Impact of epidural bupivacaine on perioperative opioid requirements, recovery characteristics, and duration of hospitalization in dogs undergoing cystotomy: A retrospective study of 56 cases

Floriano, Dario; Sahagian, Michael J; Chiavaccini, Ludovica

doi:10.1111/vsu.13290

Cited by 9 publications

(6 citation statements)

References 30 publications

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“…Lumbosacral epidural anesthesia is indicated in surgeries caudal to the diaphragm (1,2) as it promotes perioperative analgesia, reduces the metabolic, and endocrine response to surgical stress (3), expedites anesthetic recovery, and reduces the requirement for general anesthetics and opioids and, thus, their adverse effects (1,2,4).…”

Section: Introductionmentioning

confidence: 99%

Lumbar Epidural: Anatomical and Clinical Study in Dogs Submitted to Ovariohysterectomy

et al. 2020

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Epidural anesthesia minimizes perioperative pain in dogs. It is considered that epidural solution dispersion in cadavers is similar to alive dogs. The objective of the anatomical study was to compare the dispersion of 0.2 mL/kg 0.25% bupivacaine and iohexol via lumbar epidural (L1-L2) under fluoroscopic guidance in 10 thawed cadavers (GC) and 13 female dogs (G0.25) (5-15 kg; body score 4/5). The objective of the clinical study was to evaluate postoperative analgesic consumption and sedation for 6 h after extubation of dogs submitted to ovariohysterectomy when using 0.25% (G0.25; n = 10) bupivacaine with the intraoperative use of fentanyl (GF; n = 10). Parametric data were compared by the t-test and non-parametric data by the Mann Whitney test. Pain and sedation scores were evaluated over time by the Friedman test, followed by the Dunn test. Alive dogs presented greater epidural dispersion (17 ± 3 vertebrae) than thawed cadavers (11 ± 4 vertebrae; p = 0.002). All dogs treated with fentanyl and only one dog treated with 0.25% epidural bupivacaine presented pain scores above the cutoff point of the Glasgow Composite Measure Pain Scale Short-Form (GCMPS-SF) and required postoperative rescue analgesia up to 6 h after extubation. The sedation score was higher at all postoperative moments compared to preoperative moments in the G0.25 and GF, except for evaluations performed at 5 and 6 h after extubation in the GF. Greater sedation was observed immediately after extubation in the GF compared to the G0.25, and there was greater sedation in the G0.25 compared to the GF from 3 to 6 h after extubation. The conclusion of the anatomical study was that L1-L2 epidural bupivacaine dispersion is lower in canine thawed cadavers than in alive dogs. Conclusion of the clinical study was that lumbar epidural anesthesia improved postoperative analgesia and produced longer postoperative sedation when compared to fentanyl.

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Section: Introductionmentioning

confidence: 99%

Lumbar Epidural: Anatomical and Clinical Study in Dogs Submitted to Ovariohysterectomy

et al. 2020

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“…In previous reports, it has been documented that epidural use results in superior post procedural analgesia for cystotomy and cystoscopy patients. 21,22 In other studies comparing laparoscopic urolith removal with OC, anesthesia time is not directly compared between groups but rather, surgery time alone is compared and varies in statistical signfiicance. 16,23 A consideration for the lack of significance in surgical time between the groups is operator experience and function.…”

Section: Discussionmentioning

confidence: 99%

“…This difference in anesthesia time could be secondary to the OC group receiving local anesthetic blocks that extend anesthesia time, such as an epidural, in anticipation of a more painful procedure. In previous reports, it has been documented that epidural use results in superior post procedural analgesia for cystotomy and cystoscopy patients 21,22 . In other studies comparing laparoscopic urolith removal with OC, anesthesia time is not directly compared between groups but rather, surgery time alone is compared and varies in statistical signfiicance 16,23 .…”

Section: Discussionmentioning

confidence: 99%

Retrospective comparison of modified percutaneous cystolithotomy (PCCLm) and traditional open cystotomy (OC) in dogs: 218 cases (2010–2019)

