In cats undergoing midline ovariohysterectomy, is the use of local anaesthesia with bupivacaine associated with a reduction in postoperative pain score?
PICO question In cats undergoing midline ovariohysterectomy, is the use of local anaesthesia with bupivacaine via intraperitoneal or subcutaneous injections, in comparison with the use of a control substance or other analgesic measure, associated with a reduction in postoperative pain score? ...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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RCVS Knowledge
2023-02-01
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| Series: | Veterinary Evidence |
| Subjects: | |
| Online Access: | https://veterinaryevidence.org/index.php/ve/article/view/552 |
| _version_ | 1797853293612892160 |
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| author | Tara Freeman Amelia Wisbey Kate Burroughs Samantha Gentle Connie Ellis Sarah Batt-Williams |
| author_facet | Tara Freeman Amelia Wisbey Kate Burroughs Samantha Gentle Connie Ellis Sarah Batt-Williams |
| author_sort | Tara Freeman |
| collection | DOAJ |
| description | PICO question
In cats undergoing midline ovariohysterectomy, is the use of local anaesthesia with bupivacaine via intraperitoneal or subcutaneous injections, in comparison with the use of a control substance or other analgesic measure, associated with a reduction in postoperative pain score?
Clinical bottom line
The category of research question:
Treatment.
The number and type of study designs that were critically appraised:
Three studies were critically appraised in this Knowledge Summary. They included two prospective, blinded, randomised, controlled clinical trials and one prospective randomised, blinded clinical trial.
Strength of evidence:
Weak.
The outcomes reported:
Bupivacaine does not eliminate postoperative pain in cats undergoing ovariohysterectomies; minimal evidence was found to suggest that it was better at reducing postoperative pain scores in comparison to other analgesics. However, bupivacaine may provide analgesic benefits to cats when administered via intraperitoneal or subcutaneous injections as local anaesthesia and in combination with other analgesic agents. The need for postoperative rescue analgesia was minimised when bupivacaine was administered prior to or during the ovariohysterectomy.
Conclusion:
When compared to a control, pain scores for the participating cats were lower after administration of bupivacaine, however, statistical significance was only reached in one of the studies. Additionally, other medications were found to lower the post operative pain score to a greater effect. However, bupivacaine administration is cheap and simple to perform, so it’s use as part of a multimodal analgesic protocol is supported. Confounding factors within the studies may have altered the perceived effectiveness of the analgesic properties of bupivacaine though, so further investigation involving larger cohorts with standardised controls would be prudent.
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. |
| first_indexed | 2024-04-09T19:48:16Z |
| format | Article |
| id | doaj.art-0522d12e65f74e59bf1ed6c194992001 |
| institution | Directory Open Access Journal |
| issn | 2396-9776 |
| language | English |
| last_indexed | 2024-04-09T19:48:16Z |
| publishDate | 2023-02-01 |
| publisher | RCVS Knowledge |
| record_format | Article |
| series | Veterinary Evidence |
| spelling | doaj.art-0522d12e65f74e59bf1ed6c1949920012023-04-03T11:05:01ZengRCVS KnowledgeVeterinary Evidence2396-97762023-02-018110.18849/ve.v8i1.552402In cats undergoing midline ovariohysterectomy, is the use of local anaesthesia with bupivacaine associated with a reduction in postoperative pain score?Tara Freeman0https://orcid.org/0000-0002-5588-9623Amelia WisbeyKate BurroughsSamantha Gentlehttps://orcid.org/0000-0001-7949-0572Connie EllisSarah Batt-Williamshttps://orcid.org/0000-0001-8713-6944Royal Veterinary CollegePICO question In cats undergoing midline ovariohysterectomy, is the use of local anaesthesia with bupivacaine via intraperitoneal or subcutaneous injections, in comparison with the use of a control substance or other analgesic measure, associated with a reduction in postoperative pain score? Clinical bottom line The category of research question: Treatment. The number and type of study designs that were critically appraised: Three studies were critically appraised in this Knowledge Summary. They included two prospective, blinded, randomised, controlled clinical trials and one prospective randomised, blinded clinical trial. Strength of evidence: Weak. The outcomes reported: Bupivacaine does not eliminate postoperative pain in cats undergoing ovariohysterectomies; minimal evidence was found to suggest that it was better at reducing postoperative pain scores in comparison to other analgesics. However, bupivacaine may provide analgesic benefits to cats when administered via intraperitoneal or subcutaneous injections as local anaesthesia and in combination with other analgesic agents. The need for postoperative rescue analgesia was minimised when bupivacaine was administered prior to or during the ovariohysterectomy. Conclusion: When compared to a control, pain scores for the participating cats were lower after administration of bupivacaine, however, statistical significance was only reached in one of the studies. Additionally, other medications were found to lower the post operative pain score to a greater effect. However, bupivacaine administration is cheap and simple to perform, so it’s use as part of a multimodal analgesic protocol is supported. Confounding factors within the studies may have altered the perceived effectiveness of the analgesic properties of bupivacaine though, so further investigation involving larger cohorts with standardised controls would be prudent. 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.https://veterinaryevidence.org/index.php/ve/article/view/552ovariohysterectomyfelinebupivacainelocal anaesthesiapostoperative painperioperative analgesianeuteringspay |
| spellingShingle | Tara Freeman Amelia Wisbey Kate Burroughs Samantha Gentle Connie Ellis Sarah Batt-Williams In cats undergoing midline ovariohysterectomy, is the use of local anaesthesia with bupivacaine associated with a reduction in postoperative pain score? Veterinary Evidence ovariohysterectomy feline bupivacaine local anaesthesia postoperative pain perioperative analgesia neutering spay |
| title | In cats undergoing midline ovariohysterectomy, is the use of local anaesthesia with bupivacaine associated with a reduction in postoperative pain score? |
| title_full | In cats undergoing midline ovariohysterectomy, is the use of local anaesthesia with bupivacaine associated with a reduction in postoperative pain score? |
| title_fullStr | In cats undergoing midline ovariohysterectomy, is the use of local anaesthesia with bupivacaine associated with a reduction in postoperative pain score? |
| title_full_unstemmed | In cats undergoing midline ovariohysterectomy, is the use of local anaesthesia with bupivacaine associated with a reduction in postoperative pain score? |
| title_short | In cats undergoing midline ovariohysterectomy, is the use of local anaesthesia with bupivacaine associated with a reduction in postoperative pain score? |
| title_sort | in cats undergoing midline ovariohysterectomy is the use of local anaesthesia with bupivacaine associated with a reduction in postoperative pain score |
| topic | ovariohysterectomy feline bupivacaine local anaesthesia postoperative pain perioperative analgesia neutering spay |
| url | https://veterinaryevidence.org/index.php/ve/article/view/552 |
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