Teixeira Renata Cr, Monteiro Eduardo R, Campagnol Daniela, Coelho Karina, Bressan Thais F, Monteiro Betânia S
School of Veterinary Medicine, UVV - University of Vila Velha, Vila Velha, Brazil.
Vet Anaesth Analg. 2013 Nov;40(6):641-9. doi: 10.1111/vaa.12080. Epub 2013 Aug 5.
To compare the effects of tramadol alone, or in combination with dipyrone or meloxicam, on postoperative pain and analgesia requirement after unilateral mastectomy with or without ovariohysterectomy in dogs.
Prospective, randomized, clinical study.
Twenty seven bitches undergoing unilateral mastectomy with or without ovariohysterectomy.
Anesthesia was induced with propofol and maintained with isoflurane and a constant rate infusion of morphine. Before the end of surgery, dogs were randomly assigned to receive intravenous tramadol alone (3 mg kg(-1), group T), combined with dipyrone (30 mg kg(-1), group TD) or meloxicam (0.2 mg kg(-1), group TM). Dogs received additional doses of tramadol (groups T and TM) or tramadol with dipyrone (group TD) at 8 and 16 hours after extubation. Postoperative pain was assessed by a blinded observer before anesthesia (baseline) and at 1, 2, 3, 4, 6, 8, 12, 16 and 24 hours after extubation using a visual analog scale (VAS) and a modified Glasgow scale. Rescue analgesia (morphine, 0.5 mg kg(-1)) was administered if the Glasgow pain score was >3.5.
There were no significant differences among groups in pain scores evaluated by the VAS or the Glasgow scale. In groups T, TD and TM, pain scores were significantly higher than at baseline for 6, 8 and 2 hours, respectively. Rescue analgesia was administered to 3/9, 2/9 and 1/9 dogs in groups T, TD and TM, respectively (p > 0.05) [Correction added on 15 August 2013, after first online publication: 'T, TM and TD' was changed to 'T, TD and TM'.].
Under the conditions of this study, tramadol alone or in combination with dypyrone or meloxicam provided effective analgesia for 24 hours in most dogs after unilateral mastectomy with or without ovariohysterectomy. Further evaluation of combination therapies is needed in larger groups of dogs.
比较曲马多单独使用，或与安乃近或美洛昔康联合使用，对行单侧乳房切除术伴或不伴卵巢子宫切除术的犬术后疼痛及镇痛需求的影响。
前瞻性、随机、临床研究。
27只接受单侧乳房切除术伴或不伴卵巢子宫切除术的母犬。
用丙泊酚诱导麻醉，异氟醚及持续静脉输注吗啡维持麻醉。手术结束前，将犬随机分为三组，分别静脉注射单独的曲马多（3 mg·kg⁻¹，T组）、联合安乃近（30 mg·kg⁻¹，TD组）或美洛昔康（0.2 mg·kg⁻¹，TM组）。拔管后8小时和16小时，T组和TM组犬额外注射曲马多，TD组犬额外注射曲马多与安乃近的合剂。由一名不知情的观察者在麻醉前（基线）以及拔管后1、2、3、4、6、8、12、16和24小时，使用视觉模拟评分法（VAS）和改良格拉斯哥评分法评估术后疼痛。若格拉斯哥疼痛评分>3.5，则给予解救镇痛药（吗啡，0.5 mg·kg⁻¹）。
VAS或格拉斯哥评分法评估的疼痛评分在各组间无显著差异。在T组、TD组和TM组中，疼痛评分分别在6小时、8小时和2小时显著高于基线水平。T组、TD组和TM组分别有3/9、2/9和1/9的犬接受了解救镇痛（p>0.05）[2013年8月15日首次在线发表后添加的校正内容：“T，TM和TD”改为“T，TD和TM”。]。
在本研究条件下，曲马多单独使用或与安乃近或美洛昔康联合使用，对大多数行单侧乳房切除术伴或不伴卵巢子宫切除术的犬在24小时内提供了有效的镇痛效果。需要在更多犬只中进一步评估联合治疗方法。
