OCTOBRE 2018 - ACTUS DOULEURS

 

1/ Assessment of postoperative inflammatory markers and pain in cats after laparoscopy and miniceliotomy ovariectomy

Conceição, MEBAMD., Uscategui, RAR., Bertolo, PHL., de Souza, DC., Rolemberg, DDS., de Moraes, PC., Teixeira, PPM., Dias, LGGG.

Veterinary Record Published Online First: 25 September 2018.

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Videosurgery is increasingly used in veterinary medicine.
Compared with open surgery, it has been shown to cause minimal pain and promote a more rapid recovery.
There are various methods of assessing pain and postoperative inflammation in cats, although their particular behaviours may make these assessments difficult.
The aim of this study was to compare levels of postoperative pain and inflammation after laparoscopic ovariectomy with an open minimally invasive technique.

Twenty queens were randomly divided into two groups based on the method of haemostasis and surgical technique: (1) laparoscopic ovariectomy using a miniloop (miniloop group (MG)); and (2) minilaparotomy using a Snook hook (control group (CG)).
Heart rate (HR), respiratory rate (RR), end tidal CO2 (EtCO2) and body temperature were assessed using a multiparametric monitor during anaesthesia and surgery at defined surgical time points (preincision, left ovary manipulation, right ovary manipulation and skin suture).

Blood samples (2 mL each) were collected from the jugular vein before surgery and 1, 12, 24, 48 and 72 hours, and 10 days, after endotracheal extubation for blood count analysis and to assess total protein and acute phase proteins (APP). EtCO2 and RR were significantly higher in MG patients (P<0.001). HR was higher in the CG group for the duration of surgery (P=0.01).
Temperature was significantly lower in MG patients (P<0.001). Pain assessment by dynamic interactive visual analogue scale showed no difference between groups or at specific moments of time within groups. Segmented neutrophil counts increased at 24 hours postoperatively and peaked at 48 and 72 hours in MG (P=0.01).
The most important result among APPs was haptoglobin, which peaked at 72 hours in MG patients (P=0.001).
Patients undergoing minilaparotomy and laparoscopy showed comparable postoperative pain.

However, inflammatory changes such as APPs and neutrophil counts were increased in the laparoscopic group


2/ Cranial versus caudal thoracic epidural anesthesia using three volumes of lidocaine in conscious Beagle dogs

Son Won-gyun, Jang Min, Jo Sang-min, Kim Hyunseok, Lee Inhyung

Vet. Anesth. Analges., In Press, Accepted Manuscript, Available online 26 September 2018

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Objective

To compare the effects of epidural injection of three volumes of lidocaine injected at the third (T3) or eleventh thoracic vertebra (T11) in conscious dogs to induce thoracic epidural anesthesia (TEA) and to measure the epidural dispersion of iohexol under similar conditions.

Study design

Prospective crossover experiment.
Animals A group of five Beagle dogs weighing 10.4 ± 0.5 kg (mean ± standard deviation). 

Methods

Each dog was anesthetized twice, separated by 1 week, for inserting an epidural catheter at the lumbosacral space and advancing the tip to T3 (treatment TEAT3) or T11 (treatment TEAT11).
For each treatment, three volumes of 2% lidocaine (0.05, 0.10 and 0.20 mL kg−1) were administered at 24-hour intervals, and sensory blockade (SB) of dermatomes was estimated by pinching the skin with mosquito forceps.
Under identical conditions of injection volume and site, iohexol was administered 3 hours after lidocaine injection to identify epidural distribution (ED) by using computed tomography. The effects of injection site and volume on SB of thoracic dermatomes and ED were analyzed using a linear mixed model (p < 0.05). 

Results

Thoracic SB and ED significantly increased as the volume increased (p < 0.001 and p < 0.001, respectively), and significantly decreased in TEAT3 than in TEAT11 (p = 0.011 and p = 0.002, respectively).
Cervical SB was obtained in three of five dogs in TEAT3 and two of five dogs in TEAT11 injected with 0.20 mL kg−1.
One dog showed temporary inspiratory stridor probably caused by bilateral laryngeal paralysis, but no hypoxia. 

Conclusions and clinical relevance

TEA induced at T3 produced less thoracic SB than did TEA at T11 with the same volumes of lidocaine.
The cervical SB obtained with the highest volume of lidocaine may increase the risk of laryngeal paralysis and pulmonary aspiration.


 
Thierry Poitte