The effect of the use of electropolar bipolar vessel sealing system in bitches during ovariohysterectomy on postoperative serum cortisol, CRP levels and pain status

Purpose: The aim of this thesis is to investigate whether the use of an electrothermal bipolar vessel sealing system (EBVS) instead of suture ligation to ensure hemostasis of vessels during ovariohysterectomy (OHE) procedures has any effect on postoperative stress formation. Materials and Methods: In this study, 20 dogs were used and randomly divided into two groups: the Control OHE Group (Control, n = 10) and the EBVS OHE Group (EBVS, n = 10). In the EBVS group, all ligation and cutting procedures were performed using an electrothermal bipolar vessel sealing device, while in the control group, conventional methods using suture and scissors techniques were used. Serum cortisol and CRP levels were measured, and pain was assessed using the Modified Melbourne Pain Scale at 0, 1, 2, 4, and 24 hours postoperatively. Findings: It was observed that the mean serum cortisol level level in the control group was significantly higher than that of the EBVS group at postoperative 2 (T2) (Control: 11.99 ± 1.67μg/ dl; EBVS 5.17 ± 1.74 μg/ dl) and 4 (T3) hours (Control: 6.17 ± 1.19 μg/ dl; EBVS: 2.67 ± 0.45 μg/dl) (P<0.05). In intra group evaluation, the difference between (T2) and (T4) times was found to be significant in the Control group(P=0,001), whereas the time-dependent change in cortisol was not found to be significant in the EBVS group (p=0.082). No significant difference was detected between the groups in serum CRP levels. In repeated intra group measurements, it was observed that the serum CRP level, which numerically increased up to (2.83 ± 0.70 mg/dl) postoperative 4. hours (T3), in the control group,increased significantly at postoperative 24. hours (T4) to 4,98 ± 0.76mg/dl and showed a significant difference according to time (P<0.001). In the EBVS group,it was observed that the CRP level increased to 5.79 ± 0.49 mg/dl at postoperative 24. hours and that a significant difference occurred compared to the other sampling times (P<0.001). In the pain scale evaluation,it was determined that the pain scores did not show a statistically significant difference either within the Control and EBVS groups or between the groups. Conclusion: It was concluded that significantly higher cortisol levels at postop 2nd and 4th hours in the control group may be the indicator of better operative stress control in the EBVS group. It is thought that the indifference in serum CRP concentrations in between groups may be a consequence of sampling interval in this study which is limited to 24 hours and significant differences may be observed by extending this interval at least to 72 hours, in future studies. As a result it was concluded that EBVS usage may obtain better advantage regarding postoperative comfort and recovery over conventional ligation in OHE operations. Keywords: C-reactive protein, cortisol, dogs, pain, ovariohysterectomy.