İntraperitoneal ve İnsizyonel Sprey Lidokain Uygulaması Köpeklerde Ovaryohisterektomi Sonrası Erken Postoperatif Ağrıyı Azaltır

Öz

Sunulan çalışmada, ovariohisterektomi yapılan köpeklerde intraperitoneal ve insizyonel sprey lidokain uygulamasının operasyon sonrası stres, oksidatif stres ve ağrı üzerine etkilerinin araştırılması amaçlandı. Kontrol grubuna (n=12) sprey şeklinde intraperitoneal ve insizyonel % 0.9 NaCl uygulanırken, deneme grubu (n=12) bireysel doz hesaplamasını takiben eşit dozda % 0.9 NaCl ile hazırlanmış lidokain (8,8 mg/kg) aldı. Modifiye Melbourne ağrı skorlaması sedasyon öncesi (T), operasyon bitimi (T0), operasyondan 30 dakika (T½), 1 (T1), 2 (T2), 4 (T4) ve 6 (T6) saat sonra gerçekleştirildi. İlgili zamanlarda venöz kan örnekleri alınarak, serum kortizol, total oksidan durum (TOD) ve total antioksidan durum (TAD) ölçümleri yapıldı. Oksidatif stres indeksi (OSI) TOD/TAD oranına göre belirlendi. Kortizol, TAD ve OSI değerlerinin gruplar arasında istatistiksel olarak fark oluşturmadığı belirlendi (p > 0.05). Deneme grubunda TOD düzeyinin T1 zamanında en yüksek seviyede olduğu gözlendi (p<0.05). Deneme grubundaki ağrı skorlarının kontrol grubundaki T2 (p<0.05), T4 (p<0.01) ve T6 (p<0.01) zamanlarına göre daha düşük olduğu tespit edildi. Sonuç olarak, ovariohisterektomi yapılan köpeklerde intraperitoneal ve insizyonel sprey lidokain uygulamasının postoperatif ağrı yönetiminde etkili olduğu ifade edilmektedir.

Anahtar Kelimeler

• Lidokain
• TOS
• TAS
• OSI
• ağrı

Sprayed Intraperitoneal and Incisional Lidocaine Reduces Early Postoperative Pain After Ovariohysterectomy in Dogs

Öz

In the present study, it was aimed to investigate the effect of intraperitoneal and incisional sprayed lidocaine on postoperative stress, oxidative stress and pain in dogs undergoing ovariohysterectomy. The control group (n=12) received intraperitoneal and incisional sprayed 0.9 % NaCl, whereas the preparation of lidocaine (8.8 mg/kg) with the equal volume of 0.9 % NaCl following calculation of the individual doses was sprayed in the experiment group (n=12). Modified Melbourne pain assessment was performed before sedation (T), at the end of surgery (T0), 30 minutes after surgery (T½) and at 1 (T1), 2 (T2), 4 (T4) and 6 (T6) hours after the end of surgery. Venous blood samples were collected to measure the concentrations of serum cortisol, total oxidant status (TOS) and total antioxidant status (TAS) at related times. Oxidative stress index (OSI) was calculated by the determination of the rate of TOS/TAS. The concentrations of cortisol, TAS and OSI did not show any significant difference between groups (p > 0.05). The concentration of TOS was the highest at T1 in the experiment group (p<0.05). The pain scores in the experiment group were lower (p<0.05) than those detected at T2 (p<0.05), T4 (p<0.01) and T6 (p<0.01) in the control group. In conclusion, it was stated that the treatment of intraperitoneal and incisional sprayed lidocaine is effective on postoperative pain management in dogs undergoing ovariohysterectomy.

