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美洛昔康或罗非考昔给药时机对行卵巢子宫切除术猫肾功能和术后镇痛的影响:一项随机、盲法、对照临床试验。

Effect of meloxicam or robenacoxib administration timing on renal function and postoperative analgesia in cats undergoing ovariohysterectomy: A randomized, blinded, controlled clinical trial.

机构信息

Davies Veterinary Specialists, Hitchin, UK.

J.N.King Consulting, Bennwil, Switzerland.

出版信息

J Vet Pharmacol Ther. 2024 May;47(3):175-186. doi: 10.1111/jvp.13427. Epub 2024 Jan 18.

Abstract

We evaluated the effect of administration timing of meloxicam and robenacoxib on renal function, platelet cyclo-oxygenase and perioperative analgesia in 60 cats undergoing ovariohysterectomy, in a prospective randomized blinded controlled study. Twelve cats were randomly allocated to one subcutaneous treatment group: meloxicam (0.2 mg/kg) or robenacoxib (2 mg/kg) at admission (MA, RA), at induction (MI, RI) and robenacoxib at the end of surgery (RE). All cats received the same anaesthesia protocol. Plasma renin activity (PRA), plasma creatinine, drug concentrations and serum thromboxane (TxB) were measured sequentially. Anaesthesia significantly increased PRA, as activity at end of the surgery was higher than 2 h later (mean ± SD: 26.6 ± 2.8 versus 10.0 ± 3.9 ng/mL/h). PRA remained higher at 2 h post-surgery in admission groups compared to induction groups (p = .01). Serum TxB was lower with meloxicam than robenacoxib (p = .001), and was lower in the MA than each robenacoxib group at catheter placement. Admission groups (16/24 from RA and MA groups) received earlier rescue analgesia than other groups (p = .033). In conclusion, the renin-angiotensin system was activated during anaesthesia despite cyclo-oxygenase inhibition, possibly due to hypotension or surgical stimulation. There was no effect of drug or timing on the markers of renal function but one cat receiving meloxicam at induction had suspected IRIS grade II acute kidney injury.

摘要

我们在一项前瞻性随机对照盲法研究中评估了美洛昔康和罗非考昔给药时间对 60 例行卵巢子宫切除术的猫肾功能、血小板环氧化酶和围手术期镇痛的影响。12 只猫被随机分配到一个皮下治疗组:入院时(MA、RA)给予美洛昔康(0.2mg/kg)或罗非考昔(2mg/kg),诱导时(MI、RI)给予罗非考昔,手术结束时给予罗非考昔(RE)。所有猫均接受相同的麻醉方案。依次测量血浆肾素活性(PRA)、血浆肌酐、药物浓度和血清血栓素(TxB)。麻醉显著增加了 PRA,因为手术结束时的活性高于 2 小时后(平均值±SD:26.6±2.8 与 10.0±3.9ng/mL/h)。与诱导组相比,入院组在手术后 2 小时时 PRA 仍然更高(p=0.01)。与罗非考昔相比,美洛昔康组的血清 TxB 较低(p=0.001),并且在导管放置时,MA 组比每个罗非考昔组的 TxB 都较低。入院组(来自 RA 和 MA 组的 16/24 只猫)比其他组更早接受了补救性镇痛(p=0.033)。总之,尽管抑制了环氧化酶,但麻醉期间肾素-血管紧张素系统被激活,可能是由于低血压或手术刺激。药物或时间对肾功能标志物没有影响,但一只在诱导时接受美洛昔康的猫疑似出现 II 级急性肾损伤。

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