猫疼痛行为评估的系统评价
Systematic review of the behavioural assessment of pain in cats.
作者信息
Merola Isabella, Mills Daniel S
机构信息
School of Life Sciences, University of Lincoln, Lincoln, UK
School of Life Sciences, University of Lincoln, Lincoln, UK.
出版信息
J Feline Med Surg. 2016 Feb;18(2):60-76. doi: 10.1177/1098612X15578725. Epub 2015 May 13.
OBJECTIVES
The objectives were to review systematically the range of assessment tools used in cats to detect the behavioural expression of pain and the evidence of their quality; and to examine behavioural metrics (considering both the sensory and affective domains) used to assess pain.
METHODS
A search of PubMed and ScienceDirect, alongside articles known to the authors, from 2000 onwards, for papers in English was performed. This was followed by a manual search of the references within the primary data sources. Only peer-reviewed publications that provided information on the assessment tool used to evaluate the behavioural expression of pain in cats, in conscious animals (not anaesthetised cats), were included.
RESULTS
No previous systematic reviews were identified. One hundred papers were included in the final assessment. Studies were primarily related to the assessment of pain in relation to surgical procedures, and no clear distinction was made concerning the onset of acute and chronic pain. Ten broad types of instrument to assess pain were identified, and generally the quality of evidence to support the use of the various instruments was poor. Only one specific instrument (UNESP-Botucatu scale) had published evidence of validity, reliability and sensitivity at the level of a randomised control trial, but with a positive rather than placebo control, and limited to its use in the ovariohysterectomy situation. The metrics used within the tools appeared to focus primarily on the sensory aspect of pain, with no study clearly discriminating between the sensory and affective components of pain.
CONCLUSIONS AND RELEVANCE
Further studies are required to provide a higher quality of evidence for methods used to assess pain in cats. Furthermore, a consistent definition for acute and chronic pain is needed. Tools need to be validated that can detect pain in a range of conditions and by different evaluators (veterinary surgeons and owners), which consider both the sensory and emotional aspects of pain.
目的
本研究旨在系统回顾用于检测猫疼痛行为表达的评估工具范围及其质量证据；并考察用于评估疼痛的行为指标（同时考虑感觉和情感领域）。
方法
检索了PubMed和ScienceDirect数据库，以及作者已知的2000年以后的英文文献。随后对主要数据源中的参考文献进行了人工检索。仅纳入了经同行评审的出版物，这些出版物提供了关于用于评估清醒动物（而非麻醉猫）疼痛行为表达的评估工具的信息。
结果
未发现之前的系统评价。最终评估纳入了100篇论文。研究主要与手术相关疼痛的评估有关，对于急性和慢性疼痛的发作没有明确区分。确定了10种广泛的疼痛评估工具类型，总体而言，支持使用各种工具的证据质量较差。只有一种特定工具（UNESP-博图卡图量表）在随机对照试验水平上发表了有效性、可靠性和敏感性的证据，但采用的是阳性对照而非安慰剂对照，且仅限于在卵巢子宫切除术情况下使用。工具中使用的指标似乎主要集中在疼痛的感觉方面，没有研究明确区分疼痛的感觉和情感成分。
结论与意义
需要进一步研究，为评估猫疼痛的方法提供更高质量的证据。此外，需要对急性和慢性疼痛给出一致的定义。需要验证能够在一系列情况下并由不同评估者（兽医和主人）检测疼痛的工具，这些工具要同时考虑疼痛的感觉和情感方面。
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