The post-operative analgesic effects of epidurally administered morphine and transdermal fentanyl patch after ovariohysterectomy in dogs.

OBJECTIVE To investigate the analgesic and side effects of epidural morphine or a fentanyl patch after ovariohysterectomy in dogs. STUDY DESIGN Prospective, randomized clinical study. ANIMALS Twenty female mongrel dogs undergoing ovariohysterectomy. METHODS The dogs were allocated to one of two groups: epidural morphine or transdermal fentanyl patch. Anaesthesia was induced with propofol and maintained with isoflurane. Morphine (0.1 mg kg(-1)) was administered epidurally in the epidural morphine group and a transdermal fentanyl patch was applied 24 hours before the operation in the fentanyl patch group. The heart rate, respiratory rate, body temperature, plasma cortisol concentration, and sedation and analgesia scores were recorded during the 24 hour post-operative period. Adverse effects such as vomiting, anorexia, skin reactions, urinary retention, and time to start licking the surgical site were also recorded. p<0.05 was considered significant. Statistical analyses utilized anova for repeated measures, Friedman tests, Mann-Whitney U-tests and independent sample t-tests as relevant. RESULTS Pain scores were lower in the epidural group than in the fentanyl group at all post-operative times. The dogs in the epidural morphine group were calm and relaxed, whereas discomfort and vocalization were recorded in the fentanyl patch group. The sedation scores were higher in the fentanyl patch group throughout the 12 hour period. Salivation and anorexia lasted longer in the fentanyl patch group than in the epidural morphine group. Plasma cortisol concentrations were high in the early post-operative period in both groups. The fentanyl patch group had higher cortisol concentrations than the epidural morphine group. Slight erythema was recorded in two dogs when the patches were removed. CONCLUSION AND CLINICAL RELEVANCE Epidurally administered morphine provided better analgesia and caused fewer adverse effects than the fentanyl patch after ovariohysterectomy in dogs.

[1]  C. Bellenger,et al.  The effects of preoperative extradural bupivacaine and morphine on the stress response in dogs undergoing femoro-tibial joint surgery. , 2006, Veterinary anaesthesia and analgesia.

[2]  F. Corletto,et al.  Combined spinal-epidural anesthesia in a dog. , 2006, Veterinary surgery : VS.

[3]  X. Sala-Blanch,et al.  Analgesic effects of epidurally administered levogyral ketamine alone or in combination with morphine on intraoperative and postoperative pain in dogs undergoing ovariohysterectomy. , 2005, American journal of veterinary research.

[4]  J. Franch,et al.  Comparison between meloxicam and transdermally administered fentanyl for treatment of postoperative pain in dogs undergoing osteotomy of the tibia and fibula and placement of a uniplanar external distraction device. , 2005, Journal of the American Veterinary Medical Association.

[5]  E. Hofmeister,et al.  Transdermal fentanyl patches in small animals. , 2004, Journal of the American Animal Hospital Association.

[6]  P. Kalivas,et al.  Postoperative analgesia in dogs receiving epidural morphine plus medetomidine. , 2003, Journal of veterinary pharmacology and therapeutics.

[7]  P. Pibarot,et al.  Results of preemptive epidural administration of morphine with or without bupivacaine in dogs and cats undergoing surgery: 265 cases (1997-1999). , 2002, Journal of the American Veterinary Medical Association.

[8]  Dacvs Janet A. Welch Dvm,et al.  Evaluation of postoperative respiratory function by serial blood gas analysis in dogs treated with transdermal fentanyl , 2002 .

[9]  James C. Wright,et al.  Evaluation of postoperative respiratory function by serial blood gas analysis in dogs treated with transdermal fentanyl , 2002 .

[10]  J. Riviere,et al.  Potential and problems of developing transdermal patches for veterinary applications. , 2001, Advanced drug delivery reviews.

[11]  A. Nolan,et al.  Development of a behaviour-based scale to measure acute pain in dogs , 2001, Veterinary Record.

[12]  G. Edwards,et al.  Comparison of the effects of morphine administered by constant-rate intravenous infusion or intermittent intramuscular injection in dogs. , 2001, Journal of the American Veterinary Medical Association.

[13]  J. Ko,et al.  Cardiorespiratory responses and plasma cortisol concentrations in dogs treated with medetomidine before undergoing ovariohysterectomy. , 2000, Journal of the American Veterinary Medical Association.

[14]  D. Dyson,et al.  Epidural analgesia and anesthesia. , 2000, The Veterinary clinics of North America. Small animal practice.

[15]  K. Mathews Pain assessment and general approach to management. , 2000, The Veterinary clinics of North America. Small animal practice.

[16]  E. Grisneaux,et al.  Comparison of ketoprofen and carprofen administered prior to orthopedic surgery for control of postoperative pain in dogs. , 1999, Journal of the American Veterinary Medical Association.

[17]  A M Firth,et al.  Development of a scale to evaluate postoperative pain in dogs. , 1999, Journal of the American Veterinary Medical Association.

[18]  M. Markel,et al.  A comparison of transdermal fentanyl versus epidural morphine for analgesia in dogs undergoing major orthopedic surgery. , 1999, Journal of the American Animal Hospital Association.

[19]  E. Hardie,et al.  Comparison of transdermal fentanyl and intramuscular oxymorphone on post-operative behaviour after ovariohysterectomy in dogs. , 1998, Research in veterinary science.

[20]  A M Nolan,et al.  Relationship between physiological factors and clinical pain in dogs scored using a numerical rating scale. , 1998, The Journal of small animal practice.

[21]  T. Duke,et al.  Comparison of plasma fentanyl concentrations by using three transdermal fentanyl patch sizes in dogs. , 1998, Veterinary surgery : VS.

[22]  M. Conzemius,et al.  Correlation between subjective and objective measures used to determine severity of postoperative pain in dogs. , 1997, Journal of the American Veterinary Medical Association.

[23]  M. Raffe,et al.  Epidural administration of bupivacaine, morphine, or their combination for postoperative analgesia in dogs. , 1996, Journal of the American Veterinary Medical Association.

[24]  P. Pascoe,et al.  Analgesia after lateral thoracotomy in dogs. Epidural morphine vs. intercostal bupivacaine. , 1993, Veterinary surgery : VS.

[25]  C. Schmiedt,et al.  Accidental prehension and suspected transmucosal or oral absorption of fentanyl from a transdermal patch in a dog. , 2007, Veterinary anaesthesia and analgesia.