Martinez S A, Wilson M G, Linton D D, Newbound G C, Freise K J, Lin T-L, Clark T P
College of Veterinary Medicine, Washington State University, Pullman, WA, USA.
J Vet Pharmacol Ther. 2014 Aug;37(4):394-405. doi: 10.1111/jvp.12096. Epub 2013 Dec 18.
A prospective, double-blinded, positive-controlled, multicenter, noninferiority study was conducted to evaluate the safety and effectiveness of transdermal fentanyl solution (TFS) compared with oxymorphone for the control of postoperative pain in dogs. Five hundred and two (502) client-owned dogs were assigned to a single dose of TFS (2.7 mg/kg) applied 2-4 h prior to surgery or oxymorphone hydrochloride (0.22 mg/kg) administered subcutaneously 2-4 h prior to surgery and q6h through 90 h. Pain was evaluated over 4 days by blinded observers using a modified Glasgow composite pain scale, and the a priori criteria for treatment failure was a pain score ≥ 8 or adverse event necessitating withdrawal. Four TFS- and eight oxymorphone-treated dogs were withdrawn due to lack of pain control. Eighteen oxymorphone-treated, but no TFS-treated dogs were withdrawn due to severe adverse events. The one-sided upper 95% confidence interval of the difference between TFS and oxymorphone treatment failure rates was -5.3%. Adverse events associated with oxymorphone were greater in number and severity compared with TFS. It was concluded that a single administration of TFS was safe and noninferior to repeated injections of oxymorphone for the control of postoperative pain over 4 days at the dose rates of both formulations used in this study.
进行了一项前瞻性、双盲、阳性对照、多中心、非劣效性研究,以评估透皮芬太尼溶液(TFS)与羟吗啡酮相比用于控制犬术后疼痛的安全性和有效性。502只客户拥有的犬被分配接受单剂量TFS(2.7mg/kg),在手术前2 - 4小时应用,或盐酸羟吗啡酮(0.22mg/kg),在手术前2 - 4小时皮下给药,并每6小时一次,持续90小时。由盲法观察者在4天内使用改良的格拉斯哥综合疼痛量表评估疼痛,治疗失败的先验标准为疼痛评分≥8或出现需要停药的不良事件。4只接受TFS治疗和8只接受羟吗啡酮治疗的犬因疼痛控制不佳而停药。18只接受羟吗啡酮治疗但没有接受TFS治疗的犬因严重不良事件而停药。TFS与羟吗啡酮治疗失败率差异的单侧95%置信区间上限为-5.3%。与TFS相比,与羟吗啡酮相关的不良事件在数量和严重程度上更多。得出的结论是,在本研究使用的两种制剂剂量率下,单次给予TFS在控制术后4天疼痛方面是安全的,且不劣于重复注射羟吗啡酮。