The influence of the choice of preemptive analgesia on long-term postsurgical pain after tibial plateau leveling osteotomy in dogs.

Veterinary surgery : VS Pub Date : 2021-01-01 Epub Date: 2020-09-21 DOI:10.1111/vsu.13515
William Pownall, Ulrich Rytz, Gertraud Schuepbach, Claudia Spadavecchia, Helene Rohrbach
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引用次数: 3

Abstract

Objective: To evaluate the prevalence of chronic postsurgical pain (CPSP) after tibial plateau leveling osteotomy (TPLO) in dogs and to determine the influence of preemptive locoregional analgesia on CPSP.

Study design: Retrospective study.

Animals: One hundred twenty client-owned dogs.

Methods: Medical records of dogs that underwent TPLO between 2012 and 2016 were reviewed for demographic information and type of preemptive analgesia. Owners were contacted to retrospectively assess the quality of life of their dogs by using the Helsinki Chronic Pain Index (HCPI) before and 6 months after surgery and at the time of questioning. An HCPI score > 12 was considered indicative of CPSP. Medical records were reviewed for demographic information and type of preemptive analgesia. A cumulative logit model was used to assess correlation of type of perioperative analgesia, HCPI, and demographic data.

Results: The HCPI score was consistent with CPSP in 41 of 101 dogs with long-term follow-up (2.9 ± 1.5 years after surgery). Chronic postsurgical pain was documented in 11 of 32 and 13 of 28 dogs that received a spinal or epidural injection, respectively, or in 28 of 80 and 25 of 67 dogs with sciatic-femoral block at 6 months or with long-term follow-up after TPLO, respectively (P > .05). A negative correlation was found between HCPI and both weight and age 6 months after surgery. Only weight remained negatively correlated 2.9 years after surgery.

Conclusion: Forty-one percent of dogs that were evaluated exhibited HCPI values compatible with CPSP long-term after TPLO, regardless of the type of preemptive analgesia. Increased body weight was a negative prognostic factor for CPSP development.

Clinical significance: Additional studies are required to evaluate CPSP development after TPLO.

先发制人镇痛对犬胫骨平台平截骨术后长期疼痛的影响。
目的:了解犬胫骨平台平截骨术(TPLO)术后慢性术后疼痛(CPSP)的发生率,探讨预防性局部镇痛对CPSP的影响。研究设计:回顾性研究。动物:120只客户拥有的狗。方法:回顾2012 - 2016年接受TPLO手术的犬类病历,了解其人口学信息和先发制人镇痛的类型。通过使用赫尔辛基慢性疼痛指数(HCPI),在术前、术后6个月以及询问时,联系饲主回顾性评估其狗的生活质量。HCPI评分> 12被认为是CPSP的指示。回顾了医疗记录的人口统计信息和先发制人镇痛的类型。采用累积logit模型评估围手术期镇痛类型、HCPI和人口学数据的相关性。结果:101只狗长期随访(术后2.9±1.5年),其中41只狗HCPI评分与CPSP一致。32只接受脊髓或硬膜外注射的犬中有11只出现术后慢性疼痛,28只接受脊髓或硬膜外注射的犬中有13只出现术后慢性疼痛,在TPLO术后6个月或长期随访时,80只接受坐骨-股阻滞的犬中有28只出现术后慢性疼痛,67只接受坐骨-股阻滞的犬中有25只出现术后慢性疼痛(P > 0.05)。术后6个月HCPI与体重和年龄均呈负相关。只有体重在手术后2.9年仍然呈负相关。结论:无论何种类型的先发制人镇痛,41%的评估犬在TPLO后表现出与CPSP长期相容的HCPI值。体重增加是CPSP发展的负面预后因素。临床意义:需要进一步的研究来评估TPLO后CPSP的发展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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