Davila Diana, Keeshen Thomas P, Evans Richard B, Conzemius Mike G
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108, USA.
J Am Vet Med Assoc. 2013 Jul 15;243(2):225-31. doi: 10.2460/javma.243.2.225.
OBJECTIVE: To evaluate the effects of perioperative oral administration of tramadol, firocoxib, and a tramadol-firocoxib combination on signs of pain and limb function after tibial plateau leveling osteotomy in dogs. DESIGN: Randomized, blinded, prospective clinical trial. ANIMALS: 30 adult client-owned dogs with unilateral cranial cruciate ligament disease. PROCEDURES: Dogs were allocated into 3 treatment groups (tramadol, firocoxib, and a tramadol-firocoxib combination). Signs of pain (short-form Glasgow composite measure pain scale), serum cortisol concentrations, and limb function (pressure platform gait analysis) were recorded at several time points before surgery and through 3 days after surgery. Outcome measures were compared among groups. RESULTS: A significantly greater number of dogs in the tramadol group (8/10 dogs) had a pain score > 6 after surgery, compared with the other groups. No significant differences were detected in the pain scores between the firocoxib and the tramadol-firocoxib combination groups. There were no significant differences in serum cortisol concentrations among the 3 groups. Limb function was significantly decreased for dogs in the tramadol group on days 1 and 2 after surgery and in the firocoxib group on day 1 after surgery. Although limb function decreased for dogs in the tramadol-firocoxib combination group, the change was not significant for any day after surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Dogs that received firocoxib orally, alone or in combination with tramadol, had lower pain scores, lower rescue opiate administration, and greater limb function than dogs that received only tramadol. When used alone, oral administration of tramadol may not provide sufficient analgesic efficacy to treat dogs with pain after orthopedic surgical procedures.
目的:评估围手术期口服曲马多、非罗考昔以及曲马多-非罗考昔联合用药对犬胫骨平台水平截骨术后疼痛体征和肢体功能的影响。 设计:随机、盲法、前瞻性临床试验。 动物:30只成年客户拥有的单侧颅侧十字韧带疾病犬。 步骤:将犬分为3个治疗组(曲马多组、非罗考昔组和曲马多-非罗考昔联合用药组)。在手术前的几个时间点以及术后3天记录疼痛体征(简化版格拉斯哥综合疼痛量表)、血清皮质醇浓度和肢体功能(压力平台步态分析)。对组间的结果指标进行比较。 结果:与其他组相比,曲马多组中有更多数量的犬(8/10只犬)术后疼痛评分>6。非罗考昔组和曲马多-非罗考昔联合用药组之间的疼痛评分未检测到显著差异。3组之间的血清皮质醇浓度没有显著差异。曲马多组的犬在术后第1天和第2天肢体功能显著下降,非罗考昔组的犬在术后第1天肢体功能显著下降。虽然曲马多-非罗考昔联合用药组的犬肢体功能下降,但术后任何一天的变化均不显著。 结论及临床意义:口服非罗考昔单独或与曲马多联合使用的犬,与仅接受曲马多治疗的犬相比,疼痛评分更低,救援性阿片类药物使用量更低,肢体功能更好。单独使用时,口服曲马多可能无法为治疗骨科手术后疼痛的犬提供足够的镇痛效果。
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