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腹腔镜卵巢切除术、正中剖腹术或侧腹剖腹术后猫的术后疼痛评估

Assessment of Postoperative Pain in Cats After Ovariectomy by Laparoscopy, Median Celiotomy, or Flank Laparotomy.

作者信息

Gauthier Olivier, Holopherne-Doran Delphine, Gendarme Thalia, Chebroux Alexandre, Thorin Chantal, Tainturier Daniel, Bencharif Djemil

机构信息

Department of Small Animal Surgery and Anesthesia, ONIRIS Nantes-Atlantic College of Veterinary Medicine, Food Science and Engineering, Nantes, France.

Department of Reproductive Pathology, ONIRIS Nantes-Atlantic College of Veterinary Medicine, Food Science and Engineering, Nantes, France.

出版信息

Vet Surg. 2015 Jul;44 Suppl 1:23-30. doi: 10.1111/j.1532-950X.2014.12150.x. Epub 2014 Jan 31.

Abstract

OBJECTIVE

To compare postoperative pain, duration of surgery, and duration of anesthesia for 3 methods of ovariectomy in cats: (1) conventional ventral median open approach (Midline), (2) right flank approach (Flank), and (3) median 2-portal laparoscopic procedure (Lap).

STUDY DESIGN

Randomized, prospective clinical trial.

ANIMALS

Healthy, sexually intact female cats (n = 60).

METHODS

Cats were randomly assigned to 1 of 3 groups: Midline (n = 20), Flank (20), and Lap (20) were evaluated 1, 2, 4, 6, and 12 hours after endotracheal extubation. Postoperative pain was scored using the 4A-vet pain scale that combines a subjective numerical pain rating and objective scoring of physiologic and behavioral variables including the response to stimulation of the surgical site. Pain scores (PS) were compared between groups.

RESULTS

There was a significant difference in the PS between groups. PS for Midline and Flank were not significantly different but were both significantly higher compared with Lap. Depending on time, 5-20% of the cats had intense postoperative pain in both Midline and Flank groups. None of the Lap cats had intense postoperative pain.

CONCLUSIONS

Laparoscopic ovariectomy, although slower, appeared less painful compared with conventional ventral midline and flank ovariectomy. Postoperative pain did not differ significantly between midline and flank groups.

摘要

目的

比较猫卵巢切除术的三种方法的术后疼痛、手术时长和麻醉时长,这三种方法分别为:(1)传统腹正中切开法(中线法),(2)右侧腹切开法(侧腹法),以及(3)经脐双孔腹腔镜手术法(腹腔镜法)。

研究设计

随机、前瞻性临床试验。

动物

健康、未绝育的雌性猫(n = 60)。

方法

将猫随机分为3组,每组20只,分别为中线组、侧腹组和腹腔镜组。在气管插管拔管后1、2、4、6和12小时对各组进行评估。使用4A-vet疼痛量表对术后疼痛进行评分,该量表结合了主观数字疼痛评分以及对包括手术部位刺激反应在内的生理和行为变量的客观评分。比较各组间的疼痛评分(PS)。

结果

各组间的PS存在显著差异。中线组和侧腹组的PS无显著差异,但与腹腔镜组相比均显著更高。根据时间不同,中线组和侧腹组中5%-20%的猫有强烈的术后疼痛。腹腔镜组中没有猫出现强烈的术后疼痛。

结论

与传统腹正中切开法和侧腹卵巢切除术相比,腹腔镜卵巢切除术虽然速度较慢,但疼痛似乎较轻。中线组和侧腹组之间的术后疼痛没有显著差异。

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