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2015年美国动物医院协会/美国猫科动物从业者协会犬猫疼痛管理指南。

2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats.

作者信息

Epstein Mark, Rodan Ilona, Griffenhagen Gregg, Kadrlik Jamie, Petty Michael, Robertson Sheilah, Simpson Wendy

机构信息

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.).

出版信息

J Am Anim Hosp Assoc. 2015 Mar-Apr;51(2):67-84. doi: 10.5326/JAAHA-MS-7331.

Abstract

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.

摘要

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。

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