犬椎间盘疾病手术治疗后普瑞巴林镇痛的随机对照试验

Randomized controlled trial of pregabalin for analgesia after surgical treatment of intervertebral disc disease in dogs.

作者信息

Schmierer Philipp A, Tünsmeyer Julia, Tipold Andrea, Hartnack-Wilhelm Sonja, Lesczuk Piotr, Kästner Sabine B R

机构信息

Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.

Tierklinik Posthausen, Posthausen, Germany.

出版信息

Vet Surg. 2020 Jul;49(5):905-913. doi: 10.1111/vsu.13411. Epub 2020 Apr 23.

DOI:10.1111/vsu.13411

PMID:32329092

Abstract

OBJECTIVE

To assess the effect of perioperative pregabalin on pain behavior in dogs after intervertebral disc surgery.

STUDY DESIGN

Prospective, randomized, controlled clinical trial with a blinded observer.

ANIMALS

Forty-six client-owned dogs undergoing intervertebral disc surgery.

METHODS

Dogs were randomly assigned to two groups, with the placebo group receiving opioids alone and the pregabalin group receiving opioids plus pregabalin. Opioid analgesia consisted of 0.6 mg/kg l-methadone given intravenously at anesthetic induction, followed by 0.2 mg/kg given at 8, 16, and 24 hours after extubation and fentanyl patches applied at the end of surgery. Pregabalin was given orally (4 mg/kg) 1 hour before anesthesia, followed by postoperative treatment three times per day (4 mg/kg) for 5 days. The outcome measures were the treatment-group differences in peri-incisional mechanical sensitivity and Glasgow Composite Measure Pain Scale (CMPS-SF) assessed during the first 5 postoperative days. Pregabalin serum concentrations were measured after 24, 72, and 120 hours.

RESULTS

Pregabalin reduced pain levels in the treatment group by a mean of 2.5 CMPS-SF units (95% confidence interval [CI] = -3.19 to -1.83, P < .001) compared with the control group during the study period. Pregabalin increased the mechanical nociceptive threshold by a mean of 6.89 N per day (95% CI = 1.87-11.92, P < .001) and of 7.52 N per day (95% CI = 2.29-12.77, P < .001) during the study period, depending on location. Mean levels of serum pregabalin were 5.1, 4.71, and 3.68 μg/mL at 24, 72, and 120 hours postoperatively, respectively.

CONCLUSION

Postoperative signs of pain after surgical treatment of intervertebral disc herniation (IVDH) were reduced when dogs received perioperative pregabalin rather than opioids alone.

CLINICAL SIGNIFICANCE

Perioperative pregabalin reduces postoperative pain after surgical treatment of IVDH.

摘要

目的

评估围手术期使用普瑞巴林对犬椎间盘手术后疼痛行为的影响。

研究设计

采用前瞻性、随机、对照临床试验，设盲法观察者。

动物

46只接受椎间盘手术的宠物犬。

方法

将犬随机分为两组，安慰剂组仅接受阿片类药物，普瑞巴林组接受阿片类药物加普瑞巴林。阿片类镇痛方案为麻醉诱导时静脉注射0.6mg/kg左旋美沙酮，拔管后8、16和24小时各注射0.2mg/kg，并在手术结束时贴芬太尼透皮贴剂。普瑞巴林在麻醉前1小时口服（4mg/kg），术后每天给药3次（4mg/kg），共5天。观察指标为术后前5天两组在切口周围机械性敏感性和格拉斯哥综合疼痛量表（CMPS-SF）上的差异。分别在术后24、72和120小时测定普瑞巴林血清浓度。

结果

在研究期间，与对照组相比，普瑞巴林组犬的疼痛水平平均降低2.5个CMPS-SF单位（95%置信区间[CI]=-3.19至-1.83，P<.001）。根据部位不同，在研究期间，普瑞巴林使机械性伤害性感受阈值平均每天增加6.89N（95%CI=1.87-11.92，P<.001）和7.52N（95%CI=2.29-12.77，P<.001）。术后24、72和120小时普瑞巴林血清平均浓度分别为5.1、4.71和3.68μg/mL。