Steagall Paulo V, Benito Javier, Monteiro Beatriz P, Doodnaught Graeme M, Beauchamp Guy, Evangelista Marina C
1 Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada.
2 Animal Pharmacology Research Group of Québec, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Canada.
J Feline Med Surg. 2018 Aug;20(8):741-748. doi: 10.1177/1098612X17730173. Epub 2017 Sep 18.
Objectives The aim of the study was to evaluate the analgesic efficacy of gabapentin-buprenorphine in comparison with meloxicam-buprenorphine or buprenorphine alone, and the correlation between two pain-scoring systems in cats. Methods Fifty-two adult cats were included in a randomized, controlled, blinded study. Anesthetic protocol included acepromazine-buprenorphine-propofol-isoflurane. The gabapentin-buprenorphine group (GBG, n = 19) received gabapentin capsules (50 mg PO) and buprenorphine (0.02 mg/kg IM). The meloxicam-buprenorphine group (MBG, n = 15) received meloxicam (0.2 mg/kg SC), buprenorphine and placebo capsules (PO). The buprenorphine group (BG, n = 18) received buprenorphine and placebo capsules (PO). Gabapentin (GBG) and placebo (MBG and BG) capsules were administered 12 h and 1 h before surgery. Postoperative pain was evaluated up to 8 h after ovariohysterectomy using a multidimensional composite pain scale (MCPS) and the Glasgow pain scale (rCMPS-F). A dynamic interactive visual analog scale (DIVAS) was used to evaluate sedation. Rescue analgesia included buprenorphine and/or meloxicam if the MCPS ⩾6. A repeated measures linear model was used for statistical analysis ( P <0.05). Spearman's rank correlation between the MCPS and rCMPS-F was evaluated. Results The prevalence of rescue analgesia with a MCPS was not different ( P = 0.08; GBG, n = 5 [26%]; MBG, n = 2 [13%]; BG, n = 9 [50%]), but it would have been significantly higher in the BG (n = 14 [78%]) than GBG ( P = 0.003; n = 5 [26%]) and MBG ( P = 0.005; n = 4 [27%]) if intervention was based on the rCMPS-F. DIVAS and MCPS/rCMPS-F scores were not different among treatments. A strong correlation was observed between scoring systems ( P <0.0001). Conclusions and relevance Analgesia was not significantly different among treatments using an MCPS. Despite a strong correlation between scoring systems, GBG/MBG would have been superior to the BG with the rCMPS-F demonstrating a potential type II error with an MCPS due to small sample size.
目的 本研究旨在评估加巴喷丁 - 丁丙诺啡与美洛昔康 - 丁丙诺啡或单独使用丁丙诺啡相比的镇痛效果，以及猫的两种疼痛评分系统之间的相关性。方法 52只成年猫纳入一项随机、对照、盲法研究。麻醉方案包括乙酰丙嗪 - 丁丙诺啡 - 丙泊酚 - 异氟烷。加巴喷丁 - 丁丙诺啡组（GBG，n = 19）接受加巴喷丁胶囊（口服50 mg）和丁丙诺啡（0.02 mg/kg肌肉注射）。美洛昔康 - 丁丙诺啡组（MBG，n = 15）接受美洛昔康（0.2 mg/kg皮下注射）、丁丙诺啡和安慰剂胶囊（口服）。丁丙诺啡组（BG，n = 18）接受丁丙诺啡和安慰剂胶囊（口服）。加巴喷丁（GBG）和安慰剂（MBG和BG）胶囊在手术前12小时和1小时给药。在卵巢子宫切除术后长达8小时使用多维综合疼痛量表（MCPS）和格拉斯哥疼痛量表（rCMPS - F）评估术后疼痛。使用动态交互式视觉模拟量表（DIVAS）评估镇静情况。如果MCPS≥6，则救援镇痛包括丁丙诺啡和/或美洛昔康。采用重复测量线性模型进行统计分析（P<0.05）。评估MCPS与rCMPS - F之间的Spearman等级相关性。结果 使用MCPS进行救援镇痛的发生率无差异（P = 0.08；GBG，n = 5 [26%]；MBG，n = 2 [13%]；BG，n = 9 [50%]），但如果基于rCMPS - F进行干预，BG组（n = 14 [78%]）的发生率将显著高于GBG组（P = 0.003；n = 5 [26%]）和MBG组（P = 0.005；n = 4 [27%]）。各治疗组之间DIVAS和MCPS/rCMPS - F评分无差异。在评分系统之间观察到强相关性（P<0.0001）。结论及相关性 使用MCPS时各治疗组的镇痛效果无显著差异。尽管评分系统之间存在强相关性，但由于样本量小，GBG/MBG组在rCMPS - F方面优于BG组，而MCPS可能存在II类错误。