Anahtar Kelimeler

• Lidocaine
• TOS
• TAS
• OSI
• Pain

Kaynakça

1. Anup R, Aparna V, Pulimood A, Balasubramanian KA. Surgical stress and the small intestine: role of oxygen free radicals. Surgery. 1999;125:560-569.
2. Anup R, Balasubramanian KA. Surgical stress and the gastrointestinal tract. J Surg Res. 2000; 92:291-300.
3. Baysal E, Taysi S, Aksoy N, Uyar M, Celenk F, Karatas ZA, Tarakcioglu M, Bilinç H, Mumbuc S, Kanlikama M. Serum paraoxonase, arylesterase activity and oxidative status in patients with obstructive sleep apnea syndrome (OSAS). Europ Rev Med Pharmacol Sci. 2012; 16:770-774.
4. Bubalo V, Moens YP, Holzmann A, Coppens P. Anaesthetic sparing effect of local anaesthesia of the ovarian pedicle during ovariohysterectomy in dogs. Vet Anaesth Analg. 2008; 35:537-542.
5. Bugajski J, Gadek-Michalska A, Bugajski AJ. Nitric oxide and prostaglandin systems in the stimulation of hypothalamic-pituitary-adrenal axis by neurotransmitters and neurohormones. J Physiol Pharmacol. 2004;55:679-703.
6. Campagnol D, Teixeira-Neto FJ, Monteiro ER, Restitutti F, Minto BW. Effect of intraperitoneal or incisional bupivacaine on pain and the analgesic requirement after ovariohysterectomy in dogs. Vet Anaesth Analg. 2012;39(4):426-430.
7. Carpenter RE, Wilson DV, Evans AT. Evaluation of intraperitoneal and incisional lidocaine or bupivacaine for analgesia following ovariohysterectomy in the dog. Vet. Anaesthesia and Analg. 2004;31(1):46-52.
8. Church DB, Nicholson AI, Ilkiw JE, Emslie DR. Effect of non-adrenal illness, anaesthesia and surgery on plasma cortisol concentrations in dogs. Res Vet Sci. 1994;56:129-131. Davidson EB, Moll HD, Mark EP. Comparison of laparoscopic ovariohysterectomy and ovariohysterectomy in dogs. Vet Res. 2004;33:62-69.

