Delgado Cherlene, Bentley Ellison, Hetzel Scott, Smith Lesley J
Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706.
J Am Vet Med Assoc. 2014 Dec 15;245(12):1375-81. doi: 10.2460/javma.245.12.1375.
To compare analgesia provided by carprofen and tramadol in dogs after enucleation.
Randomized, masked clinical trial.
43 dogs.
Client-owned dogs admitted for routine enucleation were randomly assigned to receive either carprofen or tramadol orally 2 hours prior to surgery and 12 hours after the first dose. Dogs were scored for signs of pain at baseline (ie, before carprofen or tramadol administration) and at 0.25, 0.5, 1, 2, 4, 6, 8, 24, and 30 hours after extubation. Dogs received identical premedication and inhalation anesthesia regimens, including premedication with hydromorphone. If the total pain score was ≥ 9 (maximum possible score of 20), there was a score ≥ 3 in any of 5 behavioral categories (highest score possible per category was 3 or 4), or the visual analog scale (VAS) score was ≥ 35 (maximum possible score of 100) combined with a palpation score > 0, rescue analgesia (hydromorphone) was administered and treatment failure was recorded.
No differences were found in age, sex, or baseline pain scores between groups. Significantly more dogs receiving tramadol required rescue analgesia (6/21), compared with dogs receiving carprofen (1/22). Pain and VAS scores decreased linearly over time. No significant differences were found in pain or VAS scores between groups at any time point (dogs were excluded from analysis after rescue).
Results of this study suggested that carprofen, with opioid premedication, may provide more effective postoperative analgesia than tramadol in dogs undergoing enucleation.
比较犬眼球摘除术后卡洛芬和曲马多的镇痛效果。
随机、盲法临床试验。
43只犬。
因常规眼球摘除术入院的宠物犬在手术前2小时及首剂用药后12小时随机口服卡洛芬或曲马多。在基线(即卡洛芬或曲马多给药前)以及拔管后0.25、0.5、1、2、4、6、8、24和30小时对犬的疼痛体征进行评分。犬接受相同的术前用药和吸入麻醉方案,包括用氢吗啡酮进行术前用药。如果总疼痛评分≥9分(最高可能评分为20分)、5个行为类别中任何一个类别评分≥3分(每个类别最高可能评分为3或4分),或者视觉模拟评分(VAS)≥35分(最高可能评分为100分)且触诊评分>0,则给予救援性镇痛(氢吗啡酮)并记录治疗失败情况。
两组在年龄、性别或基线疼痛评分方面未发现差异。与接受卡洛芬的犬(1/22)相比,接受曲马多的犬需要救援性镇痛的明显更多(6/21)。疼痛和VAS评分随时间呈线性下降。在任何时间点,两组之间的疼痛或VAS评分均未发现显著差异(救援后犬被排除在分析之外)。
本研究结果表明,对于接受眼球摘除术的犬,在使用阿片类药物进行术前用药的情况下,卡洛芬可能比曲马多提供更有效的术后镇痛。