title: Effect of surgeon experience on postoperative plasma cortisol and C-reactive protein concentrations after ovariohysterectomy in the dog: a randomised trial.
abstract: OBJECTIVE
  To determine if postoperative C-reactive protein (CRP) or cortisol concentrations were significantly changed between dogs undergoing ovariohysterectomy by an experienced or inexperienced surgeon. As part of the Charles Sturt University teaching program, 45 bitches from an animal shelter were surgically sterilised between March and October 2010.
  
  
  METHODS
  The dogs were randomly assigned to surgeons, with 37 sterilised by veterinary undergraduates and 8 by experienced surgeons. Blood samples were collected preoperatively and at 2, 4 and 6 h postoperatively. A standard midline ovariohysterectomy was performed and detailed records kept.
  
  
  RESULTS
  The median surgery time for experienced surgeons was 17 min versus 87 min for inexperienced surgeons. Anaesthesia time and blood loss were greater among the inexperienced surgeons. The CRP concentration increased significantly postoperatively for all animals (P < 0.001). Bitches sterilised by inexperienced surgeons had a significantly greater rise in CRP at 4 and 6 h post-surgery (P = 0.046). Serum cortisol concentrations were found to increase significantly over time for all animals (P < 0.001), but were not affected by surgeon experience.
  
  
  CONCLUSIONS
  The results suggest that inexperienced surgeons affect their patients differently to experienced surgeons, potentially through tissue trauma or anaesthetic duration. The lack of difference in the cortisol concentrations reflects the large number of triggers for cortisol release and, potentially, that there was little difference between the groups in terms of perceived pain in the presence of good analgesia. Serum CRP concentration may be a more sensitive measure than serum cortisol of differences in surgical trauma.
authors.affiliation: School of Animal and Veterinary Science, Charles Sturt University, Wagga Wagga, New South Wales 2678, Australia. jmichelsen@csu.edu.au
authors.forename: J
authors.initials: J
authors.lastname: Michelsen
authors.forename: J
authors.initials: J
authors.lastname: Heller
authors.forename: F
authors.initials: F
authors.lastname: Wills
authors.forename: G K
authors.initials: GK
authors.lastname: Noble
mesh_terms: D000818:Animals; D002097:C-Reactive Protein / Q000032:analysis* / Q000378:metabolism; D002983:Clinical Competence; D004285:Dogs / Q000601:surgery*; D005260:Female; D006854:Hydrocortisone / Q000097:blood*; D007044:Hysterectomy / Q000662:veterinary*; D010052:Ovariectomy / Q000662:veterinary*; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology / Q000662:veterinary; D011184:Postoperative Period; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein; D006854:Hydrocortisone