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Comparison of analgesic efficacy of epidural methadone or ropivacaine/methadone with or without pre-operative oral tepoxalin in dogs undergoing tuberositas tibiae advancement surgery

Tim Bosmans (UGent) , Koen Piron (UGent) , Maarten Oosterlinck (UGent) , Frank Gasthuys (UGent) , Luc Duchateau (UGent) , Tim Waelbers (UGent) , Yves Samoy (UGent) , Delphine Van Vynckt (UGent) and Ingeborgh Polis (UGent)
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Abstract
Objective : To investigate the clinical efficacy of four analgesia protocols in dogs undergoing tibial tuberosity advancement (TTA). Study design : Prospective, randomized, blinded study. Animals : Thirty-two client owned dogs undergoing TTA-surgery. Methods : Dogs (n = 8 per treatment) received an oral placebo (PM and PRM) or tepoxalin (10 mg kg)1) tablet (TM and TRM) once daily for 1 week before surgery. Epidural methadone (0.1 mg kg)1) (PM and TM) or the epidural combination methadone (0.1 mg kg)1)/ropivacaine 0.75% (1.65 mg kg)1) (PRM and TRM) was administered after induction of anaesthesia. Intra-operative fentanyl requirements (2 lg kg)1 IV) and end-tidal isoflurane concentration after 60 minutes of anaesthesia (FE¢ISO60) were recorded. Post-operative analgesia was evaluated hourly from 1 to 8 and at 20 hours post-extubation with a visual analogue scale (VAS) and the University of Melbourne Pain Scale (UMPS). If VAS > 50 and/or UMPS > 10, rescue methadone (0.1 mg kg)1) was administered IV. Analgesic duration (time from epidural until post-operative rescue analgesia) and time to standing were recorded. Normally distributed variables were analysed with an F-test (a = 0.05) or t-test for pairwise inter-treatment comparisons (Bonferonni adjusted a = 0.0083). Non-normally distributed data were analysed with the Kruskall–Wallis test (a = 0.05orBonferonni adjusteda = 0.005for intertreatment comparison of post-operative pain scores). Results : More intra-operative analgesia interventions were required in PM [2 (0–11)] [median (range)] and TM [2 (1–2)] compared to PRM (0) and TRM (0). FE¢ISO60 was significantly lower in (PRM + TRM) compared to (PM + TM). Analgesic duration was shorter in PM (459 ± 276 minutes) (mean ± SD) and TM (318 ± 152 minutes) compared to TRM (853 ± 288 minutes), but not to PRM (554 ± 234 minutes). Times to standing were longer in the ropivacaine treatments compared to TM. Conclusions and clinical relevance : Inclusion of epidural ropivacaine resulted in reduction of FEISO60, avoidance of intra-operative fentanyl administration, a longer duration of post-operative analgesia (in TRM) and a delay in time to standing compared to TM.
Keywords
epidural, dogs, methadone, ropivacaine, tibial tuberosity advancement, tepoxalin

