Tomacheuski Rubia Mitalli, Klostermann Cassandra, Frank Diane, Taffarel Marilda Onghero, Pinho Renata Haddad, Monteiro Beatriz Paglerani, Esteves Trindade Pedro Henrique, Desrochers André, Nichols Sylvain, Gleerup Karina, Luna Stelio Pacca Loureiro, Steagall Paulo Vinicius
Department of Anaesthesiology, Medical School (FMB) of São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
Translational Research in Pain, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University (NCSU), Raleigh, North Carolina, United States of America.
PLoS One. 2025 May 23;20(5):e0323710. doi: 10.1371/journal.pone.0323710. eCollection 2025.
Pain negatively impacts animal welfare and it is still neglected in ruminants. This original study aimed to develop and validate the Bovine Pain Scale (BPS) for acute pain assessment in hospitalized cattle undergoing surgery. This was a blinded, randomized, prospective clinical study. Thirty-six animals were included in the study. The Pain Group (n = 25) included patients admitted to a veterinary teaching hospital requiring any type of soft tissue or orthopedic surgery. Videos were recorded before, 2-6 hours after surgery, 1 hour after the administration of analgesia and 24 hours after surgery. The Control Group (n = 11) included healthy animals that were video recorded twice within a 24-48h interval. The BPS was developed using content validity. A total of 118 videos of 6 minutes were randomized and analyzed by four raters who were unaware of groups, time-points and procedures in two phases with a five-week interval. Statistical analysis was performed using R software. Intra and inter-rater reliability (intra-class correlation coefficient) was very good (0.83-0.94) and ranged from good to very good, respectively (0.65-0.81). The correlation between the BPS and the Visual Analog Scale (VAS) was strong (rho = 0.77, p < 0.0001) confirming criterion validity. Item-total correlation was acceptable for 3 of 9 items (0.33-0.43) and internal consistency was below the acceptable value (0.6). The scale was responsive to pain but not the administration of analgesia. It was specific for five items, but no items showed sensitivity. The area under the curve of 0.90 demonstrated high discriminatory capacity. According to the receiver operating characteristic curve, the cut-off point for rescue analgesia was ≥ 5 of 18. The BPS is reliable and reproducible, showed content and criterion validity, and may be used in veterinary hospitals for assessing post-operative pain in cattle to guide decision-making towards rescue analgesia. Future studies should refine the instrument to guarantee construct validity and sensitivity.
疼痛对动物福利有负面影响，而在反刍动物中这一问题仍被忽视。这项原创研究旨在开发并验证牛疼痛量表（BPS），用于评估接受手术的住院牛的急性疼痛。这是一项双盲、随机、前瞻性临床研究。36只动物被纳入研究。疼痛组（n = 25）包括入住兽医教学医院需要进行任何类型软组织或骨科手术的患者。在手术前、手术后2 - 6小时、镇痛药物给药后1小时以及手术后24小时进行视频记录。对照组（n = 11）包括在24 - 48小时内进行两次视频记录的健康动物。BPS通过内容效度进行开发。总共将118个6分钟的视频随机分组，由四名不知道分组、时间点和操作程序的评估者分两个阶段进行分析，间隔为五周。使用R软件进行统计分析。评估者内和评估者间的可靠性（组内相关系数）非常好（0.83 - 0.94），分别从良好到非常好（0.65 - 0.81）。BPS与视觉模拟量表（VAS）之间的相关性很强（rho = 0.77，p < 0.0001），证实了效标效度。9个条目中有3个的条目 - 总分相关性可接受（0.33 - 0.43），内部一致性低于可接受值（0.6）。该量表对疼痛有反应，但对镇痛药物的给药无反应。它对5个条目具有特异性，但没有条目显示出敏感性。曲线下面积为0.90表明具有高鉴别能力。根据受试者工作特征曲线，救援镇痛的截断点为≥18分中的5分。BPS可靠且可重复，具有内容效度和效标效度，可用于兽医医院评估牛的术后疼痛，以指导救援镇痛决策。未来的研究应改进该工具，以确保结构效度和敏感性。
