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2022 年 ISFM 猫科动物急性疼痛管理共识指南。

2022 ISFM Consensus Guidelines on the Management of Acute Pain in Cats.

机构信息

Department of Clinical Sciences, Faculty of Veterinary Medicine, Universite de Montréal, Saint-Hyacinthe, Canada; and Department of Veterinary Clinical Sciences and Centre for Companion Animal Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China.

Lap of Love Veterinary Hospice, Lutz, Florida, USA.

出版信息

J Feline Med Surg. 2022 Jan;24(1):4-30. doi: 10.1177/1098612X211066268.

Abstract

PRACTICAL RELEVANCE

Increases in cat ownership worldwide mean more cats are requiring veterinary care. Illness, trauma and surgery can result in acute pain, and effective management of pain is required for optimal feline welfare (ie, physical health and mental wellbeing). Validated pain assessment tools are available and pain management plans for the individual patient should incorporate pharmacological and non-pharmacological therapy. Preventive and multimodal analgesia, including local anaesthesia, are important principles of pain management, and the choice of analgesic drugs should take into account the type, severity and duration of pain, presence of comorbidities and avoidance of adverse effects. Nursing care, environmental modifications and cat friendly handling are likewise pivotal to the pain management plan, as is a team approach, involving the cat carer.

CLINICAL CHALLENGES

Pain has traditionally been under-recognised in cats. Pain assessment tools are not widely implemented, and signs of pain in this species may be subtle. The unique challenges of feline metabolism and comorbidities may lead to undertreatment of pain and the development of peripheral and central sensitisation. Lack of availability or experience with various analgesic drugs may compromise effective pain management.

EVIDENCE BASE

These Guidelines have been created by a panel of experts and the International Society of Feline Medicine (ISFM) based on the available literature and the authors' experience. They are aimed at general practitioners to assist in the assessment, prevention and management of acute pain in feline patients, and to provide a practical guide to selection and dosing of effective analgesic agents.

摘要

实际意义

随着全球养猫数量的增加,需要兽医护理的猫也越来越多。疾病、创伤和手术都可能导致急性疼痛,为了实现猫的最佳福利(即身体健康和心理健康),需要对疼痛进行有效的管理。现已有经过验证的疼痛评估工具,针对个体患者的疼痛管理计划应结合药物和非药物治疗。预防和多模式镇痛,包括局部麻醉,是疼痛管理的重要原则,镇痛药物的选择应考虑疼痛的类型、严重程度和持续时间、共存疾病的存在以及避免不良反应。护理、环境改变和友好的猫处理同样是疼痛管理计划的关键,团队合作也很重要,需要猫的照顾者参与其中。

临床挑战

在猫中,疼痛传统上被低估了。疼痛评估工具尚未广泛实施,并且这种物种的疼痛迹象可能很微妙。猫代谢和共存疾病的独特挑战可能导致疼痛治疗不足和周围及中枢敏化的发展。各种镇痛药物的可用性或经验不足可能会影响疼痛的有效管理。

证据基础

这些指南由一组专家和国际猫科医学学会(ISFM)根据现有文献和作者的经验制定。其目的是为普通兽医提供帮助,以评估、预防和管理猫的急性疼痛,并为有效镇痛药物的选择和剂量提供实用指南。

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