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MLA
Bosmans, Tim, Koen Piron, Maarten Oosterlinck, et al. “Comparison of Analgesic Efficacy of Epidural Methadone or Ropivacaine/methadone with or Without Pre-operative Oral Tepoxalin in Dogs Undergoing Tuberositas Tibiae Advancement Surgery.” VETERINARY ANAESTHESIA AND ANALGESIA 39.6 (2012): 618–627. Print.
APA
Bosmans, T., Piron, K., Oosterlinck, M., Gasthuys, F., Duchateau, L., Waelbers, T., Samoy, Y., et al. (2012). Comparison of analgesic efficacy of epidural methadone or ropivacaine/methadone with or without pre-operative oral tepoxalin in dogs undergoing tuberositas tibiae advancement surgery. VETERINARY ANAESTHESIA AND ANALGESIA, 39(6), 618–627.
Chicago author-date
Bosmans, Tim, Koen Piron, Maarten Oosterlinck, Frank Gasthuys, Luc Duchateau, Tim Waelbers, Yves Samoy, Delphine Van Vynckt, and Ingeborgh Polis. 2012. “Comparison of Analgesic Efficacy of Epidural Methadone or Ropivacaine/methadone with or Without Pre-operative Oral Tepoxalin in Dogs Undergoing Tuberositas Tibiae Advancement Surgery.” Veterinary Anaesthesia and Analgesia 39 (6): 618–627.
Chicago author-date (all authors)
Bosmans, Tim, Koen Piron, Maarten Oosterlinck, Frank Gasthuys, Luc Duchateau, Tim Waelbers, Yves Samoy, Delphine Van Vynckt, and Ingeborgh Polis. 2012. “Comparison of Analgesic Efficacy of Epidural Methadone or Ropivacaine/methadone with or Without Pre-operative Oral Tepoxalin in Dogs Undergoing Tuberositas Tibiae Advancement Surgery.” Veterinary Anaesthesia and Analgesia 39 (6): 618–627.
Vancouver
1.
Bosmans T, Piron K, Oosterlinck M, Gasthuys F, Duchateau L, Waelbers T, et al. Comparison of analgesic efficacy of epidural methadone or ropivacaine/methadone with or without pre-operative oral tepoxalin in dogs undergoing tuberositas tibiae advancement surgery. VETERINARY ANAESTHESIA AND ANALGESIA. 2012;39(6):618–27.
IEEE
[1]
T. Bosmans et al., “Comparison of analgesic efficacy of epidural methadone or ropivacaine/methadone with or without pre-operative oral tepoxalin in dogs undergoing tuberositas tibiae advancement surgery,” VETERINARY ANAESTHESIA AND ANALGESIA, vol. 39, no. 6, pp. 618–627, 2012.
@article{3047041,
  abstract     = {Objective : To investigate the clinical efficacy of four analgesia protocols in dogs undergoing tibial tuberosity advancement (TTA).
Study design : Prospective, randomized, blinded study.
Animals : Thirty-two client owned dogs undergoing TTA-surgery.
Methods : Dogs (n = 8 per treatment) received an oral placebo (PM and PRM) or tepoxalin (10 mg kg)1) tablet (TM and TRM) once daily for 1 week before surgery. Epidural methadone (0.1 mg kg)1) (PM and TM) or the epidural combination methadone (0.1 mg kg)1)/ropivacaine 0.75% (1.65 mg kg)1) (PRM and TRM) was administered after induction of anaesthesia. Intra-operative fentanyl requirements (2 lg kg)1 IV) and end-tidal isoflurane concentration after 60 minutes of anaesthesia (FE¢ISO60) were recorded. Post-operative analgesia was evaluated hourly from 1 to 8 and at 20 hours post-extubation with a visual analogue scale (VAS) and the University of Melbourne Pain Scale (UMPS). If VAS > 50 and/or UMPS > 10, rescue methadone (0.1 mg kg)1) was administered IV. Analgesic duration (time from epidural until post-operative rescue analgesia) and time to standing were recorded. Normally distributed variables were analysed with an F-test (a = 0.05) or t-test for pairwise inter-treatment comparisons (Bonferonni adjusted a = 0.0083). Non-normally distributed data were analysed with the Kruskall–Wallis test (a = 0.05orBonferonni adjusteda = 0.005for intertreatment comparison of post-operative pain scores).
Results : More intra-operative analgesia interventions were required in PM [2 (0–11)] [median (range)] and TM [2 (1–2)] compared to PRM (0) and TRM (0). FE¢ISO60 was significantly lower in (PRM + TRM) compared to (PM + TM). Analgesic duration was shorter in PM (459 ± 276 minutes) (mean ± SD) and TM (318 ± 152 minutes) compared to TRM (853 ± 288 minutes), but not to PRM (554 ± 234 minutes). Times to standing were longer in the ropivacaine treatments compared to TM.
Conclusions and clinical relevance : Inclusion of epidural ropivacaine resulted in reduction of FEISO60, avoidance of intra-operative fentanyl administration, a longer duration of post-operative analgesia (in TRM) and a delay in time to standing compared to TM.},
  author       = {Bosmans, Tim and Piron, Koen and Oosterlinck, Maarten and Gasthuys, Frank and Duchateau, Luc and Waelbers, Tim and Samoy, Yves and Van Vynckt, Delphine and Polis, Ingeborgh},
  issn         = {1467-2987},
  journal      = {VETERINARY ANAESTHESIA AND ANALGESIA},
  keywords     = {epidural,dogs,methadone,ropivacaine,tibial tuberosity advancement,tepoxalin},
  language     = {eng},
  number       = {6},
  pages        = {618--627},
  title        = {Comparison of analgesic efficacy of epidural methadone or ropivacaine/methadone with or without pre-operative oral tepoxalin in dogs undergoing tuberositas tibiae advancement surgery},
  url          = {http://dx.doi.org/10.1111/j.1467-2995.2012.00744.x},
  volume       = {39},
  year         = {2012},
}

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