title: Comparison of analgesic efficacy of preoperative or postoperative carprofen with or without preincisional mepivacaine epidural anesthesia in canine pelvic or femoral fracture repair.
abstract: OBJECTIVE
  To compare analgesic efficacy of preoperative versus postoperative administration of carprofen and to determine, if preincisional mepivacaine epidural anesthesia improves postoperative analgesia in dogs treated with carprofen.
  
  
  METHODS
  Blind, randomized clinical study.
  
  
  METHODS
  Dogs with femoral (n=18) or pelvic (27) fractures.
  
  
  METHODS
  Dogs were grouped by restricted randomization into 4 groups: group 1 = carprofen (4 mg/kg subcutaneously) immediately before induction of anesthesia, no epidural anesthesia; group 2 = carprofen immediately after extubation, no epidural anesthesia; group 3 = carprofen immediately before induction, mepivacaine epidural block 15 minutes before surgical incision; and group 4 = mepivacaine epidural block 15 minutes before surgical incision, carprofen after extubation. All dogs were administered carprofen (4 mg/kg, subcutaneously, once daily) for 4 days after surgery. Physiologic variables, nociceptive threshold, lameness score, pain, and sedation (numerical rating scale [NRS], visual analog scale [VAS]), plasma glucose and cortisol concentration, renal function, and hemostatic variables were measured preoperatively and at various times after surgery. Dogs with VAS pain scores >30 were administered rescue analgesia.
  
  
  RESULTS
  Group 3 and 4 dogs had significantly lower pain scores and amount of rescue analgesia compared with groups 1 and 2. VAS and NRS pain scores were not significantly different among groups 1 and 2 or among groups 3 and 4. There was no treatment effect on renal function and hemostatic variables.
  
  
  CONCLUSIONS
  Preoperative carprofen combined with mepivacaine epidural anesthesia had superior postoperative analgesia compared with preoperative carprofen alone. When preoperative epidural anesthesia was performed, preoperative administration of carprofen did not improve postoperative analgesia compared with postoperative administration of carprofen.
  
  
  CONCLUSIONS
  Preoperative administration of systemic opioid agonists in combination with regional anesthesia and postoperative administration of carprofen provides safe and effective pain relieve in canine fracture repair.
authors: Small Animal Clinic, School of Veterinary Medicine, Bischofsholer Damm 15, Hannover, Germany.
authors: Hannes M
authors: HM
authors: Bergmann
authors: Ingo
authors: I
authors: Nolte
authors: Sabine
authors: S
authors: Kramer
mesh_terms: D000700:Analgesics / Q000008:administration & dosage / Q000494:pharmacology*; D000767:Anesthesia, Epidural / Q000379:methods / Q000662:veterinary*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000494:pharmacology; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000494:pharmacology*; D002227:Carbazoles / Q000008:administration & dosage / Q000494:pharmacology*; D004285:Dogs; D004311:Double-Blind Method; D005260:Female; D005264:Femoral Fractures / Q000601:surgery / Q000662:veterinary; D007279:Injections, Subcutaneous / Q000662:veterinary; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage / Q000494:pharmacology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control / Q000662:veterinary*; D010384:Pelvic Bones / Q000293:injuries; D011182:Postoperative Care / Q000379:methods / Q000662:veterinary; D011292:Premedication; D011300:Preoperative Care / Q000379:methods / Q000662:veterinary*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D002227:Carbazoles; D008619:Mepivacaine; C007005:carprofen