Epstein Mark, Rodan Ilona, Griffenhagen Gregg, Kadrlik Jamie, Petty Michael, Robertson Sheilah, Simpson Wendy
From the Total Bond Veterinary Hospitals PC, Gastonia, NC (M.E.); Cat Care Clinic and Feline-Friendly Consultations, Madison, WI (I.R.); Veterinary Teaching Hospital, Colorado State University School of Veterinary Medicine, Fort Collins, CO (G.G.); Pet Crossing Animal Hospital & Dental Clinic, Bloomington, MN (J.K.); Arbor Pointe Veterinary Hospital/Animal Pain Center, Canton, M.I. (M.P.); Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, MI (S.R.); and Morrisville Cat Hospital, Morrisville, NC (W.S.).
J Am Anim Hosp Assoc. 2015 Mar-Apr;51(2):67-84. doi: 10.5326/JAAHA-MS-7331.
The robust advances in pain management for companion animals underlie the decision of AAHA and AAFP to expand on the information provided in the 2007 AAHA/AAFP Pain Management Guidelines for Dogs and Cats . The 2015 guidelines summarize and offer a discriminating review of much of this new knowledge. Pain management is central to veterinary practice, alleviating pain, improving patient outcomes, and enhancing both quality of life and the veterinarian-client-patient relationship. The management of pain requires a continuum of care that includes anticipation, early intervention, and evaluation of response on an individual-patient basis. The guidelines include both pharmacologic and nonpharmacologic modalities to manage pain; they are evidence-based insofar as possible and otherwise represent a consensus of expert opinion. Behavioral changes are currently the principal indicator of pain and its course of improvement or progression, and the basis for recently validated pain scores. A team-oriented approach, including the owner, is essential for maximizing the recognition, prevention, and treatment of pain in animals. Postsurgical pain is eminently predictable but a strong body of evidence exists supporting strategies to mitigate adaptive as well as maladaptive forms. Degenerative joint disease is one of the most significant and under-diagnosed diseases of cats and dogs. Degenerative joint disease is ubiquitous, found in pets of all ages, and inevitably progresses over time; evidence-based strategies for management are established in dogs, and emerging in cats. These guidelines support veterinarians in incorporating pain management into practice, improving patient care.
伴侣动物疼痛管理方面的显著进展,是美国动物医院协会(AAHA)和美国猫科从业者协会(AAFP)决定扩展2007年《AAHA/AAFP犬猫疼痛管理指南》所提供信息的依据。2015年版指南总结并对许多此类新知识进行了有鉴别力的综述。疼痛管理是兽医实践的核心,可减轻疼痛、改善患者预后,并提升生活质量以及兽医-客户-患者关系。疼痛管理需要持续的护理,包括预期、早期干预以及基于个体患者的反应评估。这些指南包括管理疼痛的药物和非药物方法;它们尽可能基于证据,否则代表专家意见的共识。行为改变目前是疼痛及其改善或进展过程的主要指标,也是最近验证的疼痛评分的基础。包括主人在内的团队导向方法对于最大限度地识别、预防和治疗动物疼痛至关重要。术后疼痛是完全可预测的,但有大量证据支持减轻适应性和非适应性疼痛形式的策略。退行性关节病是猫和狗最常见且诊断不足的疾病之一。退行性关节病普遍存在,见于所有年龄段的宠物,且不可避免地会随时间进展;基于证据的犬类管理策略已确立,猫的相关策略也正在出现。这些指南支持兽医将疼痛管理纳入实践,改善患者护理。