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Abstract

PICO question

In bitches, is an ovariectomy/ovariohysterectomy by laparoscopy superior to an ovariectomy/ovariohysterectomy by a midline surgical laparotomy in causing less postoperative pain?

 

Clinical bottom line

Category of research question

Treatment

The number and type of study designs reviewed

Seven papers were critically appraised. They comprised of three blinded randomised controlled trials, two non-blinded randomised controlled trials and two non-blinded non-randomised controlled trials

Strength of evidence

Weak

Outcomes reported

In bitches, ovariectomy/ovariohysterectomy by laparoscopy is superior to ovariectomy/ovariohysterectomy by a midline laparotomy in causing less postoperative pain

Conclusion

Despite the widely held belief that laparoscopic surgery is associated with less postoperative pain, the available veterinary literature only provides weak evidence to support this in bitches undergoing ovariectomy/ovariohysterectomy. There are many uncontrolled variables to consider across these underpowered studies including surgeon number (and experience), the choice of perioperative analgesia, method of pain scoring and the laparoscopic technique. It is therefore clear that laparoscopic procedures cannot be viewed equally and the strength of the answer to the clinical question may change based upon these variables. It is also important to note that the incidence of complications or the effect of the above variables on postoperative pain have not been critically reviewed and warrant careful consideration when deciding on a laparoscopic approach

 

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.

 

Open Access Peer Reviewed