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Objective: To compare perioperative opioid consumption in dogs undergoing pelvic limb surgeries and receiving a lumbosacral plexus block by combining a lumbar [lateral pre-iliac (LPI)] block with a lumbosacral trunk [i.e. parasacral (PS group) or greater ischiatic notch plane (GIN group)] block. Study design Retrospective, descriptive, exploratory, noninferiority cohort study., Methods: Medical records of 37 client-owned dogs were analyzed. Intraoperative (primary outcome) and postoperative (24 hours) opioid use, 24 hour cumulative pain scores and prevalence of complications were compared between the two groups. Opioid use was quantified in morphine equivalents (ME, mg kg -1 ). The noninferiority limit for intraoperative opioid consumption was set at 0.05 ME kg -1 hour -1 . Demographic data, procedure duration, surgery type and perioperative dexmedetomidine and ketamine use were also collected. A t-test or Wilcoxon rank-sum test, a Fisher's exact test and multivariable linear regression were used. Significance was set at p < 0.05., Results: The GIN and PS groups comprised 17 and 20 dogs, respectively. Total intraoperative ME consumption was 0.17 (0.11-0.21) and 0.22 (0.16-0.30) mg kg -1 hour -1 for the GIN and PS groups, respectively (p = 0.077). The noninferiority analysis adjusted by surgery type and body mass revealed that the mean difference between the groups (GIN - PS) was -0.039 (95% CI -0.11-0.03, p = 0.247) ME mg kg -1 hour -1 , indicating that the GIN group was not inferior to the PS group regarding intraoperative ME consumption. Dexmedetomidine and ketamine use, postoperative ME consumption and pain scores were similar between groups., Conclusions and Clinical Relevance: This retrospective study and preliminary observations support the clinical use of the GIN plane block, demonstrating its noninferiority to the PS block when combined with the LPI block for multimodal perioperative analgesia in dogs undergoing pelvic limb surgeries., (Copyright © 2024 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Objective: To compare the perioperative effects and pharmacoeconomics of peripheral nerve blocks (PNBs) versus fentanyl target-controlled infusion (fTCI) in dogs undergoing tibial plateau levelling osteotomy (TPLO)., Study Design: Randomized clinical study., Animals: A total of 39 dogs undergoing unilateral TPLO., Methods: After acepromazine and methadone, anaesthesia was induced with propofol and maintained with isoflurane. Dogs were allocated to group fTCI [target plasma concentration (TPC) 1 ng mL -1 ] or group PNB (nerve stimulator-guided femoral-sciatic block using 0.2 and 0.1 mL kg -1 of levobupivacaine 0.5%, respectively). If nociceptive response occurred, isoflurane was increased by 0.1%, and TPC was increased by 0.5 ng mL -1 in group fTCI; a fentanyl bolus (1 μg kg -1 ) was administered in group PNB. During the first 24 postoperative hours, methadone (0.2 mg kg -1 ) was administered intramuscularly according to the Short Form Glasgow Composite Pain Scale, or if pain was equal to 5/24 or 4/20 for two consecutive assessments, or if the dog was non-weight bearing. The area under the curve (AUC) of pain scores, cumulative postoperative methadone requirement, food intake and pharmacoeconomic implications were calculated., Results: Incidence of bradycardia (p = 0.025), nociceptive response to surgery (p = 0.041) and AUC of pain scores (p < 0.0001) were greater in group fTCI. Postoperatively, 16/19 (84.2%) and eight/20 (40%) dogs in groups fTCI and PNB, respectively, were given at least one dose of methadone (p = 0.0079). Food intake was greater in group PNB (p = 0.049). Although total cost was not different (p = 0.083), PNB was more cost-effective in dogs weighing >15 kg., Conclusions and Clinical Relevance: Compared with group fTCI, incidence of bradycardia, nociceptive response to surgery, postoperative pain scores, cumulative methadone requirement were lower, and food intake was greater in group PNB, with an economic advantage in dogs weighing >15 kg., (Copyright © 2019 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Objective: To compare the efficacy and side effects of postoperative methadone administered according to pain score (PS) or every 4 hours (Q4), after unilateral uncomplicated tibial plateau levelling osteotomy (TPLO) in dogs in which a peripheral nerve block (PNB) was administered., Study Design: Retrospective, case-control study., Animals: Clinical records of dogs that underwent a TPLO in 2015 were retrieved; 136 out of 174 dogs were included: 52 assigned to group PS, 84 to group Q4., Methods: In group PS, methadone was administered according to the short form of the Glasgow Composite Measure Pain Scale (CMPS-SF), whereas in group Q4 methadone was administered at 4 hour intervals. Demographic data, anaesthetic technique, surgery time, American Society of Anesthesiologists classification, PNB performed, local anaesthetic used and dose, anti-inflammatory drugs administered, end-expiratory fraction of isoflurane, perioperative opioid consumption, time to first postoperative methadone administration, pain scores, time to first pain score, food intake, number of postoperative observations, presence/absence of specific keywords