Comparison of epidural morphine and buprenorphine for hindlimb orthopaedic surgery in dogs
2020
Thomas Towers
PICO question In dogs undergoing hindlimb orthopaedic surgery does epidural with local anaesthetic and buprenorphine provide equivalent intra- and postoperative analgesia as epidural with local anaesthetic and morphine? Clinical bottom line Category of research question Treatment The number and type of study designs reviewed One double-blinded randomised controlled trial Strength of evidence Weak Outcomes reported Epidural analgesia with buprenorphine and bupivacaine may provide equivalent analgesia to more traditional morphine and bupivacaine epidural injection Conclusion There is weak evidence that buprenorphine may provide equivalent analgesia to morphine when combined with bupivacaine epidurally. The reduced regulatory requirements imposed on buprenorphine may sway some clinicians to utilise buprenorphine but further, higher powered, controlled trials are necessary to confirm equivalency How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
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