Faculty of Veterinary Medicine-Small Animal Clinic, 48358University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic.
J Vet Dent. 2020 Dec;37(4):184-191. doi: 10.1177/0898756420986926. Epub 2021 Jan 25.
The early effectiveness of 5 analgesics was investigated after periodontal treatment. Dogs were assigned to 6 groups (n = 14 each). A prospective, randomized and blinded clinical study was performed. Before anesthesia was induced, butorphanol, morphine, carprofen and saline were administered. After induction, a maxillary and mandibular block was performed with lidocaine or bupivacaine. Painful periodontal therapies were performed. Two hours after the administration of analgesics and after anesthesia reversal, pain was scored using the Visual Analog Scale for pain (VAS) and the modified University of Melbourne Pain Score (UMPS). Blood glucose and cortisol levels were measured prior to analgesic administration and again 2 hours later. Rescue analgesia was provided when the VAS exceeded 50 mm or the UMPS exceeded 14 points. Rescue analgesia was required in one patient in the morphine group and one in the carprofen group. The VAS values were significantly lower in the butorphanol group compared to those of the saline group and in the bupivacaine group vs. those in the saline and lidocaine groups. Significantly lower UMPS values were obtained in the bupivacaine group compared to those in the saline, butorphanol and lidocaine groups and in the carprofen group vs. those in the saline and lidocaine groups. Significantly higher serum cortisol values were found in the lidocaine group compared to those in the saline, bupivacaine and carprofen groups. Administration of carprofen or the use of nerve blocks with bupivacaine improved analgesia after periodontal treatment more than did butorphanol, morphine or nerve blocks using lidocaine.
本研究旨在评估 5 种镇痛药在牙周治疗后的早期效果。将犬分为 6 组（每组 14 只）。采用前瞻性、随机、双盲临床试验。在诱导麻醉前，分别给予丁丙诺啡、吗啡、卡洛芬和生理盐水。诱导后，用利多卡因或布比卡因行上颌和下颌阻滞。行牙周治疗。在给予镇痛药和麻醉逆转后 2 小时，采用疼痛视觉模拟评分（VAS）和改良墨尔本大学疼痛评分（UMPS）评估疼痛。在给予镇痛药前和 2 小时后，测量血糖和皮质醇水平。当 VAS 超过 50mm 或 UMPS 超过 14 分时，给予解救性镇痛。吗啡组和卡洛芬组各有 1 只犬需要解救性镇痛。与生理盐水组和利多卡因组相比，丁丙诺啡组的 VAS 值明显更低；与生理盐水组和利多卡因组相比，布比卡因组的 UMPS 值明显更低。与生理盐水组、丁丙诺啡组和利多卡因组相比，利多卡因组的皮质醇水平显著更高；与生理盐水组和利多卡因组相比，卡洛芬组的皮质醇水平显著更高。与布比卡因相比，使用丁丙诺啡或使用布比卡因进行神经阻滞可提高牙周治疗后的镇痛效果，而使用利多卡因进行神经阻滞则无此效果。
