomy in dogs were included. Results: A total of 31 trials met the criteria and were, therefore, included in the study. Data on the type of analgesic drugs used, the technique of administration, and the need for rescue analgesia were extracted from the papers. Individual analgesic protocols were used in 83.9% of the studies compared to multimodal drug therapy, which was used in 16.1% of the studies. Opioids were used in 39.0% of studies, nonsteroidal anti-inflammatory drugs (NSAIDs) in 19.4%, a combination of NSAIDs and opioids in 19.4%, local analgesics in 6.5%, and acupuncture in 3.2% of the studies. Drug administration was done using three approaches that included pre-operative (64.5%), post-operative (22.6%) as well as combined pre-and post-operative approach (12.9%). In 77.4% of the studies, administration of analgesics was done once, while in 12.9%, it was done as a 72-h post-operative course. 24-h and 48-h courses of post-operative pain therapy were done in 6.5% and 3.2% of the studies, respectively. About 57% of the dogs in the control groups required rescue analgesia as compared to 21.6% in the single and 11.3% in multimodal drug therapy groups. The requirement for rescue analgesics was highest in dogs treated using acupuncture (43.8%) and lowest in dogs treated using NSAID-opioid combination (8.6%). Fewer dogs among those that received pain medication preoperatively and postoperatively required rescue analgesia compared to those in groups given drugs before and after surgery only. More dogs (26.4%) among those given analgesics only once postoperatively required rescue analgesia as compared to those that received analgesics daily for 72 h (4.4%). Conclusions: This study provides evidence that opioids are the mainstream analgesic drugs used in managing acute post-operative pain in dogs' post-ovariohysterectomy. In addition, multimodal drug therapy, particularly, NSAID-opioids combination is more effective for pain management than single drug administration. Administering analgesics both before and after surgery is associated with better outcomes and so is a protracted course of post-operative pain therapy. Although these practices should be encouraged, controlled studies should be conducted to conclusively determine the best practices for pain management in dogs undergoing ovariohysterectomy.

Paraclinical Investigations of Electroacupuncture Analgesia in a Rabbit Ovariohysterectomy

Journal of Acupuncture and Meridian Studies, 2015

The aim of this study is to investigate paraclinical changes in glycemia, serum cortisol, and adrenocorticotropic hormone (ACTH) due to electroacupuncture analgesia (EAA) in a rabbit undergoing an ovariohysterectomy. Seven clinically healthy New Zealand white rabbits were used in this study. Local and systemic analgesia was represented by EAA. Blood samples were collected at preoperative, operative, and postoperative times. At the operative time, increased cortisolemia does not promote a proportional increase in glycemia even though it is correlated with an increased level of ACTH. EAA follows the stress mechanism, which is coordinated by neuroendocrine activity. EAA in a rabbit ovariohysterectomy underscores the crucial involvement of the hypothalamusepituitary eadrenal axis with a direct influence on paraclinical changes, including changes in glycemia, cortisol, and ACTH, which are specific for stress changes.

Intra- and post-operative analgesic effects of carprofen in medetomidine premedicated dogs undergoing ovariectomy

Acta veterinaria, 2005

Intra-and post-operative analgesic effects of pre-operative administration of carprofen were investigated in 16 medetomidinepremedicated dogs undergoing elective ovariectomy. Dogs were randomly allocated into carprofen (n=8; 4 mg/kg, intramuscularly) or placebo group (n=8). After medetomidine (1000 mg/m 2 , intramuscularly) premedication, they were induced with propofol (1 mg/kg, intravenously) and maintained with isoflurane (F E 'ISO 1.0 %) in 100% oxygen. During anaesthesia, the analgesia was assessed in terms of changes in heart rate, respiratory rate and arterial blood pressure as a response to the surgery. Assessments of post-operative sedation (simple numerical rating scale) and pain (multifactorial pain scale) were made at 15 minutes, 30 minutes, 1, 2, 3, 4, 5, and 6 hours after the surgery. In addition, pulse rate, respiratory rate and body temperature were measured at the same time. During anaesthesia, lower heart rate, respiratory rate and mean arterial blood pressure and higher tidal volume of respiration were observed in the carprofen group. Post-operative pain score was relatively low in both groups of dogs, however it was higher, but not significantly, in the placebo group. There was no difference between the groups in terms of respiratory and pulse rate after surgery. The post-operative sedation score was higher in the placebo group only in the early post-operative period, most probably due to misinterpretation of pain behaviour. Carprofen together with other anaesthetic drugs provided sufficient intra-operative analgesia only until major painful surgical stimulus occurred, after which analgesia had to be supplemented with a subanaesthetic dose of ketamine. Comparing to that analgesia was insufficient in the placebo group throughout the procedure. The post-operative pain scoring system was probably not sensitive enough to detect the differences between the groups; however, the effects of other drugs that extended in the post-operative period may be responsable for a low postoperative pain score in both groups of dogs.

