Pain Management and Recovery after TPLO Surgery
“Effects of buprenorphine and bupivacaine combination in epidural for hind limb orthopedic surgery in dogs”
Purpose of Study
Local anesthesia techniques have many advantages besides producing pain relief during surgery. They also promote 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 duration time of six hours. Human research has shown that adding buprenorphine, a partial opioid, to a nerve block can increase pain relief duration threefold. This could benefit patients undergoing surgeries by providing prolonged pain relief after discharge from the hospital.
The aim of this study is to evaluate the effect of buprenorphine added to the local anesthetic (bupivacaine) for epidural in dogs that will undergo tibial plateau leveling osteotomy (TPLO). The effect of this drug combination will be compared to the effects of epidural-given morphine and bupivacaine, which is the standard protocol at the WSU Veterinary Teaching Hospital (VTH).
You and your dog will help researchers determine if the addition of buprenorphine to the bupivacaine in the epidural will result in longer lasting pain management and quicker recovery after surgery. In addition, this study will cover the costs of the epidural and two nights of boarding after surgery (a value of approximately $200).
Enrolled dogs must be healthy, at least 1 year old, weigh 33lbs or more, and scheduled for TPLO surgery at the WSU VTH. Dogs will be excluded from the study if they have any of the following conditions: orthopedic disease in a limb other than the one undergoing TPLO; neurological disease; unmanageable behavior; are pregnant; coagulopathy; skin infection at the epidural site; or history of liver, kidney, gastrointestinal disease or any other contraindication for use of non-steroidal anti-inflammatory drugs or local anesthetic agents.
Your dog will be randomly assigned to one of two study groups: dogs receiving buprenorphine with bupivacaine in the epidural or dogs receiving morphine with bupivacaine in the epidural. They will be anesthetized for the TPLO procedure according to normal protocols. Once anesthesia is induced, the epidural will be performed by an anesthesiologist. Anesthesia will be routinely monitored during the surgical procedure. Pain score will be measured immediately after your dog starts to wake up from anesthesia and at 1, 4, 8, 12, 16, 24, 36, and 48 hours thereafter. Pain medication will be given to your pet at any time that postoperative caregivers think it is needed. At these same time points, your pet’s locomotor function, urinary production, and appetite will also be assessed.
Owners are responsible for bringing their dog to the WSU VTH for the TPLO surgical procedure. They will be responsible for paying the costs associated with anesthesia and the surgery.