Single thoracic epidural injection for intra‐ and post‐lateral thoracotomy analgesia in a dog

Abstract

A 16-month-old cocker spaniel, body mass 15 kg, was presented for general anaesthesia for thoracotomy and lung lobectomy. Preanaesthetic medication was with intramuscular medetomidine (0.01 mg/kg) and methadone (0.2 mg/kg). General anaesthesia was induced with propofol and maintained with propofol and ketamine infusions. A single thoracic epidural injection with levobupivacaine (0.5%, 1 mg/kg) and morphine (0.1 mg/kg) at the 12th-13th thoracic intervertebral space was performed. Postoperative analgesia was with one intravenous dose of methadone (0.2 mg/kg), levobupivacaine (1 mg/kg) via indwelling thoracostomy tube and intravenous paracetamol (10 mg/kg) every 8 hours, and meloxicam (0.1 mg/kg) orally every 24 hours. Pain scoring (Glasgow CMPS-SF) was carried out every 4 hours until 1 hour after removal of the thoracostomy tube, never exceeding 2/24. No further opioid analgesics were administered and the patient was discharged with no complications.

Thoracic epidural anaesthesia vs intrathecal morphine in dogs undergoing major thoracic and abdominal surgery: clinical study

“…Two common neuraxial techniques for severe acute postoperative pain in human patients are thoracic epidural analgesia (TEA) and intrathecal morphine (ITM). There is scant clinical research on neuraxial analgesia in dogs undergoing thoracotomy and cranial abdomen surgery, however [2][3][4]. To our best knowledge, no prospective clinical studies in veterinary anaesthesia have investigated the efficacy of TEA in treating perioperative pain, although the technique for accessing thoracic epidural space in dogs is the same as that described for humans decades ago [5,6].…”