Postoperative pain control in cats: clinical trials with pre-emptive lidocaine epidural co-administered with morphine or methadone

Abstract

Objectives The aim of the study was to evaluate the effectiveness of epidural lidocaine in combination with either methadone or morphine for postoperative analgesia in cats undergoing ovariohysterectomy. Methods Under general anesthesia, 24 cats that underwent ovariohysterectomy were randomly allocated into three treatment groups of eight each. Treatment 1 included 2% lidocaine (4.0 mg/kg); treatment 2 included lidocaine and methadone (4.0 mg/kg and 0.3 mg/kg, respectively); and treatment 3 included lidocaine and morphine (4.0 mg/kg and 0.1 mg/kg, respectively). All drugs were injected in a total volume of 0.25 ml/kg via the lumbosacral route in all cats. During the anesthetic and surgical periods, the physiologic variables (respiratory and heart rate, arterial blood pressure and rectal temperature) were measured at intervals of time zero, 10 mins, 20 mins, 30 mins, 60 mins and 120 mins. After cats had recovered from anesthesia, a multidimensional composite pain scale was used to assess postoperative analgesia 2, 4, 8, 12, 18 and 24 h after epidural. Results The time to first rescue analgesic was significantly ( P <0.05) prolonged in cats that received both lidocaine and methadone or lidocaine and morphine treatments compared with those that received lidocaine treatment alone. All cats that received lidocaine treatment alone required rescue analgesic within 2 h of epidural injections. All treatments produced significant cardiovascular and respiratory changes but they were within an acceptable range for healthy animals during the surgical period. Conclusions and relevance The two combinations administered via epidural allowed ovariohysterectomy with sufficient analgesia in cats, and both induced prolonged postoperative analgesia.

Avaliação da anestesia epidural com lidocaína associada ao tramadol ou à dexmedetomidina, em gatas submetidas à ovariosalpingohisterectomia, anestesiadas com propofol

“…Lee et al (2004) corroboram a assertiva ao atestarem progressão entre T7 e T11 relativa à administração de 0,3mL/kg de azul de metileno no espaço epidural (L7-S1) de felinos. Em estudo recente, o uso epidural (L7-S1) de lidocaína associada à morfina ou à metadona em volume final de 0,25mL/kg, determinou analgesia adequada e prolongada em felinas submetidas à OSH (DeRossi et al, 2016). Complementarmente, a associação tramadollidocaína, em doses idênticas à do estudo em pauta, demonstrou analgesia superior ao uso do anestésico local isolado, com propagação cranial satisfatória (T13-L1) em felinas (Hermeto et al, 2015).…”

Analgesic effect of epidural maropitant and the combination of maropitant and lidocaine in cats subjected to ovariohysterectomy

“…The groups that received only lidocaine (ELG) and only maropitant (EMG) required rescue analgesia two hours into the post-operative period, while the group that received both maropitant and lidocaine (ELMG) required rescue analgesia three hours after the operation. While evaluating the use of lidocaine through epidural administration, previous studies (DeRossi et al, 2016) also observed that the animals that received only lidocaine required rescue analgesia after two hours in the postoperative period. These results are similar in female dogs subjected to ovariohysterectomy that received only lumbosacral epidural lidocaine (Hermeto et al, 2017).…”

“…Research, Society and Development, v. 11, n. 7, e17511729612, 2022 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v11i7.29612 3 The use of epidural analgesics is advantageous because of long duration of action and the low required doses (Castro et al, 2009). In cats and dogs, both anesthesia and analgesia through the epidural space can be used for both elective and emergency surgical procedures (Robertson & Taylor, 2004;Valverde, 2008;DeRossi et al, 2016;Fernandez-Parra et al, 2017;Steagall et al, 2017). Although some drugs such as α2-adrenergic agonists and ketamine are used for the purpose of analgesia, opioids are used more frequently (Valverde, 2008;Steagall et al, 2017).…”

Preperitoneal ropivacaine infusion versus epidural ropivacaine–morphine for postoperative analgesia in dogs undergoing ovariohysterectomy: a randomized clinical trial

“…Epidural anaesthesia allows postoperative pain management with the use of different drugs, such as opioids, local anaesthetics or α2--adrenoceptor agonists (DeRossi et al 2016;Steagall et al 2017;Garcia-Pereira, 2018). Although it is a commonly used technique, complications such as hypotension, bradycardia, ventilatory depression or urinary retention have been reported (Jones, 2001;Cerasoli et al 2017).…”