Comparison of harmonic blade versus traditional approach in canine patients undergoing spinal decompressive surgery for naturally occurring thoracolumbar disk extrusion

Hettlich, Bianca Felicitas; Cook, Lloyd Allen; London, Cheryl A.; Fosgate, Geoffrey T.

doi:10.1371/journal.pone.0172822

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…No standardized protocol for postoperative pain management is available, but based on studies that report specific protocol details, combinations of opioids and anti-inflammatory drugs are used frequently. 28,91,97,102,119,144,[176][177][178] The impact of adding various additional treatments to an existing analgesic protocol has been examined in RCTs and case cohort retrospective studies ( Note: Existing veterinary clinical evidence suggests these are not effective at improving locomotor outcome. Some may have evidence supporting their utility in other aspects of thoracolumbar intervertebral disc extrusion (noted where applicable).…”

Section: Management Of Postoperative Painmentioning

confidence: 99%

“…No standardized protocol for postoperative pain management is available, but based on studies that report specific protocol details, combinations of opioids and anti‐inflammatory drugs are used frequently 28,91,97,102,119,144,176‐178 . The impact of adding various additional treatments to an existing analgesic protocol has been examined in RCTs and case cohort retrospective studies (Table 6).…”

Section: Pain Managementmentioning

confidence: 99%

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ACVIMconsensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion

Moore

Olby

Brisson³

et al. 2022

Veterinary Internal Medicne

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Background Thoracolumbar intervertebral disc extrusion (TL‐IVDE) is the most common cause of acute paraparesis and paraplegia in dogs; however, guidelines on management of the condition are lacking. Objectives To summarize the current literature as it relates to diagnosis and management of acute TL‐IVDE in dogs, and to formulate clinically relevant evidence‐based recommendations. Animals None. Methods A panel of 8 experts was convened to assess and summarize evidence from the peer‐reviewed literature in order to develop consensus clinical recommendations. Level of evidence available to support each recommendation was assessed and reported. Results The majority of available literature described observational studies. Most recommendations made by the panel were supported by a low or moderate level of evidence, and several areas of high need for further study were identified. These include better understanding of the ideal timing for surgical decompression, expected surgical vs medical outcomes for more mildly affected dogs, impact of durotomy on locomotor outcome and development of progressive myelomalacia, and refining of postoperative care, and genetic and preventative care studies. Conclusions and Clinical Importance Future efforts should build on current recommendations by conducting prospective studies and randomized controlled trials, where possible, to address identified gaps in knowledge and to develop cost effectiveness and number needed to treat studies supporting various aspects of diagnosis and treatment of TL‐IVDE.

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Section: Management Of Postoperative Painmentioning

confidence: 99%

Section: Pain Managementmentioning

confidence: 99%

ACVIMconsensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion

Moore

Olby

Brisson³

et al. 2022

Veterinary Internal Medicne

View full text Add to dashboard Cite

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“…Some other methods related to this are nerve stimulation, and hypnosis for anesthesia. However all these are not widely accepted [5] .…”

