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山本新头皮针用于猫卵巢子宫切除术后疼痛管理

Yamamoto New Scalp Acupuncture for postoperative pain management in cats undergoing ovariohysterectomy.

作者信息

Ribeiro Matheus R, de Carvalho Carolina B, Pereira Ricardo H Z, Nicácio Gabriel M, Brinholi Rejane B, Cassu Renata N

机构信息

Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of Western São Paulo, SP, Brazil.

Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of Western São Paulo, SP, Brazil.

出版信息

Vet Anaesth Analg. 2017 Sep;44(5):1236-1244. doi: 10.1016/j.vaa.2017.03.004. Epub 2017 Apr 13.

Abstract

OBJECTIVE

To evaluate the analgesic efficacy of Yamamoto New Scalp Acupuncture (YNSA) as an adjuvant for postoperative pain management in cats.

STUDY DESIGN

Prospective, randomized, blinded, clinical study.

ANIMALS

Twenty cats aged (mean ± standard deviation) 25 ± 9 months and weighing 2.7 ± 0.6 kg undergoing ovariohysterectomy.

METHODS

The cats were sedated with intramuscular (IM) ketamine (5 mg kg), midazolam (0.5 mg kg) and tramadol (2 mg kg). The cats were randomly distributed before induction of anesthesia into two groups of 10 cats each: group YNSA, in which bilateral basic D points were stimulated with a dry needle from 20 minutes prior to anesthetic induction to the end of the surgery; group Control, in which no acupuncture was applied. Postoperative analgesia was assessed at 1, 2, 4, 8, 12, 18 and 24 hours postextubation using an Interactive Visual Analog Scale and Universidade Estadual Paulista-Botucatu Multidimensional Composite Pain Scale (UNESP-Botucatu MCPS). Rescue analgesia was provided with IM tramadol (2 mg kg), and the pain scores were reassessed 30 minutes after rescue intervention. If the analgesia remained insufficient, meloxicam (0.2 mg kg as a single dose) was administered IM. Data were analyzed using Student t-test, Fisher exact test, Mann-Whitney U test and Friedman test (p < 0.05).

RESULTS

Significantly lower pain scores were observed in YNSA when compared with Control at 1-4 hours based on the UNESP-Botucatu MCPS scores. Although significant differences were not identified between groups requiring rescue analgesia, additional postoperative analgesia was administered to four of 10 cats in Control and no cats in YNSA.

CONCLUSION AND CLINICAL RELEVANCE

Perioperative YNSA resulted in decreased pain scores and a reduction in postoperative requirement for rescue analgesia in cats. This method should be considered a viable option as an adjuvant analgesic therapy for cats undergoing ovariohysterectomy.

摘要

目的

评估山本新头皮针(YNSA)作为猫术后疼痛管理辅助手段的镇痛效果。

研究设计

前瞻性、随机、双盲临床研究。

动物

20只年龄(平均±标准差)为25±9个月、体重2.7±0.6千克的猫,接受卵巢子宫切除术。

方法

猫通过肌肉注射(IM)氯胺酮(5毫克/千克)、咪达唑仑(0.5毫克/千克)和曲马多(2毫克/千克)进行镇静。在麻醉诱导前,将猫随机分为两组,每组10只:YNSA组,从麻醉诱导前20分钟至手术结束,用干针刺激双侧基本D点;对照组,不进行针刺。拔管后1、2、4、8、12、18和24小时,使用交互式视觉模拟量表和圣保罗州立大学-博图卡图多维复合疼痛量表(UNESP-Botucatu MCPS)评估术后镇痛效果。使用肌肉注射曲马多(2毫克/千克)提供解救镇痛,解救干预30分钟后重新评估疼痛评分。如果镇痛效果仍然不足,则肌肉注射美洛昔康(0.2毫克/千克,单次剂量)。使用学生t检验、费舍尔精确检验、曼-惠特尼U检验和弗里德曼检验分析数据(p<0.05)。

结果

根据UNESP-Botucatu MCPS评分,YNSA组在1-4小时的疼痛评分显著低于对照组。虽然在需要解救镇痛的组间未发现显著差异,但对照组10只猫中有4只需要额外的术后镇痛,而YNSA组没有猫需要。

结论及临床意义

围手术期YNSA可降低猫的疼痛评分,并减少术后解救镇痛的需求。对于接受卵巢子宫切除术的猫,该方法应被视为一种可行的辅助镇痛疗法。

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