9. Devitt CM, Cox RE, Hailey JJ. Duration, complications, stress, and pain of open ovariohysterectomy versus a simple method of laparoscopic-assisted ovariohysterectomy in dogs. J Am Vet Med Assoc. 2005;227(6):921-927.
10. Distel M, Mueller C, Bluhmki E, Fries J. Safety of meloxicam: a global analysis of clinical trials. Br J Rheumatol. 1996;35(Suppl 1):68-77. Epstein ME, Rodan I, Griffenhagen G, Kadrlik J, Petty M, Robertson SA, Simpson W. 2015 AAHA/AAFP pain management guidelines for dogs and cats. J Am Anim Hospital Assoc. 2015;51(2):67-84.
11. Erel O. A novel automated direct measurement method for total antioxidant capacity using a new generation, more stable ABTS radical cation. Clin Biochem. 2004;37:277-285.
12. Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem. 2005;38:1103-1111.
13. Fitzpatrick CL, Weir HL, Monnet E. Effects of infiltration of the incision site with bupivacaine on postoperative pain and incisional healing in dogs undergoing ovariohysterectomy. J Am Vet Med Assoc. 2010;237:395-401.
14. Fox SM, Mellor DJ, Firth EC, Hodge H, Lawoko CRO. Changes in plasma cortisol concentrations before, during and after analgesia, anaesthesia and anaesthesia plus ovariohysterectomy in bitches. Res Vet Sci. 1994;57(1):110-118.
15. Gadek-Michalska A, Spyrka J, Bugajski J. Psychosocial stress affects the involvement of prostaglandins and nitric oxide in the lipopolysaccharide-induced hypothalamic-pituitary-adrenal response. J Physiol Pharmacol. 2005;56:287-298.
16. Gautier A, Graff EC, Bacek L, Fish EJ, White A, Palmer L, Kuo1 K. Effects of ovariohysterectomy and hyperbaric oxygen therapy on systemic inflammation and oxidation in dogs. Front Vet Sci. 2019;6:506.
17. Gunay A, Gunes N, Gunay U. Effect of ovariohysterectomy on lipid peroxidation and levels of some antioxidants and biochemical parameters in bitches. Bull Vet Inst Pulawy. 2011;55:695-698.
18. Halliwell B. Free radicals and antioxidants: a personal view. Nutr Rev. 1994;70:257-265.
19. Hellyer PW, Robertson SA, Fails AD. Pain and Its Management In: Lumb & Jones’ Veterinary Anesthesia and Analgesia, Ed; Tranquilli WJ, Thurmon JC, Grimm KA, 4th Ed., Blackwell Publishing, UK. 2007; pp. 31-60.
20. Kibar M, Tuna B, Kısadere İ, Güzelbektaş H. Comparison of instilled lidocaine and procaine effects on pain relief in dogs undergoing elective ovariohysterectomy. Israel J Vet Med 2019;74(3):148-154.
21. Kim YK, Lee SS, Suh EH, Lee L, Lee HC, Lee HJ, Yeon SC. Sprayed intraperitoneal bupivacaine reduces early postoperative pain behavior and biochemical stress response after laparoscopic ovariohysterectomy in dogs. Vet J. 2012;191(2):188-192.
22. Korkmaz M, Yilmaz O, Saritas AK, Demirkan I, Jaroszewski JJ. Evaluation of intraperitoneal and incisional bupivacaine or levobupivacaine for postoperative analgesia in ovariohysterectomized dogs. Acta Sci Vet 2019;47:1666.
23. Lamont LA, Tranquilly WJ, Grimm KA. Physiology of pain. Vet Clin North Am Small Anim Pract 2000;30:703-728.
24. Lauretti GR. Mechanisms of analgesia of intravenous lidocaine. Rev Bras Anestesiol. 2008;58(3):280-286.
25. Lee JY, Kim MC. Comparison of oxidative stress status in dogs undergoing laparoscopic and open ovariectomy. J Vet Med Sci. 2014;76(2):273-276.
26. Lemke KA, Dawson SD. Local and regional anesthesia. Vet Clin North Am Small Anim. Pract. 2000;30:839-857.
27. Lemke KA, Runyon CL, Horney BS. Effects of preoperative administration of ketoprofen on anesthetic requirements and signs of postoperative pain in dogs undergoing elective ovariohysterectomy. J Am Vet Med Assoc. 2002;221(9): 1268-1275.
28. Lu D, Wu C, Yin Y, Ma X. Analgesic Effects of Lidocaine and Fentanyl Alone or in Combination Undergoing Ovariohysterectomy in Female Dogs. Pakistan Vet J. 2016;36(4):435-439.
29. Mathews KA, Paley DM, Foster RA, Valliant AE, Young SS. A comparison of Ketorolac with Flunixin, Butorphanol, and Oxymorphone in controlling postoperative pain in dogs, Can. Vet. J. 1996;37:557-567.
30. McKune CM, Pascoe PJ, Lascelles BDX, Kass PH. The challenge of evaluating pain and a pre-incisional local anesthetic block. Peer J. 2014;2:e341.
31. Michelsen J, Heller J, Wills F, Noble G. Effect of surgeon experience on postoperative plasma cortisol and C-reactive protein concentrations after ovariohysterectomy in the dog: A randomised trial. Australian Vet J. 2012;90(12):474-478.
32. Mohn CE, Fernandez-Solari J, De Laurentiis A, Prestifilippo JP, de la Cal C, Funk R, Bornstein SR, McCann SM, Rettori V. The rapid release of corticosterone from the adrenal induced by ACTH is mediated by nitric oxide acting by prostaglandin E2. Proc Natl Acad Sci USA. 2005;102:6213-6218.
33. Nenadović K, Vučinić M, Radenković-Damnjanović B, Janković L, Teodorović R, Voslarova E, Becskei Z. Cortisol concentration, pain and sedation scale in free roaming dogs treated with carprofen after ovariohysterectomy. Vet World. 2017;10(8):888-894.
34. Rettori V, Fernandez-Solari J, Mohn C, Zorrilla Zubilete MA, de la Cal C, Prestifilippo JP, De Laurentiis A. Nitric oxide at the crossroad of immunoneuroendocrine interactions. Ann NY Acad Sci. 2009;1153:35-47.
35. Sies H. Oxidative stress: oxidants and sntioxidants. Exp Physiol. 1997;82:291-295.
36. Szymczyk G, Beltowski J, Marciniak A, Kotarski J. Assessment of serum lipid peroxide levels and antioxidant status in females who had undergone total abdominal hysterectomy without closing of the peritoneum. Ginekol Pol, 2003; 74:1397-1403.
37. Tsai TY, Chang SK, Chou PY, Yeh LS. Comparison of postoperative effects between lidocaine infusion, meloxicam, and their combination in dogs undergoing ovariohysterectomy. Vet Anaesth Analg. 2013;40:615-622.
38. Wang H, Walker SW, Mason JI, Morley SD, Williams BC. Role of arachidonic acid metabolism in ACTH-stimulated cortisol secretion by bovine adrenocortical cells. Endocr Res. 2000;26:705-709.
39. Wilson DV, Barnes KS, Hauptman JG. Pharmacokinetics of combined intraperitoneal and incisional lidocaine in the dog following ovariohysterectomy. J Vet Pharmacol Ther. 2004;27(2):105-109.
40. Yilmaz O, Korkmaz M, Jaroszewski JJ, Yazici E, Ulutas E, Saritas ZK. Comparison of flunixin meglumine and meloxicam influence on postoperative and oxidative stress in ovariohysterectomized bitches. Polish J Vet Sci. 2014;17(3):493-499.