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confidence: 99%

Comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy

2019

JMPB

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Objective: The basic aim of this study is to find out comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy.Methodology: This randomized control trial was conducted in Surgery Department, Bahawal Victoria Hospital Bahawalpur. This study was completed in 5 months (August 2018 to January 2019) and all the patients under trial were asked for informed consent. A total number of 100% (n=62) were taken in this trial and online source Openepi.com was used for calculating sample size. Patients were selected by lottery method. Computer software SPSS version 23.2 was used for complete data entry and analysis. All the descriptive variables like onset of action and age were presented as SD and mean. Statistical test ANOVA was applied to find the significance among all groups. Chi square test was applied for analysis of continuous stats among groups. P value 0.05 was to be considered as significant.Result: A total number of 100% (n=62) patients were included, divided into two equal groups, 31 in each i.e. harmonic scalpel and conventional knot groups. The mean age of the patients, in harmonic scalpel group, was 45.29±4.56 years. There were 64.5% (n=20) males and 35.5% (n=11) females. The mean age of the patients, in conventional knot, was 44.96±2.97 years. There were 74.2% (n=23) males and 25.8% (n=8) females. No significant difference was found for age (t=0.329, p=0.743) and gender (χ 2 =0.683, p=0.409) in groups. The main outcome variables of this study were the time of procedure (minutes) and blood loss volume (ml). The mean time of procedure was 98.80±16.52minutes and 119.81±9.95 minutes for the harmonic scalpel and conventional knot groups respectively. Significant difference was found for the time of procedure in groups (t=-6.060, p-value = 0.000). Conclusion:The whole study can be ended with this conclusion that the harmonic scalpel is more effective than the conventional method of ligation or knotting in thyroidectomy. Its use offer many clinical benefits including reduction in time of surgery and blood volume as well. Introduction:The description about the thyroid gland is very prehistoric' for the first time it was name as "shield shape gland" by the Romans [1] . In the literature during 12 th or 13 th century not only the thyroid masses were mentioned but in 1170 Robert Frugard explained the complication of goiter. Thyroid surgery was begun in 12 th century by using hot iron, Setons and caustics powers (most results were fatal).At that time, the major advancement was, antisepsis, artery forceps and anesthesia to be practice [2] .The pioneers of thyroid surgery, Theodor Koches and Theodor Billroth, formulated many acceptable techniques of thyroid surgery between the year 1873 and 1883 [3] . In conventional method knot tying and ligation were important process. The very important thing of this operation is that the thyroid gland is one of the highly vascularized among all the organs having rich blood vessels and plexuses present in the parenchyma. This needs to be controlle...

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Analgesic effects of intraorbital insertion of an absorbable gelatin hemostatic sponge soaked with 1% ropivacaine solution following enucleation in dogs

Shilo‐Benjamini

Slav

Kahane³

et al. 2019

javma

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OBJECTIVE To evaluate analgesic effects and complications associated with intraorbital insertion of an absorbable gelatin hemostatic sponge (AGHS) soaked with 1% ropivacaine solution following enucleation in dogs. ANIMALS 20 client-owned dogs undergoing enucleation. PROCEDURES Dogs were randomly assigned to receive an AGHS soaked with 1% ropivacaine solution (n = 10) or saline (0.9% NaCl) solution (control group; 10) inserted intraorbitally prior to skin closure following enucleation. Carprofen (2 mg/kg [0.9 mg/lb]) was administered SC once after orotracheal extubation and then PO twice a day for 5 days. During the postoperative recovery period, apparent pain level was scored at various points with a modified short-form Glasgow Composite Pain Scale (score range, 0 to 19), and methadone was administered for rescue analgesia if any score was ≥ 5. After dogs returned home, owners recorded their behavior and apparent pain level for the first 3 days following enucleation. RESULTS At extubation, the median (range) pain score was significantly higher in the control group (8 [2 to 14]) versus the ropivacaine group (3 [1 to 7]). A greater proportion of dogs in the control group received methadone (7/10 vs 1/10) and had crying or attention-seeking behavior on the first day following enucleation (7/10 vs 1/10). No complications were observed in either group. CONCLUSIONS AND CLINICAL RELEVANCE Addition of intraorbital insertion of a ropivacaine-soaked AGHS to the analgesic protocol for dogs undergoing enucleation provided better analgesia than was achieved without this treatment as measured immediately and the first day after surgery, with no noted adverse effects.

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Comparison of harmonic blade versus traditional approach in canine patients undergoing spinal decompressive surgery for naturally occurring thoracolumbar disk extrusion

Cited by 3 publications

References 30 publications

ACVIMconsensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion

ACVIMconsensus statement on diagnosis and management of acute canine thoracolumbar intervertebral disc extrusion

Comparison between conventional and harmonic techniques in bleeding control during Thyroidectomy

Analgesic effects of intraorbital insertion of an absorbable gelatin hemostatic sponge soaked with 1% ropivacaine solution following enucleation in dogs

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