Department of Surgery, Small Animal Clinic, Vetsuisse Faculty, University of Berne, Berne, Switzerland.
Department of Clinical Research and Veterinary Public Health, Vetsuisse Faculty, University of Berne, Berne, Switzerland.
Vet Surg. 2021 Jan;50(1):71-80. doi: 10.1111/vsu.13515. Epub 2020 Sep 21.
To evaluate the prevalence of chronic postsurgical pain (CPSP) after tibial plateau leveling osteotomy (TPLO) in dogs and to determine the influence of preemptive locoregional analgesia on CPSP.
Retrospective study.
One hundred twenty client-owned dogs.
Medical records of dogs that underwent TPLO between 2012 and 2016 were reviewed for demographic information and type of preemptive analgesia. Owners were contacted to retrospectively assess the quality of life of their dogs by using the Helsinki Chronic Pain Index (HCPI) before and 6 months after surgery and at the time of questioning. An HCPI score > 12 was considered indicative of CPSP. Medical records were reviewed for demographic information and type of preemptive analgesia. A cumulative logit model was used to assess correlation of type of perioperative analgesia, HCPI, and demographic data.
The HCPI score was consistent with CPSP in 41 of 101 dogs with long-term follow-up (2.9 ± 1.5 years after surgery). Chronic postsurgical pain was documented in 11 of 32 and 13 of 28 dogs that received a spinal or epidural injection, respectively, or in 28 of 80 and 25 of 67 dogs with sciatic-femoral block at 6 months or with long-term follow-up after TPLO, respectively (P > .05). A negative correlation was found between HCPI and both weight and age 6 months after surgery. Only weight remained negatively correlated 2.9 years after surgery.
Forty-one percent of dogs that were evaluated exhibited HCPI values compatible with CPSP long-term after TPLO, regardless of the type of preemptive analgesia. Increased body weight was a negative prognostic factor for CPSP development.
Additional studies are required to evaluate CPSP development after TPLO.
评估犬胫骨平台平整截骨术（TPLO）后慢性术后疼痛（CPSP）的发生率，并确定预防性局部镇痛对 CPSP 的影响。
回顾性研究。
120 只患犬。
回顾性分析 2012 年至 2016 年间接受 TPLO 的犬的病历，记录其人口统计学信息和预防性镇痛类型。通过赫尔辛基慢性疼痛指数（HCPI），在术前和术后 6 个月以及询问时，联系犬主人对其犬的生活质量进行回顾性评估。HCPI 评分＞12 被认为存在 CPSP。回顾病历，记录人口统计学信息和预防性镇痛类型。采用累积对数模型评估围手术期镇痛类型、HCPI 和人口统计学数据的相关性。
在 101 只具有长期随访（TPLO 后 2.9±1.5 年）的犬中，有 41 只犬的 HCPI 评分与 CPSP 一致。在分别接受椎管内或硬膜外注射的 32 只和 28 只犬中，或在接受坐骨股神经阻滞的 6 个月或长期随访的 67 只和 80 只犬中，分别记录到 11 只和 13 只犬存在慢性术后疼痛（P＞.05）。术后 6 个月，HCPI 与体重和年龄呈负相关。TPLO 后 2.9 年，仅体重仍与 CPSP 呈负相关。
在 TPLO 后长期评估的犬中，有 41%的犬出现 HCPI 值与 CPSP 相符，而与预防性镇痛类型无关。体重增加是 CPSP 发生的负预后因素。
需要进一步研究来评估 TPLO 后 CPSP 的发生情况。
