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Opioid-free anaesthesia for the surgical correction of abnormalities associated with brachycephalic obstructive airway syndrome in five dogs

02 March 2021
7 mins read
Volume 26 · Issue 3

Abstract

Opioid-free anaesthesia is currently becoming more popular in human medicine, as it provides multimodal analgesia, affecting multiple nociceptive pathways without the use of opioids, in order to minimise opioid-related side effects. This article presents the cases of five dogs undergoing surgical correction of abnormalities associated with brachycephalic obstructive airway syndrome, all of whom received opioid-free anaesthesia for surgery. All dogs received a bilateral maxillary nerve block with bupivacaine 0.5% and a combination of non-opioid analgesic drugs. Buprenorphine was allowed during the postoperative period, based on pain assessment. Three out of five dogs received buprenorphine 6–7 hours after the nerve block was performed. Opioid-free anaesthesia provided adequate conditions for surgery and no adverse effects were reported. Prospective controlled studies comparing opioid-free anaesthesia with opioid-based techniques are required to elucidate whether or not opioid-free anaesthesia confers objective advantages.

Opioids are effective analgesic drugs often used to control pain or nociception and contribute to sedation in small animals (Epstein et al, 2015). However, they are not exempt from adverse effects. Some of the reported unwanted side effects, reported in both humans and dogs, include respiratory depression, ileus, nausea, vomiting, dysphoria, hyperalgesia and immunomodulatory effects (Lefebvre et al, 1981; Chu et al, 2008; De Boer et al, 2017; Bini et al, 2018).

Opioid-free anaesthesia has been receiving increased attention in recent years because of the opioid abuse crisis in the USA. As a result, there is now a better understanding of their unwanted side effects (Gupta et al, 2020). The aim of opioid-free anaesthesia is to modulate intraoperative nociceptive stimuli, effectively combining regional anaesthetic techniques with non-opioid analgesics (Frauenknecht et al, 2019). Scarce reports in veterinary medicine describe the use of this technique in dogs with good outcomes (White et al, 2017; Zannin et al, 2020).

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