Haddad Pinho Renata, Luna Stelio Pacca Loureiro, Esteves Trindade Pedro Henrique, Augusto Justo André, Santilli Cima Daniela, Werneck Fonseca Mariana, Watanabe Minto Bruno, Del Lama Rocha Fabiana, Miller Amy, Flecknell Paul, Leach Matthew C
Department of Surgical Specialties and Anesthesiology, Botucatu Medical School, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil.
Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (Unesp), Botucatu, São Paulo, Brazil.
PLoS One. 2022 May 26;17(5):e0268973. doi: 10.1371/journal.pone.0268973. eCollection 2022.
Considering the widespread use of rabbits in research that potentially causes pain and discomfort and the limited number of pain assessment validated tools in this species, we aimed to develop and validate a scale of acute postoperative pain in rabbits (RPBS). Footage of 58 rabbits from previous studies were used, recorded at 'baseline' (before orthopaedic and soft tissue surgeries), 'pain' (after surgery), 'analgesia' (after analgesic), and '24h post' (24 hours after surgery). The videos were randomised and assessed twice by four evaluators, within one-month interval between evaluations. After content validation, RBPS was further refined using the criteria from the validation. According to the principal component analysis, RPBS was considered unidimensional. The intra- and inter-observer reliability was excellent (ICC>0.80) for all evaluators. There was a high Spearman's correlation of the RPBS with unidimensional scales (>0.80) and a moderate correlation with the Rabbit Grimace Scale (0.68), confirming criterion validity. According to the mixed linear model, the scale was responsive, shown by the increase in pain scores after surgery. Construct validity was confirmed by known-group approach and internal relationships among items. Adequate item-total correlation (>0.3) was observed for all items, except for the attention to the affected area (0.04). The internal consistency was very good (Cronbach's α coefficient = 0.78; Mcdonald's ω coefficient = 0.83). The cut-off score for rescue analgesia was ≥3, with an area under the curve >0.95, demonstrating a high discriminatory capacity of the instrument. Scores 3 and 4 were within the uncertainty diagnostic zone. Specificity was 87% and sensitivity was 90%. It was concluded that the RPBS presented content, criterion, and construct validities, responsiveness, and reliability to assess acute pain in rabbits submitted to orthopaedic and soft tissue surgeries. The cut-off for rescue analgesia serves as a basis for the administration of analgesics to rabbits submitted to painful procedures.
考虑到兔子在研究中的广泛使用可能会导致疼痛和不适，且该物种中经过验证的疼痛评估工具数量有限，我们旨在开发并验证一种兔急性术后疼痛量表（RPBS）。使用了先前研究中58只兔子的视频，这些视频记录于“基线”（骨科和软组织手术前）、“疼痛”（手术后）、“镇痛后”（使用镇痛剂后）和“术后24小时”（手术后24小时）。视频被随机分配，并由四名评估者在两次评估之间间隔一个月的时间内进行两次评估。在内容验证之后，根据验证标准对RPBS进行了进一步完善。根据主成分分析，RPBS被认为是单维的。所有评估者的观察者内和观察者间信度都非常好（ICC>0.80）。RPBS与单维量表的斯皮尔曼相关性较高（>0.80），与兔面部表情量表的相关性中等（0.68），证实了标准效度。根据混合线性模型，该量表具有反应性，表现为手术后疼痛评分增加。通过已知组方法和项目之间的内部关系证实了结构效度。除了对受影响区域的关注度（0.04）外，所有项目的项目总分相关性均足够（>0.3）。内部一致性非常好（克朗巴赫α系数 = 0.78；麦克唐纳ω系数 = 0.83）。救援镇痛的截断分数≥3，曲线下面积>0.95，表明该工具具有较高的区分能力。分数3和4处于不确定诊断区域内。特异性为87%，敏感性为90%。结论是，RPBS在评估接受骨科和软组织手术的兔子的急性疼痛方面具有内容效度、标准效度和结构效度、反应性及可靠性。救援镇痛的截断分数为对接受疼痛手术的兔子使用镇痛剂提供了依据。
