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Comparison of postoperative pain after ovariohysterectomy by harmonic scalpel-assisted laparoscopy compared with median celiotomy and ligation in dogs
Authors:Hancock Robert B  Lanz Otto I  Waldron Don R  Duncan Robert B  Broadstone Richard V  Hendrix Paula K
Institution:Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA 24061, USA.
Abstract:OBJECTIVE: To compare the effects of postoperative pain after ovariohysterectomy by harmonic scalpel-assisted laparoscopy (HALO) and traditional ovariohysterectomy (OVH) in dogs. STUDY DESIGN: A randomized, blinded, prospective study. SAMPLE POPULATION: Sixteen, purpose-bred, intact female, Beagle dogs. METHODS: Dogs were divided into 2 groups: Group 1 (8 dogs), which had OVH by HALO, and Group 2 (8 dogs), which had traditional OVH. Physiologic data, abdominal nociceptive threshold scores, and University of Melbourne pain scores (UMPS) were recorded at 2, 6, 12, 24, 48, and 72 hours after surgery. Blood samples for measurement of plasma cortisol, glucose, and creatine phosphokinase (CPK) concentrations were collected at the time of the incision, and 2, 6, 12, 24, 48, and 72 hours after surgery. RESULTS: No significant surgical complications occurred. The HALO mean surgical time was significantly longer (55.7 minutes) than traditional OVH (31.7 minutes). No significant differences were observed between groups for the pain measures of heart rate, respiratory rate, temperature, CPK, and glucose concentrations. The OVH group had significantly higher mean plasma cortisol levels at hour 2 after surgery than the HALO group (P=.0001). The mean UMPS were significantly higher in OVH than the HALO group at all postoperative times (P=.0001). The mean nociceptive threshold measurements revealed significantly higher tolerated palpation pressures in HALO than OVH at all postoperative times, except hour 72 (P=.0002). CONCLUSIONS: Dogs appeared to be in less pain with HALO than OVH. The harmonic scalpel coagulated ovarian and uterine vessels completely with minimal collateral damage to surrounding tissues. CLINICAL RELEVANCE: HALO is a safe alternative to OVH and offers a minimally invasive and less painful method of surgery.
Keywords:laparoscopy  ovariohysterectomy  harmonic scalpel  pain score  University of Melbourne pain score  dog
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