Retrospective assessment of the relationship between intraoperative nociception and postoperative analgesia requirements in dogs undergoing thoracic surgery

Abstract

Background The analgesia management of thoracic surgery can be challenging and debate exists regarding the efficacy of pre‐emptive analgesia and its relationship with postoperative pain. The aim of this study was to assess the relationship between intraoperative nociception and postoperative pain in dogs undergoing thoracic surgery. If proven, effective prevention of intraoperative nociception could imply prospective lower postoperative analgesia requirements. Methods The study was retrospective and observational. Clinical records from dogs undergoing thoracic surgery (2015–2019) were reviewed and cases were allocated to one of two groups: NOCI‐FREE – dogs with no evidence of intraoperative nociception; NOCI – dogs that required intraoperative rescue analgesia to address a nociceptive response. Pre‐anaesthetic medication, locoregional analgesia, intraoperative infusions and rescue analgesia were used. Additionally, postoperative pain scores and analgesia plans were registered and compared between groups. Results Our study failed to identify a difference in the postoperative pain scores and analgesia requirements between dogs having signs of intraoperative nociception and those without. Additionally, the use of postoperative analgesic preventive infusions and rescue analgesia was similar for both NOCI and NOCI‐FREE. Being on an intraoperative infusion of opioids, dexmedetomidine or lidocaine was identified as a protective factor for nociception [OR = 11; (4.15–29.7)]. Conclusions In the population studied, it appears that dogs showing signs of nociception intraoperatively do not necessarily show higher pain scores nor do they need additionally pain relief in the postoperative period.

Anestesia livre de opioides com infusão contínua de sulfato de magnésio e bloqueio intercostal em toracotomia exploratória em um cão

“…Segundo Corrêa (2021), a analgesia obtida por bloqueios locorregionais tem sido sugerida como a técnica mais eficaz na redução de estímulos nociceptivos durante a cirurgia, inclusive em toracotomias, onde os bloqueios paravertebral, intercostal ou interpleural são Brazilian Journal of Health Review, Curitiba, v. 7, n. 1, p. 874-887, jan./fev., 2024 considerados eficientes (KHALIL et al, 2017). No presente caso, o bloqueio dos nervos intercostais para toracotomia exploratória foi fundamental para garantir analgesia e ausência de nocicepção durante todo o período intraoperatório, proporcionando também maior conforto no pós-operatório imediato.…”