title: Evaluation of topical epidural analgesia delivered in gelfoam for postoperative hemilaminectomy pain control.
abstract: OBJECTIVE
  To evaluate efficacy of a topical epidural analgesia used alone, or in combination with hydromorphone, against a standard pain protocol for the 48 hours immediately after hemilaminectomy.
  
  
  METHODS
  Randomized, blinded, controlled, clinical trial.
  
  
  METHODS
  Dogs (n = 30) with thoracolumbar intervertebral disc disease treated with hemilaminectomy.
  
  
  METHODS
  Dogs were randomly divided into 3 groups: group 1 received intermittent hydromorphone postoperatively, group 2 received a topical epidural of preservative-free morphine and dexmedetomidine administered via gel foam, group 3 received both forms of analgesia. All dogs were monitored and assessed for pain for 48 hours immediately postoperatively. Data were analyzed using MANOVA and Wilcoxon Rank Sum Tests.
  
  
  RESULTS
  There was a significant temporal difference in treatment groups 1 and 3 when using a 0-10 pain scale (MANOVA, P = .02). There was also a significant difference at the 48th hour postoperatively between groups 1 and 3 (Wilcoxon Rank Sum Test).
  
  
  CONCLUSIONS
  Topical epidural of preservative-free morphine and dexmedetomidine administered via gelfoam is not sufficient analgesia alone post hemilaminectomy but in conjunction with other opioid administration may lead to superior pain relief.
authors.affiliation: Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA. jbarker@bvns.net
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Barker
authors.forename: Stuart C
authors.initials: SC
authors.lastname: Clark-Price
authors.forename: Wanda J
authors.initials: WJ
authors.lastname: Gordon-Evans
mesh_terms: D000287:Administration, Topical; D015360:Analgesia, Epidural / Q000379:methods / Q000662:veterinary*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D000818:Animals; D004283:Dog Diseases / Q000188:drug therapy / Q000601:surgery; D004285:Dogs; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage*; D004091:Hydromorphone / Q000008:administration & dosage* / Q000627:therapeutic use*; D007275:Injections, Intravenous; D055959:Intervertebral Disc Degeneration / Q000601:surgery / Q000662:veterinary; D007405:Intervertebral Disc Displacement / Q000601:surgery / Q000662:veterinary; D007796:Laminectomy / Q000009:adverse effects / Q000379:methods / Q000662:veterinary*; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control / Q000662:veterinary*
chemical_list: D000701:Analgesics, Opioid; D004091:Hydromorphone