DOI
https://doi.org/10.18849/ve.v5i2.291Abstract
PICO question
In dogs undergoing hindlimb orthopaedic surgery does epidural with local anaesthetic and buprenorphine provide equivalent intra- and postoperative analgesia as epidural with local anaesthetic and morphine?
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
One double-blinded randomised controlled trial
Strength of evidence
Weak
Outcomes reported
Epidural analgesia with buprenorphine and bupivacaine may provide equivalent analgesia to more traditional morphine and bupivacaine epidural injection
Conclusion
There is weak evidence that buprenorphine may provide equivalent analgesia to morphine when combined with bupivacaine epidurally. The reduced regulatory requirements imposed on buprenorphine may sway some clinicians to utilise buprenorphine but further, higher powered, controlled trials are necessary to confirm equivalency
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
References
Bergh, M. S., Sullivan, C., Ferrell, C.L., Troy, J. & Budsberg, S.C. (2014). ‘Systematic review of surgical treatments for cranial cruciate ligament disease in dogs’, Journal of the American Animal Hospital Association, 50(5), pp. 315–321. DOI: https://doi.org/10.5326/JAAHA-MS-6356
Epstein, M. E., Rodan, I., Griffenhagen, G., Kadrlik, J., Petty, M.C., Robertson, S.A. & Simpson, W. (2015). ‘2015 AAHA/AAFP pain management guidelines for dogs and cats.’, Journal of Feline Medicine and Surgery. SAGE Publications, 17(3), pp. 251–272. DOI: https://doi.org/10.1177/1098612X15572062
Heard, D. J., Webb, A. I. & Daniels, R. T. (1986). ‘Effect of acepromazine on the anesthetic requirement of halothane in the dog’, American Journal of Veterinary Research, 47(10), pp. 2113–2115.
Reid, J., Nolan, A.M., Hughes, J.M.L., Lascelles, D., Pawson, P. & Scott, E.M. (2007). ‘Development of the short-form Glasgow Composite Measure Pain Scale (CMPS-SF) and derivation of an analgesic intervention score’, Animal Welfare. Universities Federation for Animal Welfare, 16(SUPPL.), pp. 97–104.
Smith, L. J. & Yu, J. K. A. (2001). ‘A comparison of epidural buprenorphine with epidural morphine for postoperative analgesia following stifle surgery in dogs’, Veterinary Anaesthesia and Analgesia, 28(2), pp. 87–96. DOI: https://doi.org/10.1046/j.1467-2987.2000.00038.x
Valverde, A., Dyson, D. H. & McDonell, W. N. (1989). ‘Epidural morphine reduces halothane MAC in the dog’, Canadian Journal of Anaesthesia. Springer, 36(6), pp. 629–632. DOI: https://doi.org/10.1007/BF03005412
License
Copyright (c) 2020 Thomas Towers
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