Objective To compare the perioperative cumulative opioid consumption and the incidence of cardiovascular complications in dogs undergoing hemilaminectomy in which either an erector spinae plane (ESP) block or systemic opioids were administered. Study design Prospective randomized clinical trial. Animals A total of 60 client-owned dogs. Methods Dogs were randomized to one of three groups: an ESP block (group ESP), a constant rate infusion of fentanyl (group FNT, positive control) or a single dose of methadone as premedication (group MTD, negative control). Intraoperative nociceptive response was treated with fentanyl [1 μg kg–1, intravenously (IV)] boli. Before closure of the surgical site, morphine (0.1 mg kg–1) was applied to the dura mater. The cumulative dose of opioids was recorded and compared between groups. The incidence of intraoperative bradycardia and/or hypotension and the time to extubation were compared between groups. The short form of the Glasgow Composite Pain Scale (SF-GCPS) was used to score nociception before anaesthetic induction and 1, 2, 6, 12,18 and 24 hours postoperatively. Methadone 0.2 mg kg–1 was administered IV if the SF-GCPS score was ≥ 5. Results Group MTD required more intraoperative rescue analgesia than groups ESP (p = 0.008) and FNT (p = 0.001). The total cumulative intraoperative dose of fentanyl was higher in groups FNT (p < 0.0001) and MTD (p = 0.002) than in group ESP. The incidence of cardiovascular complications was similar between groups. Extubation time was longer in group MTD (p = 0.03). Postoperatively, the time to first rescue analgesia was longer in group ESP than in group MTD (p = 0.03). The cumulative postoperative opioid consumption and pain scores were similar between groups. Conclusions and clinical relevance The ESP block resulted in a reduced intraoperative opioid consumption compared with the control positive and negative groups.
Evaluation of erector spinae plane block as an opioid-sparing technique in dogs undergoing hemilaminectomy: A prospective randomized trial / Bendinelli, Cristiano; D’Angelo, Marianna; Leonardi, Fabio; Verdier, Natali; Cozzi, Francesca; Lombardo, Rocco; Portela, Diego A.. - In: VETERINARY ANAESTHESIA AND ANALGESIA. - ISSN 1467-2987. - 51:3(2024), pp. 279-287. [10.1016/j.vaa.2024.02.002]
Evaluation of erector spinae plane block as an opioid-sparing technique in dogs undergoing hemilaminectomy: A prospective randomized trial.
Fabio Leonardi;
2024-01-01
Abstract
Objective To compare the perioperative cumulative opioid consumption and the incidence of cardiovascular complications in dogs undergoing hemilaminectomy in which either an erector spinae plane (ESP) block or systemic opioids were administered. Study design Prospective randomized clinical trial. Animals A total of 60 client-owned dogs. Methods Dogs were randomized to one of three groups: an ESP block (group ESP), a constant rate infusion of fentanyl (group FNT, positive control) or a single dose of methadone as premedication (group MTD, negative control). Intraoperative nociceptive response was treated with fentanyl [1 μg kg–1, intravenously (IV)] boli. Before closure of the surgical site, morphine (0.1 mg kg–1) was applied to the dura mater. The cumulative dose of opioids was recorded and compared between groups. The incidence of intraoperative bradycardia and/or hypotension and the time to extubation were compared between groups. The short form of the Glasgow Composite Pain Scale (SF-GCPS) was used to score nociception before anaesthetic induction and 1, 2, 6, 12,18 and 24 hours postoperatively. Methadone 0.2 mg kg–1 was administered IV if the SF-GCPS score was ≥ 5. Results Group MTD required more intraoperative rescue analgesia than groups ESP (p = 0.008) and FNT (p = 0.001). The total cumulative intraoperative dose of fentanyl was higher in groups FNT (p < 0.0001) and MTD (p = 0.002) than in group ESP. The incidence of cardiovascular complications was similar between groups. Extubation time was longer in group MTD (p = 0.03). Postoperatively, the time to first rescue analgesia was longer in group ESP than in group MTD (p = 0.03). The cumulative postoperative opioid consumption and pain scores were similar between groups. Conclusions and clinical relevance The ESP block resulted in a reduced intraoperative opioid consumption compared with the control positive and negative groups.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
