Multimodal Analgesia Provides Superior Postoperative Pain Control Following Orthopedic Surgery in Small-Breed Dogs

Area of Science:

• Veterinary Surgery
• Pain Management
• Pharmacology

Background:

• Effective postoperative pain management is crucial for small-breed dogs due to their limited physiological reserves.
• Orthopedic surgeries in small dogs require tailored analgesic strategies to ensure optimal recovery and welfare.

Purpose of the Study:

• To compare the analgesic efficacy and tolerability of five distinct postoperative pain management protocols.
• To identify the most effective and safest pain relief strategy for small-breed dogs after orthopedic procedures.

Main Methods:

• Retrospective analysis of 205 small-breed dogs (≤7 kg) undergoing orthopedic surgery.
• Evaluation of five analgesic protocols: carprofen, tramadol-lidocaine-ketamine CRI, butorphanol CRI, hydromorphone CRI, and multimodal analgesia.
• Pain assessment using the Glasgow Composite Measure Pain Scale-Short Form at multiple time points (6-72 h).

Main Results:

• Multimodal analgesia demonstrated the most rapid and sustained pain relief, with complete resolution by 48 hours.
• Hydromorphone alone was effective but linked to increased adverse effects.
• Tramadol-lidocaine-ketamine infusion resulted in delayed pain relief and the highest incidence of severe side effects.

Conclusions:

• Multimodal analgesia provides superior pain control and acceptable safety in small-breed dogs post-orthopedic surgery.
• The choice of analgesic protocol should consider surgical invasiveness and individual patient response.
• This study supports the routine use of multimodal analgesia for enhanced postoperative care in this patient population.