Current British Veterinary attitudes to the use of analgesia in routine neutering.

Re: Current British Veterinary attitudes to the use of analgesia in routine neutering.

Rachael Williams — Mon, 11 Oct 2010 11:46:46 GMT

[quote user="alison howell"]

I have never heard of anyone using local anaesthetic for small animal neutering.

I doubt many people use ketamine or alpha-2s for their pain relief properties in neutering either...more likely to be for anaesthesia, and then the alpha-2 would be reversed, also reversing the pain relief effect...

[/quote]

Thanks for your interest in this survey. You may have never heard of anyone using local anaesthetic for small animal neutering, but I can assure you I have seen it used routinely for speys and castrations And with regards to alpha-2 agonists, I realise they are probably used more for their sedative rather than analgesic effects, but as they do have potent analgesic effects they must form part of the survey, as some veterinary surgeons may choose these drugs for that purpose. Thanks for pointing this out, it is interesting, that for something as routine as neutering so many people have slightly different views on what analgesia is neccessary(if any) and when is the most appropriate time to administer it. I really appreciate everyone who has taken the time to fill out this online survey.

Re: Current British Veterinary attitudes to the use of analgesia in routine neutering.

Utlendigur — Sat, 09 Oct 2010 15:43:45 GMT

[quote user="Evelyn Barbour-Hill"]

Sorry to be horrid, but if you are having regular problems with wound interference you should be looking critically at your surgical technique.

How would local analgesic infiltration help? How long would it last? What would the wound feel like when it wore off?

Grumpy old fart, should have stayed on holiday.

[/quote]

I definitely agree with the first sentence, but quite a few of the surgery CPDs I've been to recently are pushing greater use of local as part of multimodal analgesia ie to block pain pathways at numerous points to try to reduce up-regulation of pain in the CNS. I've started using infiltration of local around main nerves prior to cutting them in limb amputations for example and it does seem to help. Another method suggested was putting a catheter with perforations subcut along a mammary strip wound and irrigating with local several times over the first 24hrs or so.

Re: Current British Veterinary attitudes to the use of analgesia in routine neutering.

Bob Russell — Sat, 09 Oct 2010 10:21:21 GMT

Very few of our patients show particular distress on recovery (I know pain is not always that straight forward to quantify). ACP/buprenorphine/NSAI pre-surgery follow up buprenorphine top up if and when needed post-op. We may send the 'wimps' home with buprenorphine for oral administration but this is more often if owners are particularly anxious.

NSAI for couple of days after.

Hopefully ketamine level analgesia rarely necessary.

Dogs frequently pull on a lead going out of kennels so would say discomfort levels acceptable.

The more work that is done on peri-operative pain the better. You cannot slice an animal open without causing pain!!! I look back with horror and guilt to the days where pain relief was not routine. Thank goodness things have moved forward!!!

Re: Current British Veterinary attitudes to the use of analgesia in routine neutering.

Mark Hedberg — Fri, 08 Oct 2010 23:18:26 GMT

Delighted to respond. We use buprenorphine for preoperative analgesia, and meloxicam if animal shows more obvious pain post surgery. Ketamine? We use that in cats in combination anasthesia, but not for pain relief iv.

Re: Current British Veterinary attitudes to the use of analgesia in routine neutering.

Michael Woodhouse — Fri, 08 Oct 2010 20:27:18 GMT

[quote user="Rachael Williams"]

I understand where you are coming from with regards to local anaesthetics, but I have been to practices where they use local anaesthetics for things such as bitch spays, at these practicies they have anecdotal reports of a reduction in wound interference after using the local anaesthetic. As rabbits especially, are renowned for wound interference after surgery, I was wondering if anyone had tried local anaesthetics in this species.

[/quote]

Your questioning is admirable. If no one questioned the status quo nothing would ever change. That said I send buster collars home with all spays and most castrates so the owner can use it if they need to. I must get 95% back. There shouldn't be any need assuming good surgical technique and skin knots not too tight.

The problem I have with your questionnaire is no facility to state that a product was administered as a pre-med, the closest was preoperatively.

Re: Current British Veterinary attitudes to the use of analgesia in routine neutering.

Evelyn Barbour-Hill — Fri, 08 Oct 2010 19:54:17 GMT

Sorry to be horrid, but if you are having regular problems with wound interference you should be looking critically at your surgical technique.

How would local analgesic infiltration help? How long would it last? What would the wound feel like when it wore off?

Grumpy old fart, should have stayed on holiday.

Re: Current British Veterinary attitudes to the use of analgesia in routine neutering.

Mark Holmes — Fri, 08 Oct 2010 16:21:51 GMT

I use ketamine for analgesia, 0.05ml iv per 10kg in dogs, cats get ketamine anyway with D and K. It does seem to make a difference. I heard its very good at resetting any wind up. It is also good for arthritic pain if given occasionally. Never used local for suturing, some concern about it affecting wound healing.

Re: Current British Veterinary attitudes to the use of analgesia in routine neutering.

vs0u — Fri, 08 Oct 2010 16:09:54 GMT

I have never heard of anyone using local anaesthetic for small animal neutering.

Re: Current British Veterinary attitudes to the use of analgesia in routine neutering.

Rachael Williams — Fri, 08 Oct 2010 14:47:16 GMT

Re: Current British Veterinary attitudes to the use of analgesia in routine neutering.

Michael Woodhouse — Fri, 08 Oct 2010 14:01:21 GMT

[quote user="Rachael Williams"]So as not to bias my research what is the current opinion of using local anaesthetic in rabbit and cat speys - i.e. infiltration of incision. And what local anaesthetic are vets using?[/quote]

What a way to waste time and distort tissues would be my first thought.

I used to do line blocks in cattle, but the tissue is so much easier to handle with paravertabral anaesthesia I wouldn't go back.

Local anaesthetic in the wound is a step in the wrong direction IMO.

Re: Current British Veterinary attitudes to the use of analgesia in routine neutering.

Rachael Williams — Fri, 08 Oct 2010 12:48:36 GMT

Thanks everyone so far for filling in my survey. Just as a discussion point, my survey is currently about the use of analgesia in routine neutering of dogs. So as not to bias my research what is the current opinion of using local anaesthetic in rabbit and cat speys - i.e. infiltration of incision. And what local anaesthetic are vets using?