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Evaluation of post-operative pain after active desufflation at completion of laparoscopy in mares undergoing ovariectomy.

Abstract: The cause of transient post-operative pain in a subset of horses undergoing laparoscopy is unclear. The objective of this study was to evaluate if residual pneumoperitoneum is associated with transient post-operative pain in mares undergoing ovariectomy. Thirty-eight mares undergoing routine standing laparoscopic ovariectomy were randomly allocated into 2 groups. At the completion of laparoscopy, either the abdominal cavity was actively desufflated or the cannulas were opened to achieve ambient pressure before incisional closure. Assessments were performed for 18 hours after surgery using a validated visceral/somatic pain scale for horses. Overall, pain was minimal in both groups (median score 2/39) post-surgery. Active desufflation of the pneumoperitoneum at the completion of laparoscopy approached statistical significance ( = 0.07) in decreasing pain at 12 hours after laparoscopy. However, effects of active desuffation were not significant throughout the monitored 18-hour post-surgery period. We conclude that the decision to actively desufflate at the completion of laparoscopy should be based on surgeon's preference. . La cause d’une douleur postopératoire transitoire dans un sous-groupe de chevaux subissant une laparoscopie est indéterminée. Cette étude avait pour objectif d’évaluer si le pneumopéritoine résiduel est associé à de la douleur postopératoire chez les juments subissant une ovariectomie. Trente-huit juments subissant une ovariectomie laparascopique debout de routine ont été réparties au hasard dans deux groupes. À l’achèvement de la laparoscopie, soit la cavité abdominale a été activement désoufflée ou les canules ont été ouvertes pour obtenir une pression ambiante avant la fermeture de l’incision. Des évaluations ont été réalisées pendant 18 heures après la chirurgie en utilisant une échelle de douleur viscérale/somatique validée pour les chevaux. Dans l’ensemble, la douleur a été minimale dans les deux groupes (note médiane de 2/39) après la chirurgie. La désoufflement actif du pneumopéritoine à l’achèvement de la laparoscopie s’approchait de l’importance statistique (valeur de = 0,07) en réduisant la douleur à 12 heures après la laparoscopie. Cependant, les effets du désoufflement actif n’étaient pas significatifs pendant la période de surveillance 18 heures après la chirurgie. La décision de désouffler activement à l’achèvement de la laparoscopie est toujours sujette à la préférence du chirurgien.(Traduit par Isabelle Vallières).
Publication Date: 2018-03-31 PubMed ID: 29599556PubMed Central: PMC5819046
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  • Clinical Trial
  • Veterinary
  • Journal Article

Summary

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The study investigates if active desufflation—or removing air from the abdomen—at the end of laparoscopic surgery for ovary removal in mares contributes to postoperative pain. The research discovered minimal evidence of pain in both the group of horses that underwent active desufflation and the control group, leading to the conclusion that the decision to actively desufflate should be based on the surgeon’s preference.

Research Objectives and Methodology

  • With a focus on understanding the cause of temporary post-operative pain in horses following laparoscopy, the study sought to examine if the remaining air (pneumoperitoneum) in the abdomen post-surgery contributes to this discomfort.
  • The experiment involved 38 mares that were undergoing a standard procedure called a standing laparoscopic ovariectomy—a minimally invasive surgery for ovary removal.
  • These subjects were randomly divided into two groups. One group had their abdominal cavity actively desufflated at the end of the laparoscopy, while in the other group, surgeons left the cannulas open to reach ambient pressure before closing the incisions.

Assessment and Findings

  • The research team assessed the horses for 18 hours after surgery using a validated visceral/somatic pain scale particularly composed for horses.
  • The results showed minimal pain in both the test group and the control group, with a median score of 2 out of a possible 39.
  • Although the active desufflation showed a trend towards statistically significant results (P = 0.07) in decreasing pain 12 hours after surgery, this significance was not carried throughout the full 18-hour post-surgery monitoring period.

Conclusion

  • The study concludes that active desufflation at the end of laparoscopy does not significantly contribute to postoperative pain management in mares undergoing ovariectomy.
  • The decision to perform active desufflation or not should therefore be decided based on the surgeon’s preference, rather than as a general practice to reduce post-operative pain.

Cite This Article

APA
Devick IF, Leise BS, Rao S, Hendrickson DA. (2018). Evaluation of post-operative pain after active desufflation at completion of laparoscopy in mares undergoing ovariectomy. Can Vet J, 59(3), 261-266.

Publication

ISSN: 0008-5286
NlmUniqueID: 0004653
Country: Canada
Language: English
Volume: 59
Issue: 3
Pages: 261-266

Researcher Affiliations

Devick, Ian F
  • Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado 80523, United States (Devick, Rao, Hendrickson); Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, United States (Leise).
Leise, Britta S
  • Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado 80523, United States (Devick, Rao, Hendrickson); Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, United States (Leise).
Rao, Sangeeta
  • Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado 80523, United States (Devick, Rao, Hendrickson); Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, United States (Leise).
Hendrickson, Dean A
  • Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado 80523, United States (Devick, Rao, Hendrickson); Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, United States (Leise).

MeSH Terms

  • Animals
  • Female
  • Horses / physiology
  • Horses / surgery
  • Insufflation / adverse effects
  • Insufflation / veterinary
  • Laparoscopy / veterinary
  • Ovariectomy / veterinary
  • Pain Measurement / veterinary
  • Pain, Postoperative / etiology
  • Pain, Postoperative / veterinary
  • Random Allocation

Conflict of Interest Statement

The authors declare no conflict of interest related to this report.

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Citations

This article has been cited 5 times.
  1. Guo L, Liu Y, Wang M. Effect of Perioperative Dexmedetomidine Anesthesia on Prognosis of Elderly Patients with Gastrointestinal Tumor Surgery. Comput Math Methods Med 2022;2022:7889372.
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  2. Straticò P, Guerri G, Palozzo A, Varasano V, Petrizzi L. Current Use of Equine Laparoscopy in Urogenital Disorders: A Scoping Review of the Literature from 2000 to 2021. Vet Sci 2022 Jan 22;9(2).
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  3. Devick IF, Hendrickson DA. Effects of Leaving Amputated Ovaries Intra-Abdominally during Elective Bilateral Standing Laparoscopic Ovariectomy in Equids. Animals (Basel) 2021 Jan 18;11(1).
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  4. Devick IF, Leise BS, McCue PM, Rao S, Hendrickson DA. Ovarian histopathology, pre- and post-operative endocrinological analysis and behavior alterations in 27 mares undergoing bilateral standing laparoscopic ovariectomy. Can Vet J 2020 Feb;61(2):181-186.
    pubmed: 32020939
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