Short‐term efficacy of epidural pain management in dogs undergoing cystoscopy

Abstract

Background: The effects of epidural anesthesia in dogs undergoing cystoscopy are unknown. Objective: To investigate the effect of epidural analgesia on postcystoscopy pain in dogs. Animals: Twenty-six dogs undergoing routine cystoscopy for lower urinary tract disease. Methods: Prospective, randomized, blinded observational study. Dogs were assigned either to a treatment group that received epidural anesthesia (preservative free morphine sulfate, 0.09 mg/kg; 1% ropivacaine, 0.2 mg/kg; total volume delivered, 1 mL/4.5 kg of body weight to a maximum of 10 mL; n = 9) or to a nonepidural control group (n = 13). Vital signs were monitored for 24 hours, and sedation and pain scores, behavioral assessments, and presence or absence of complications was evaluated for 5 days postprocedure. Results: All dogs tolerated the epidural without complications. Four dogs were removed from the study because of status unblinding, lack of patient cooperation, or incomplete follow-up. No significant differences were noted in postprocedural pain scores in dogs that received epidural analgesia. Significant differences in postprocedural pain scores were noted in the nonepidural control group. No significant differences were noted in vital signs, behavioral assessments, or the proportion of dogs with a 50% increase in pain scores between the epidural and nonepidural groups. Conclusions and Clinical Importance: Epidural anesthesia was well-tolerated. Dogs not receiving the epidural had poor postprocedural pain control. A consistent benefit for the epidural vs nonepidural group could not be identified. Additional studies are required to better assess the impact and efficacy of epidural anesthesia for cystoscopic procedures.

Retrospective comparison of modified percutaneous cystolithotomy (PCCLm) and traditional open cystotomy (OC) in dogs: 218 cases (2010–2019)

“…In previous reports, it has been documented that epidural use results in superior post procedural analgesia for cystotomy and cystoscopy patients. 21,22 In other studies comparing laparoscopic urolith removal with OC, anesthesia time is not directly compared between groups but rather, surgery time alone is compared and varies in statistical signfiicance. 16,23 A consideration for the lack of significance in surgical time between the groups is operator experience and function.…”

“…This difference in anesthesia time could be secondary to the OC group receiving local anesthetic blocks that extend anesthesia time, such as an epidural, in anticipation of a more painful procedure. In previous reports, it has been documented that epidural use results in superior post procedural analgesia for cystotomy and cystoscopy patients 21,22 . In other studies comparing laparoscopic urolith removal with OC, anesthesia time is not directly compared between groups but rather, surgery time alone is compared and varies in statistical signfiicance 16,23 .…”