Schmierer Philipp A, Tünsmeyer Julia, Tipold Andrea, Hartnack-Wilhelm Sonja, Lesczuk Piotr, Kästner Sabine B R
Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.
Tierklinik Posthausen, Posthausen, Germany.
Vet Surg. 2020 Jul;49(5):905-913. doi: 10.1111/vsu.13411. Epub 2020 Apr 23.
To assess the effect of perioperative pregabalin on pain behavior in dogs after intervertebral disc surgery.
Prospective, randomized, controlled clinical trial with a blinded observer.
Forty-six client-owned dogs undergoing intervertebral disc surgery.
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.
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.
Postoperative signs of pain after surgical treatment of intervertebral disc herniation (IVDH) were reduced when dogs received perioperative pregabalin rather than opioids alone.
Perioperative pregabalin reduces postoperative pain after surgical treatment of IVDH.
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。
采用前瞻性、随机、对照临床试验，设盲法观察者。
46只接受椎间盘手术的宠物犬。
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。
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。
犬在围手术期接受普瑞巴林而非仅接受阿片类药物时，椎间盘突出症（IVDH）手术治疗后的术后疼痛体征减轻。
围手术期使用普瑞巴林可减轻IVDH手术治疗后的术后疼痛。