Analgesic efficacy of laser acupuncture and electroacupuncture in cats undergoing ovariohysterectomy

Journal of Veterinary Medical Science, 2019

The aim of this study was to compare the effects of laser acupuncture and electroacupuncture on postoperative pain and analgesic requirements in cats. In a prospective, randomized and blinded clinical study, thirty cats undergoing ovariohysterectomy were sedated with intramuscular (IM) ketamine (5 mg/kg), midazolam (0.5 mg/kg), and tramadol (2 mg/ kg). Before the induction of anesthesia, the animals were randomly distributed into three groups of ten cats each: LA: bilateral Stomach 36 (ST-36) and Spleen 6 (SP-6) acupoints were stimulated with an infrared laser; EA: bilateral ST-36 and SP-6 acupoints were stimulated with an electrical stimulus; Control: no acupuncture was applied. Postoperative analgesia was evaluated in the first 24 hr post-extubation using the Interactive Visual Analogue Scale and UNESP-Botucatu Multidimensional Composite Pain Scale. Rescue analgesia was provided with IM tramadol (2 mg/ kg), and the pain scores were reassessed 30 min after the rescue intervention. If the analgesia remained insufficient, meloxicam (0.2 mg/kg IM, single dose) was administered. Data were analyzed using t-tests, the Mann-Whitney U test, and Friedman test. P<0.05 was considered significant. The pain scores did not significantly differ between the treatment groups at any time point (P>0.05). The prevalence of rescue analgesia was significantly higher in the Control group than in the LA and EA groups (P=0.033). Preoperative laser and electroacupuncture reduced the need for rescue analgesia during the first 24 hr after ovariohysterectomy.

Premedication with acetazolamide: Is its use for postoperative pain and stress control after laparoscopic ovariectomy in dogs ruled out

Background: Studies in human medicine have concluded that acetazolamide reduces pain associated with carbon dioxide insufflation during laparoscopic surgery. However, there are no published reports regarding the use of acetazolamide for this purpose in companion animals, despite the increasing popularity of laparoscopic techniques in veterinary medicine due to their advantages over open surgeries. Objectives: Thirty mixed-breed female dogs were included in the study and randomly assigned to one of three groups: OVE (median celiotomy ovariectomy; n = 10), OVEL (laparoscopic ovariectomy, n = 10) and OVELA (laparoscopic ovariectomy with acetazolamide preoperative administration; n = 10). Experienced surgeons performed all procedures, and the anaesthetic and analgesic protocols were identical for all animals. Acetazolamide was administered orally (at a dose of 25 mg/kg) 2 h prior to induction in the OVELA group. Postoperative pain was evaluated using serum cortisol, salivary cortisol, and the University of Melbourne Pain Scale (UMPS) Score. Results: Any statistical differences were observed in the UMPS scores when the OVELA group was compared to the OVEL group at 1 h after surgery (p = 0.515), 12 h (p = 0.375) and 24 h (p = 0.242). Animals undergoing open surgery (OVE group) had significantly higher pain scores at all times after surgery when compared with OVEL and OVELA groups. A high positive correlation (r = 0.792; p = 0.01) was found between serum and saliva cortisol concentrations. Mean saliva cortisol concentration was not significantly lower for the OVELA group compared to the other groups. Conclusions: This study found evidence that preoperative administration of acetazolamide may be beneficial in managing postoperative pain in dogs after laparoscopic surgeries. However, further research with a larger sample size is needed to confirm this and to determine if acetazolamide should be included in a multimodal postoperative analgesia protocol for laparoscopic ovariectomy in dogs.