2022

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ObjectiveTo compare short‐ and long‐term clinical variables between dogs undergoing a modified percutaneous cystolithotomy (PCCLm) and open cystotomy (OC) and evaluate for risk factors associated with complications and outcomes within the groups.Study designRetrospective study.AnimalsA total of 218 dogs.MethodsRecords were reviewed for dogs that underwent PCCLm or OC between January 2010 and December 2019. Signalment; history and diagnostic findings; procedural, anesthetic, and hospitalized care data; complications; urolith recurrence; and follow‐up were recorded. Logistic regression analysis was used to evaluate effects of clinical variables on outcomes within PCCLm and OC groups and to identify significant categorical variables between PCCLm and OC groups. Two sample t‐tests were used to identify significant numerical variables between PCCLm and OC groups.ResultsA total of 60.1% (131/218) of dogs underwent the PCCLm procedure and 39.9% (87/218) of dogs underwent the OC procedure. Anesthesia time (p < .001) was significantly longer in the OC group. No significant difference in incomplete urolith removal was noted between groups. Although surgical site infection and inflammation rates were not significantly different between OC and PCCLm groups, incisional infections were significantly associated with complications occurring during PCCLm (p = .027). Significantly reduced postoperative lower urinary tract signs (p = .022) were noted in the PCCLm group.ConclusionThe PCCLm may result in reduced lower urinary tract signs postoperatively compared to OC, but other clear advantages of the PCCLm were not identified in this study.Clinical significancePCCLm procedures are an effective alternative to OC for urolith removal in dogs.

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“…In dogs, the mortality rate after cholecystectomy ranges between 2 and 40% (1-7). Extradural anaesthesia-analgesia (EAA) has been commonly used in dogs to decrease the requirement for inhalational anaesthetic agents and intraoperative opioids, to reduce the stress response and also postoperative opioid consumption (8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Extradural anaesthesia-analgesia in dogs undergoing cholecystectomy: A single centre retrospective study

Sambugaro¹,

Gennaro²,

Hattersley³

et al. 2022

Front. Vet. Sci.

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ObjectivesTo assess the effects of extradural anaesthesia-analgesia (EAA) in dogs undergoing cholecystectomy.Materials and methodsMedical records of dogs undergoing cholecystectomy between 2011 and 2019 were retrieved and allocated to two groups depending if analgesia was provided systemically (group SA) or extradurally (EAA). Preoperative data, intraoperative antinociceptive medications, postoperative analgesia, perioperative complications, and food intake were compared.ResultsOverall 41 medical records were included in the study: 19 and 22 dogs were allocated to groups SA and EAA, respectively. In group EAA, an extradural catheter was placed preoperatively in 8 dogs; in the remaining, it was placed postoperatively but an extradural injection was performed preoperatively. The extradural catheter tip was between the 4th lumbar and the 10th thoracic vertebrae. Intraoperatively, nociception was more likely to occur in group SA [OR 55.42 (2.97–1,035.06)]. During the first 24 and 48 h postoperatively, more dogs in group SA required methadone [OR 24 (2.81–268.4) and OR 11.56 (2.37–45.06), respectively] and additional analgesic drugs [OR 25 (3.47–281.9) and OR 35.29 (1.86–668.2), respectively] compared to group EAA. Voluntary postoperative food intake was also significantly higher in group EAA.Clinical significanceCompared to systemic analgesia, the use of extradural anaesthesia-analgesia reduced perioperative analgesic requirement and promoted postoperative food intake in dogs undergoing cholecystectomy.

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Impact of epidural bupivacaine on perioperative opioid requirements, recovery characteristics, and duration of hospitalization in dogs undergoing cystotomy: A retrospective study of 56 cases

Cited by 9 publications

References 30 publications

Lumbar Epidural: Anatomical and Clinical Study in Dogs Submitted to Ovariohysterectomy

Lumbar Epidural: Anatomical and Clinical Study in Dogs Submitted to Ovariohysterectomy

Retrospective comparison of modified percutaneous cystolithotomy (PCCLm) and traditional open cystotomy (OC) in dogs: 218 cases (2010–2019)

Extradural anaesthesia-analgesia in dogs undergoing cholecystectomy: A single centre retrospective study

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