Edentulism, blood-based neurodegenerative biomarkers, and 10-year dementia risk: A mediation analysis in a nationally representative United States cohort.

Laparoscopic ovariectomy (LOE) is a minimally invasive surgical technique widely used for elective sterilization in female dogs. Compared with conventional open laparotomy approaches, it is associated with reduced tissue trauma, decreased perioperative pain and faster postoperative recovery, which has contributed to its growing preference in contemporary veterinary practice (Fuertes‐Recuero et al. ; Costa et al. ; Del Prete et al. ). Clinical studies involving LOE combined with minimally invasive gastropexy have also reported acceptable complication rates and mild postoperative pain, further supporting the clinical relevance of laparoscopic techniques in dogs (Leonardi et al. ). Despite the minimally invasive character of the procedure, manipulation of the ovarian pedicle, mesovarium and associated ligamentous structures may still elicit clinically relevant nociceptive stimulation during ovariectomy. Previous studies evaluating local anaesthetic techniques directed at the ovarian pedicle or mesovarium support the clinical relevance of this region as a target for perioperative analgesia in dogs undergoing ovariectomy or ovariohysterectomy (Bubalo et al. ; Cicirelli et al. ). Therefore, the provision of effective perioperative analgesia remains a critical component of LOE from a clinical standpoint. In the domain of surgical practice, the administration of multimodal analgesic strategies is a widely recommended approach to optimize pain control (Kianian et al. ; Graham et al. ). The concurrent use of analgesic modalities with divergent mechanisms of action facilitates the suppression of nociceptive transmission at multiple levels, thereby enabling a more stable perioperative course (Yang et al. ; Jiang et al. ). In this regard, the intraoperative administration of bupivacaine HCl, a long‐acting local anaesthetic, directly to the surgical site has been considered a potentially effective approach. It has been hypothesized that the attenuation of peripheral nociceptive input may serve to limit visceral pain responses and enhance the overall perioperative analgesic efficacy of the procedure (Fuertes‐Recuero et al. ; Pezzanite et al. ). Surgical procedures have been shown to induce not only clinical pain symptoms but also a systemic biological stress response characterized by inflammatory activation and changes in antioxidant defence activity. Increases in pro‐inflammatory cytokine levels and changes in antioxidant enzyme activities are considered important indicators of the systemic response to surgery (Savic Vujovic et al. ; Zivkovic et al. ). The evaluation of these biological parameters in combination with clinical pain scores has the potential to facilitate a more comprehensive understanding of the effectiveness of analgesic approaches.