title: Comparison of intra-articular and epidural morphine for analgesia following stifle arthrotomy in dogs.
abstract: We prospectively studied 18 dogs that presented for exploratory stifle arthrotomy, with or without meniscectomy, and lateral extracapsular stabilization as a result of cranial cruciate ligament rupture. Dogs were premedicated with acepromazine, induced with thiopental, and maintained with halothane in oxygen. Preoperatively, dogs were assigned to one of three groups. Group 1 (n = 6) received intra-articular morphine (0.1 mg/kg diluted in 1 mL/10 kg body weight of saline) and epidural saline (1 mL/5 kg body weight saline plus the volume of saline representing 0.1 mg/kg of morphine). Group 2 (n = 6) received intra-articular saline (1 mL/10 kg body weight of saline plus the volume of saline representing 0.1 mg/kg of morphine) and epidural saline (1 mL/5 kg body weight saline plus the volume of saline representing 0.1 mg/kg of morphine). Group 3 (n = 6) received intra-articular saline (1 mL/10 kg body weight of saline plus the volume of saline representing 0.1 mg/kg of morphine) and epidural morphine (0.1 mg/kg of morphine diluted in 1 mL/5 kg body weight saline). The efficacy of each analgesia regimen was evaluated for 6 hours postoperatively with a pain score based on subjective and objective variables. Serum cortisol and blood glucose concentrations were measured. Butorphanol was used to provide analgesia as needed based on a predetermined maximum pain score. Supplemental analgesics were required postoperatively every 2 to 3 hours for 6 hours in all dogs that did not initially receive analgesics (group 2). Pain scores were significantly lower in dogs administered morphine intra-articularly (group 1) and epidurally (group 3) at 30 minutes and 30, 120, and 360 minutes, respectively, compared with dogs that did not initially receive analgesics (group 2). One dog in group 1 and one dog in group 3 required supplemental analgesia with butorphanol. There was no difference between analgesia produced by intra-articular morphine compared with that of epidural morphine. Side effects after intra-articular or epidural morphine were not observed. Intra-articular administration of morphine can produce effective analgesia in dogs comparable with that produced by epidural administration of morphine.
authors.affiliation: College of Veterinary Medicine, Mississippi State University, MS 39759-9825, USA.
authors.forename: T K
authors.initials: TK
authors.lastname: Day
authors.forename: W T
authors.initials: WT
authors.lastname: Pepper
authors.forename: T A
authors.initials: TA
authors.lastname: Tobias
authors.forename: M F
authors.initials: MF
authors.lastname: Flynn
authors.forename: K M
authors.initials: KM
authors.lastname: Clarke
mesh_terms: D000698:Analgesia / Q000379:methods / Q000662:veterinary*; D015360:Analgesia, Epidural / Q000662:veterinary; D000818:Animals; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D007270:Injections, Intra-Articular / Q000662:veterinary; D008297:Male; D009020:Morphine / Q000008:administration & dosage*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control / Q000662:veterinary*; D011446:Prospective Studies; D012421:Rupture / Q000601:surgery / Q000662:veterinary; D013264:Stifle / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D009020:Morphine