A comparison of extradural tramadol and extradural morphine for postoperative analgesia in female dogs undergoing ovariohysterectomy

Acta Cirurgica Brasileira, 2012

PURPOSE: To compare the postoperative analgesic effects of the extradural tramadol or morphine in female dogs undergoing ovariohysterectomy. METHODS: Sixteen female dogs were randomly assigned to two groups of eight animals each and received morphine (0.1mg kg-1 M group) or tramadol (2mg kg-1 T group). The pre-anesthetic medication was intravenously (iv) acepromazine (0.05mg kg-1). Anesthesia was induced with propofol (4mg kg-1iv) and maintained with isoflurane. The degree of analgesia was evaluated using a numerical rating scale that included physiologic and behavior variables. Dogs were scored at one, three, six and 12 hours after surgery by one blinded observer. Dogs were treated with morphine (0.5mg kg-1) if their scores were >6. Serum cortisol was measured before the pre-anesthetic medication was administered (basal), at the time of the ovarian pedicle clamping (T0), and at 1 (T1), 6 (T6) and 12 (T12) hours postoperative. RESULTS: The pain score did not differ between morphi...

The post-operative analgesic effects of ketamine after canine ovariohysterectomy--a comparison between pre- or post-operative administration

Research in veterinary science, 2000

Thirty-six female dogs undergoing ovariohysterectomy were randomly allocated into three groups in this assessor-blinded study. The control group received no ketamine, the preketamine group were given ketamine (2.5 mg kg(-1)i.m.) at anaesthetic induction (in addition to the induction agents), the post-ketamine group received ketamine (2.5 mg kg(-1)i.m.) at extubation. Mechanical nociceptive thresholds and visual analogue scale (VAS) scores were measured before premedication and post-operatively at 20 minutes, 1, 2, 4, 8 and 18 hours after extubation. Dogs in the control group required more rescue analgesics than those in the other two groups (significantly more than the preketamine group), they also had consistently higher VAS pain scores throughout the post-operative period. Administration of ketamine post-operatively delayed the onset of post-operative wound hyperalgesia; dogs in the control group had the greatest amount of post-operative wound hyperalgesia. A single subanaesthetic...

Efficacy and Kinetics of Carprofen, Administered Preoperatively or Postoperatively, for the Prevention of Pain in Dogs Undergoing Ovariohysterectomy

Veterinary Surgery, 1998

Objective-To determine what effect the timing of carprofen administration has on the severity of postoperative pain in dogs undergoing ovariohysterectomy and to investigate the pharmacokinetics of carprofen under these conditions. Study Design-A prospective, randomized, double-blind, clinical trial. Animals-Sixty-two adult bitches weighing between 10 and 25 kgs, undergoing elective ovariohysterectomy. Methods-Examinations were performed for 20 hours postoperatively using subjective visual assessment scoring systems (DIVAS) and objective mechanical nociceptive threshold measurements. Forty dogs were assigned to one of three groups: (1) preoperative carprofen; (2) postoperative carprofen; and (3) no analgesics (saline injections). The dose of carprofen was 4.0 mgkg subcutaneously. In another 22 bitches, the pharmacokinetics of carprofen given preoperatively or postoperatively at the same dose were examined. Results-The dogs given carprofen preoperatively had lower pain scores than the other groups, significantly so at 2 hours postextubation (P < .O1 and P < .OS, Kruskal-Wallis and post hoc Dunn's). Mechanical pain thresholds measured at the distal tibia showed the development of hyperalgesia at 12 and 20 hours postextubation; this was prevented by both the preoperative (P < .05 at 12 and 20 hours, Kruskal-Wallis) and postoperative (P < .OS at 20 hours, Kruskal-Wallis) administration of carprofen. Mechanical pain threshold testing at the wound showed a significant analgesic effect of carprofen. Plasma concentrations of carprofen were not directly related to analgesia; maximum plasma concentration, the area under the curve to the last data point, and area under the first moment curve up to the last data point were all significantly higher in the dogs given carprofen postoperatively (P < .05, Mann-Whitney). Conclusion-Preoperative administration of carprofen has a greater analgesic effect than postoperative administration in the early postoperative period in dogs undergoing ovariohysterectomy. Plasma levels of carprofen are not related to the degree of analgesia achieved. Clinical Relevance-Carprofen provides effective analgesia after canine ovariohysterectomy. The timing of analgesic administration is important to optimize the control of postoperative pain.