Huss Monika K, Felt Stephen A, Pacharinsak Cholawat
Department of Comparative Medicine, Stanford University, Stanford, California;, Email:
Department of Comparative Medicine, Stanford University, Stanford, California.
Comp Med. 2019 Dec 1;69(6):535-545. doi: 10.30802/AALAS-CM-19-000013. Epub 2019 Sep 27.
The surgical stress response and resulting physiologic changes can lead to postoperative complications and negatively impact animal welfare. Although appropriate pain management is crucial to reduce the pain and stress response to surgery, analgesic choice can significantly affect bone and wound healing. This review aims to summarize data from rat and mouse studies and to provide recommendations for integrating analgesia into orthopedic and wound healing models in these species. Data from other species, such as humans, rabbits and other rodents, is included, where available. From these data, we conclude that for orthopedic surgical models, opioids, local anesthetics and dissociative agents have minimal impact on fracture healing; cyclooxygenase 2 (COX2) selective nonsteroidal antiinflammatory drugs (NSAID) may be used in the shortterm; and steroids should be avoided. For wound healing models, short-term systemic or topical opioids have negligible impact on wound healing; NSAID or local anesthetics may be used short-term; and systemic steroids should be avoided. Alternative analgesics such as tramadol, gabapentin, ketamine, and acetaminophen warrant consideration and further evaluation for both orthopedic and wound healing models. In all cases, researchers and veterinarians should work together to determine the appropriate analgesic plan to minimize pain, as well as to minimize unwanted effects on the orthopedic and wound healing models themselves.
手术应激反应及由此产生的生理变化可导致术后并发症,并对动物福利产生负面影响。尽管适当的疼痛管理对于减轻手术疼痛和应激反应至关重要,但镇痛药物的选择会显著影响骨骼和伤口愈合。本综述旨在总结大鼠和小鼠研究的数据,并为将镇痛措施纳入这些物种的骨科和伤口愈合模型提供建议。如有可用数据,也会纳入来自其他物种(如人类、兔子和其他啮齿动物)的数据。从这些数据中,我们得出结论:对于骨科手术模型,阿片类药物、局部麻醉药和解离剂对骨折愈合影响最小;环氧合酶2(COX2)选择性非甾体抗炎药(NSAID)可短期使用;应避免使用类固醇。对于伤口愈合模型,短期全身或局部使用阿片类药物对伤口愈合影响可忽略不计;NSAID或局部麻醉药可短期使用;应避免全身使用类固醇。曲马多、加巴喷丁、氯胺酮和对乙酰氨基酚等替代镇痛药值得在骨科和伤口愈合模型中考虑并进一步评估。在所有情况下,研究人员和兽医应共同努力确定适当的镇痛方案,以尽量减轻疼痛,并尽量减少对骨科和伤口愈合模型本身的不良影响。