Escuela de Medicina Veterinaria, Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile.
Hospital Clínico Veterinario de la Universidad de Chile sede Bilbao, Santiago, Chile.
J Feline Med Surg. 2024 Mar;26(3):1098612X231224662. doi: 10.1177/1098612X231224662.
The aim of this study was to compare the analgesic efficacy and the effect on physiological variables and behavior of the use of tramadol, methadone and morphine as preoperative analgesia in healthy cats undergoing elective ovariohysterectomy.
Cats undergoing ovariohysterectomy were randomly assigned to receive one of the following premedication treatments intramuscularly: methadone (0.2 mg/kg; n = 10); morphine (0.2 mg/kg; n = 10); or tramadol (3 mg/kg; n = 10). Induction of anesthesia was done with propofol, and maintenance of anesthesia was done with isoflurane. Intraoperative heart rate, arterial blood pressure, respiratory rate, end-tidal isoflurane concentration and frequency of rescue analgesia (fentanyl 2.5 µg/kg) were compared between groups. Postoperative analgesia was assessed using the UNESP-Botucatu Multidimensional Composite Pain Scale, and perioperative serum glucose, cortisol concentrations and postoperative rescue analgesia were evaluated.
Intraoperative rescue analgesia was required in 76.5% of cats at some time during surgery, and 27% of cats required postoperative rescue analgesia up to 6 h after extubation. There were no significant differences between groups with respect to intraoperative and postoperative rescue analgesia, pain scale scores and end-tidal isoflurane concentrations. In the immediate postoperative period, after extubation, most of the patients presented with hypothermia; however, 1-6 h postoperatively, hyperthermia was observed in most of the patients, and was most common in the tramadol group.
Under the conditions of this study, methadone, morphine and tramadol produced satisfactory postoperative analgesia in most of the cats undergoing ovariohysterectomy, and the effects lasted up to 6 h postoperatively. Intraoperative analgesia was not sufficient in most cases. Significant cardiovascular or respiratory effects contraindicating the use of these drugs were not found. Postanesthetic hyperthermia occurred with all opioids studied and was more frequent in the tramadol group.
本研究旨在比较曲马多、美沙酮和吗啡作为接受择期卵巢子宫切除术的健康猫术前镇痛的镇痛效果以及对生理变量和行为的影响。
接受卵巢子宫切除术的猫被随机分配接受以下肌肉注射预给药治疗之一：美沙酮（0.2mg/kg；n=10）；吗啡（0.2mg/kg；n=10）；或曲马多（3mg/kg；n=10）。用丙泊酚诱导麻醉，异氟烷维持麻醉。比较各组之间术中的心率、动脉血压、呼吸频率、呼气末异氟烷浓度和抢救性镇痛（芬太尼 2.5μg/kg）的频率。使用 UNESP-Botucatu 多维复合疼痛量表评估术后镇痛，并评估围手术期血清葡萄糖、皮质醇浓度和术后抢救性镇痛。
在手术过程中的某个时间，76.5%的猫需要术中抢救性镇痛，27%的猫在拔管后 6 小时内需要术后抢救性镇痛。在术中及术后抢救性镇痛、疼痛评分和呼气末异氟烷浓度方面，各组之间无显著差异。在拔管后的即刻术后期间，大多数患者出现体温过低；然而，在术后 1-6 小时，大多数患者出现体温升高，且在曲马多组最常见。
在本研究条件下，美沙酮、吗啡和曲马多在接受卵巢子宫切除术的大多数猫中产生了令人满意的术后镇痛效果，并且效果持续到术后 6 小时。大多数情况下，术中镇痛不足。未发现有迹象表明这些药物的使用会产生重大心血管或呼吸影响。研究的所有阿片类药物均引起术后发热，且在曲马多组更为常见。
