The challenge of evaluating pain and a pre-incisional local anesthetic block

Abstract

Background. Our objective was to test the effectiveness of a local anesthetic line block administered before surgery in reducing postoperative pain scores in dogs undergoing ovariohysterectomy (OVHX).Methods. This study is a prospective, randomized, blinded, clinical trial involving 59 healthy female dogs. An algometric pressure-measuring device was used to determine nociceptive threshold, and compared to three subjective pain scales. Group L/B received a line block of lidocaine (4 mg/kg) and bupivacaine (1 mg/kg) subcutaneously in the area of the incision site and saline subcutaneously as premedication; group L/BM (positive control) received a similar block and morphine (0.5 mg/kg) subcutaneously for premedication; and group SS (negative control) received a saline line block and saline premedication. Criteria for rescue analgesia were defined before the study. Dogs were assessed prior to surgery, at extubation (time 0) and at 2, 4, 6, 8 and 24 h post-recovery. The data were analyzed with one-way ANOVA, and a Split Plot Repeated Measures ANOVA with one grouping factor and one repeat factor (time). P < 0.05 was considered statistically significant.Results. Approximately 33% of dogs required rescue analgesia at some point during the study, with no significant difference between groups. There was no significant difference between treatment groups with any assessment method.Conclusions. As there were no statistically significant differences between positive and negative controls, the outcome of this technique cannot be proven.

Meta-analysis of pain and stress in emergency department patients

“…The individual factors regarding the way of feeling pain for patients and the preferences might also be of great importance [14][15][16]. Our findings have shown that women are statistically less frequent to report pain.…”

Comparison of bupivacaine and dexmedetomidine femoral and sciatic nerve blocks with bupivacaine and buprenorphine epidural injection for stifle arthroplasty in dogs

“…Hence there was no evidence to support technical failure in the animals that required early rescue analgesia. An alternative explanation is that the CMPS-SF might not be able to discriminate anxiety or dysphoria from pain behavior (McKune et al 2014). That being the case, animals experiencing emergence dysphoria could have received pain scores that erroneously indicated a need for rescue analgesia.…”

Intraperitoneal bupivacaine with or without incisional bupivacaine for postoperative analgesia in dogs undergoing ovariohysterectomy

“…; McKune et al. ). The pre‐ and post‐INC administration of bupivacaine ± lidocaine did not show analgesic benefits in two studies (Fitzpatrick et al.…”

“…; McKune et al. ). The combination of IP and INC bupivacaine was shown to provide effective analgesia in one study (Carpenter et al.…”