representing the general state and behaviour of the animal, use of the operated limb and reaction to wound palpation were retrieved. Fisher's exact test, chi-square test, Student t test or Mann-Whitney U test were used, considering p<0.05 significant. Odds ratios and 95% confidence intervals were calculated, when indicated., Results: Four times more methadone was administered to dogs in group Q4, and whilst not having lower pain scores or better short-term outcome (e.g. toe-touching and weight bearing), were 23.42 times (1.37 to 400.40) more likely to vomit, 3.76 (1.50 to 9.49) more likely to vocalize, and their food intake was 38% less than dogs in group PS. No dogs in group PS vomited postoperatively., Conclusions and Clinical Relevance: Administration of methadone Q4 caused more side effects than administration guided by CMPS-SF. This should be considered when planning postoperative analgesia in dogs undergoing uncomplicated TPLO and in which a PNB has been performed., (Copyright © 2018 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Objective: To investigate the effect of intraoperative extradural morphine administration on postoperative analgesia in dogs undergoing thoracolumbar spinal surgery to treat disk extrusion., Design: Prospective clinical trial., Animals: 26 client-owned dogs undergoing thoracolumbar spinal surgery., Procedures: Animals were randomly allocated to receive morphine (0.1 mg/kg [0.045 mg/lb], extradurally) or no treatment (control group). Following preanesthetic medication with methadone (0.25 mg/kg [0.11 mg/lb], IM), anesthesia was induced with propofol and maintained with isoflurane or sevoflurane in oxygen. Lidocaine and fentanyl were administered during surgery in both groups at fixed rates. In the morphine administration group, morphine was splashed over the dura mater immediately prior to wound closure. Postoperative analgesia was assessed for 48 hours by assessors unaware of group allocation, and methadone was administered as rescue analgesic. Demographic characteristics, urinary output, days of hospitalization, and perioperative use of analgesics were compared via a Mann-Whitney U test., Results: Demographic data were similar between groups. In the morphine administration group, 2 of 13 dogs required postoperative methadone, and in the control group, methadone was administered to 11 of 13 dogs. The total number of doses of methadone administered in the 48 hours after surgery was 28 in the control group and 3 in the morphine administration group. No adverse effects were recorded in any group., Conclusions and Clinical Relevance: Intraoperative extradural morphine administration was effective in reducing postoperative analgesic requirement. Dogs undergoing thoracolumbar spinal surgery benefited from topical administration of preservative-free morphine administered directly on the dura mater as part of analgesic management.

Objectives: To compare the analgesic and sedative effects of butorphanol and pethidine (meperidine) in dogs., Methods: Twenty-eight female dogs undergoing ovariectomy (20) or ovariohysterectomy (8) were randomly divided into two groups. Pre-anaesthetic medication in group B consisted of 20 μg/kg intramuscular (im) acepromazine and 0·4 mg/kg butorphanol, while group P received 20 μg/kg acepromazine with 5 mg/kg pethidine. The resulting sedation (simple descriptive scale), propofol dose required to induce anaesthesia, several intraoperative cardiorespiratory variables and postoperative pain (Colorado Pain Scoring System) were compared between the two groups. A 0·2 mg/kg meloxicam dose was administered intravenously to all animals at the end of the 4 hours observation period, or earlier if the pain score was more than 13., Results: Sedation scores, propofol induction doses and intraoperative cardiorespiratory variables were not different between groups. Postoperative pain scores were also similar although one dog in group B required rescue analgesia. Five dogs in group P vomited postoperatively., Clinical Significance: Either butorphanol and pethidine, combined with acepromazine, produced reliable sedation and analgesia up to 4 hours after intramuscular injection in dogs., (© 2011 British Small Animal Veterinary Association.)

Tramadol is a synthetic opioid agonist used extensively in human and, to a lesser extent, veterinary medicine throughout the world. The clinical efficacy and pharmacokinetic profile of intravenous (i.v.) and extradural (e.d.) tramadol (2 mg/kg) and its o-desmethyl metabolite were studied in dogs undergoing tibial plateau levelling osteotomy (TPLO). Intra-operative cardiorespiratory variables were monitored and post-operative pain was assessed using the short form of the Glasgow Composite Pain Scale. A rapid (<5 min) and effective production of o-desmethyl tramadol was recorded. The pharmacokinetic profile was similar for tramadol and its metabolite irrespective of the route of administration. E.d. tramadol provided sufficient intra- and post-operative analgesia without significant clinical side-effects, but the post-operative analgesia was comparable to that following i.v. administration and the e.d. route could therefore not be considered a practical alternative to the i.v. route., (2008 Elsevier Ltd. All rights reserved.)