Pain Management and Recovery after Canine Elbow Arthroscopy
“Effects of buprenorphine and bupivacaine combination in brachial plexus block for elbow arthroscopy in dogs”
Purpose of Study
Local anesthesia techniques have many advantages besides producing pain relief during surgery. It also promotes pain relief after surgery, better recovery from surgical procedures, and a faster healing time. Bupivacaine has been the agent of choice for local blocks due to its longer duration of time (6 hours). Human research has shown that adding buprenorphine, a partial opioid, to a nerve block can increase the analgesia (inability to feel pain) duration threefold. This could benefit patients undergoing surgeries by providing prolonged analgesia after discharge from the hospital. The aim of this study is to evaluate the effect of buprenorphine added to the local anesthetic (bupivacaine) for brachial plexus block in dogs that will be subjected to elbow arthroscopy. The effect of this drug combination will be compared to the effects of a bupivacaine-only brachial plexus block.
Information gained from this study will lead to a better understanding of how to manage pain relief during and after surgery for dogs. Dogs will receive a free local pain block and 48 hours boarding for postoperative care at the Veterinary Teaching Hospital.
To be eligible for this study, dogs need to be scheduled for an elbow arthroscopy procedure at Washington State University Veterinary Teaching Hospital (WSU VTH). Enrolled dogs must be healthy, weigh more than 33 pounds (15 kg) and older than one year. Exclusion criteria will include: orthopedic disease in a limb other than the one undergoing the elbow arthroscopy, neurological disease, unmanageable behavior, pregnancy, coagulopathy, skin infections at the site of injection (axillary region), history of liver, kidney or gastrointestinal disease or any contraindication for use of non-steroidal anti-inflammatory drugs or local anesthetic agents.
Once enrolled, your dog will be randomly assigned to one of two groups. Dogs in the control group will receive the routine anesthesia and local bupivacaine block protocols used for elbow scope surgeries. Dogs in the treatment group will receive the routine anesthesia protocol and a local bupivacaine block with an opioid. After surgery, your dog will stay at the VTH for 48 hours for recovery and post-operative pain assessment. Assessments for this study will include
intraoperative cardiorespiratory variables, postoperative pain and lameness scores, and opioid consumption postoperatively, which will be given when any dog is showing signs of pain.
Owners are responsible for costs associated with elbow arthroscopy and general anesthesia. For this study, owners must agree to leave their dog at the WSU VTH for one extra day after the elbow arthroscopy procedure is completed for recovery and post-operative pain assessment.