The Canadian veterinary journal = La revue veterinaire canadienne2018; 59(3); 261-266;

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

Devick, IF
·
Leise, BS
·
Rao, S
·
Hendrickson, DA

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).

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Publication Date: 2018-03-31 PubMed ID: 29599556PubMed Central: PMC5819046

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Summary
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Affiliations
MeSH
Conflict of Interest
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Clinical Trial
Veterinary
Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

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

The Canadian veterinary journal = La revue veterinaire canadienne

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.

References

This article includes 28 references

Hanson CA, Galuppo LD. Bilateral laparoscopic ovariectomy in standing mares: 22 cases.. Vet Surg 1999 Mar-Apr;28(2):106-12.
pubmed: 10100764doi: 10.1053/jvet.1999.0106google scholar: lookup
Rodgerson DH, Belknap JK, Wilson DA. Laparoscopic ovariectomy using sequential electrocoagulation and sharp transection of the equine mesovarium.. Vet Surg 2001 Nov-Dec;30(6):572-9.
pubmed: 11704954doi: 10.1053/jvet.2001.28435google scholar: lookup
Seabaugh KA, Goodrich LR, Bohn AA, Morley PS, Hendrickson DA. A comparison of peritoneal fluid values in mares following bilateral laparoscopic ovariectomy using a vessel sealing and dividing device versus placement of two ligating loops.. Vet J 2014 Nov;202(2):297-302.
pubmed: 25280800doi: 10.1016/j.tvjl.2014.08.025google scholar: lookup
Daniel A, McCue P, Ferris R, Miller C, Leise B. Bilateral ovarian leiomyoma treated by standing laparoscopic ovariectomy.. Equine Vet Educ 2015;27:510–514.
Fischer AT Jr. Standing laparoscopic surgery.. Vet Clin North Am Equine Pract 1991 Dec;7(3):641-7.
pubmed: 1687917doi: 10.1016/s0749-0739(17)30491-1google scholar: lookup
Ragle CA, Schneider RK. Ventral abdominal approach for laparoscopic ovariectomy in horses.. Vet Surg 1995 Nov-Dec;24(6):492-7.
pubmed: 8560744doi: 10.1111/j.1532-950x.1995.tb01360.xgoogle scholar: lookup
Hendrickson DA, Wilson DG. Instrumentation and techniques for laparoscopic and thoracoscopic surgery in the horse.. Vet Clin North Am Equine Pract 1996 Aug;12(2):235-59.
pubmed: 8856876doi: 10.1016/s0749-0739(17)30281-xgoogle scholar: lookup
Röcken M, Mosel G, Seyrek-Intas K, Seyrek-Intas D, Litzke F, Verver J, Rijkenhuizen AB. Unilateral and bilateral laparoscopic ovariectomy in 157 mares: a retrospective multicenter study.. Vet Surg 2011 Dec;40(8):1009-14.
pubmed: 22092147doi: 10.1111/j.1532-950x.2011.00884.xgoogle scholar: lookup
Hendrickson DA. A review of equine laparoscopy.. ISRN Vet Sci 2012;2012:492650.
pmc: PMC3671724pubmed: 23762585doi: 10.5402/2012/492650google scholar: lookup
Hendrickson D. Laparoscopic cryptorchidectomy and ovariectomy in horses.. Vet Clin North Am Equine Pract 2006 Dec;22(3):777-98.
pubmed: 17129803doi: 10.1016/j.cveq.2006.08.006google scholar: lookup
Diamant M, Benumof JL, Saidman LJ. Hemodynamics of increased intra-abdominal pressure: Interaction with hypovolemia and halothane anesthesia.. Anesthesiology 1978 Jan;48(1):23-7.
pubmed: 619705doi: 10.1097/00000542-197801000-00005google scholar: lookup
Crist DW, Gadacz TR. Complications of laparoscopic surgery.. Surg Clin North Am 1993 Apr;73(2):265-89.
