Laparoscopic Ovariectomy Versus Ovariectomy Via Midline Coeliotomy or Flank Laparotomy in Cats: Effects on Postoperative Pain

The purpose of this prospective clinical study was to compare three methods of ovariectomy in cats. We hypothesised that laparoscopic ovariectomy would cause less postoperative pain than open midline and flank approaches and that other studied parameters would be similar.

Sixty-eight ASA1 client-owned female cats were initially enrolled. Eight cats were excluded (pregnancy, uterine abnormalities, aggressiveness). The cats were randomly assigned to one of three groups: Midline group (n=20), Flank group (n=20), Lap group (n=20). All open and laparoscopic procedures were performed by 2 different senior surgeons. Surgical assistants were veterinary students in all cases. The animals were premedicated with IM medetomidine and morphine hydrochloride. General anaesthesia was induced with propofol and maintained with isoflurane. For laparoscopic ovariectomy, a transabdominal suspension ligature was used and haemostasis was achieved with an endoscopic bipolar vessel-sealing device. The patients were evaluated 1h, 2h, 4h, 6h, and 12h after extubation. Postoperative pain was scored using the 4A-vet pain scale. This compound pain scale combines a subjective numerical pain rating and the objective scoring of physiological and behavioural parameters, including the response to stimulation of the surgical site. Additional postoperative analgesia was provided as required according to the Pain Score by IV administration of morphine. Recorded parameters were age, body weight, duration of anaesthesia, duration of surgery, duration of recovery, dose of propofol required for anaesthetic induction, number of perioperative morphine injections, quality of the recovery, level of postoperative consciousness, preoperative and postoperative heart rate, respiratory rate, body temperature, and pain score at each of the different examinations. For quantitative parameters, statistical analysis was performed using one-way ANOVA with a post-hoc Tukey test . Qualitative parameters were compared using a Fisher exact test. Significance was set at P < 0.05.  [...]