pubmed: 8456357doi: 10.1016/s0039-6109(16)45981-5google scholar: lookup
Shettko DL. Complications in laparoscopic surgery.. Vet Clin North Am Equine Pract 2000 Aug;16(2):377-83, vii-viii.
pubmed: 14983914doi: 10.1016/s0749-0739(17)30112-8google scholar: lookup
Duke T, Cruz AM, Cruz JI, Howden KJ. Cardiopulmonary effects associated with head-down position in halothane-anesthetized ponies with or without capnoperitoneum.. Vet Anaesth Analg 2002 Apr;29(2):76-89.
pubmed: 28404303doi: 10.1046/j.1467-2995.2002.00077.xgoogle scholar: lookup
Latimer FG, Eades SC, Pettifer G, Tetens J, Hosgood G, Moore RM. Cardiopulmonary, blood and peritoneal fluid alterations associated with abdominal insufflation of carbon dioxide in standing horses.. Equine Vet J 2003 May;35(3):283-90.
pubmed: 12755432doi: 10.2746/042516403776148273google scholar: lookup
Fischer AT Jr, Lloyd KC, Carlson GP, Madigan JE. Diagnostic laparoscopy in the horse.. J Am Vet Med Assoc 1986 Aug 1;189(3):289-92.
pubmed: 2943716
Walmsley JP. Review of equine laparoscopy and an analysis of 158 laparoscopies in the horse.. Equine Vet J 1999 Nov;31(6):456-64.
pubmed: 10596925
Hendrickson DA. Complications of laparoscopic surgery.. Vet Clin North Am Equine Pract 2008 Dec;24(3):557-71, viii.
pubmed: 19203701doi: 10.1016/j.cveq.2008.09.003google scholar: lookup
Fredman B, Jedeikin R, Olsfanger D, Flor P, Gruzman A. Residual pneumoperitoneum: a cause of postoperative pain after laparoscopic cholecystectomy.. Anesth Analg 1994 Jul;79(1):152-4.
pubmed: 8010427
Alexander JI, Hull MG. Abdominal pain after laparoscopy: the value of a gas drain.. Br J Obstet Gynaecol 1987 Mar;94(3):267-9.
pubmed: 2952161doi: 10.1111/j.1471-0528.1987.tb02366.xgoogle scholar: lookup
Bouré L, Marcoux M, Laverty S. Paralumbar fossa laparoscopic ovariectomy in horses with use of Endoloop ligatures.. Vet Surg 1997 Nov-Dec;26(6):478-83.
pubmed: 9387212doi: 10.1111/j.1532-950x.1997.tb00520.xgoogle scholar: lookup
Bussières G, Jacques C, Lainay O, Beauchamp G, Leblond A, Cadoré JL, Desmaizières LM, Cuvelliez SG, Troncy E. Development of a composite orthopaedic pain scale in horses.. Res Vet Sci 2008 Oct;85(2):294-306.
pubmed: 18061637doi: 10.1016/j.rvsc.2007.10.011google scholar: lookup
Barczyński M, Herman RM. Low-pressure pneumoperitoneum combined with intraperitoneal saline washout for reduction of pain after laparoscopic cholecystectomy: a prospective randomized study.. Surg Endosc 2004 Sep;18(9):1368-73.
pubmed: 15803238doi: 10.1007/s00464-003-9299-ygoogle scholar: lookup
Wills VL, Hunt DR. Pain after laparoscopic cholecystectomy.. Br J Surg 2000 Mar;87(3):273-84.
pubmed: 10718794doi: 10.1046/j.1365-2168.2000.01374.xgoogle scholar: lookup
Evans RM, Hulbert JC, Reddy PK. Complications of laparoscopy.. Semin Urol 1992 Aug;10(3):164-8.
pubmed: 1387969
Jackson SA, Laurence AS, Hill JC. Does post-laparoscopy pain relate to residual carbon dioxide?. Anaesthesia 1996 May;51(5):485-7.
pubmed: 8694166doi: 10.1111/j.1365-2044.1996.tb07798.xgoogle scholar: lookup
Ragle CA, Schneider RK, Southwood LL. Abdominal laparoscopy in horses.. Compend Contin Educ Pract Vet 1996;18:1231–1239.
van Loon JPAM, Back W, Hellebrekers LJ, van Weeren PR. Application of a composite pain scale to objectively monitor horses with somatic and visceral pain under hospital conditions.. J Equine Vet Sci 2010;30:641–649.