Lascelles B D, Cripps P, Mirchandani S, Waterman A E
Department of Clinical Veterinary Science, Langford House, Bristol.
J Small Anim Pract. 1995 Dec;36(12):535-41. doi: 10.1111/j.1748-5827.1995.tb02805.x.
The aim of this study was to titrate the optimal dose of carprofen for single dose usage, for alleviating postoperative pain, under a double-blind and randomised protocol, using both negative and positive controls. Renal tolerance was assessed by screening plasma urea and creatinine. Pre- and postoperative assessment of pain and sedation was made using a dynamic and interactive visual analogue scoring system in 60 cats undergoing ovariohysterectomy. The cats were randomly assigned to one of six groups: (1) carprofen at 1.0 mg/kg subcutaneously (sc); (2) carprofen at 2.0 mg/kg sc; (3) carprofen at 4.0 mg/kg sc; (4) pethidine at 5.0 mg/kg intramuscularly (im), (5) pethidine at 10.0 mg/kg im: and (6) no analgesics (injection of saline). All injections were given postoperatively on tracheal extubation and administered in a double-blind manner. Assessments were made up to 20 hours post extubation. Prior to induction and at 20 hours post extubation, blood samples were taken for laboratory analysis of the urea and creatinine content to check for any adverse effect on renal function. Cats given pethidine did not appear more sedated than the groups receiving carprofen or saline. Cats receiving carprofen were in less pain postoperatively overall, with 4.0 mg/kg being the most effective dose rate (significantly better than the other doses of carprofen at four and eight hours post extubation). The highest dose of pethidine provided significantly better analgesia than the highest dose of carprofen up to two hours post extubation, but from two to 20 hours post extubation carprofen at 4.0 mg/kg provided significantly better analgesia than the pethidine. None of the analgesic regimens appeared to affect renal function adversely, as measured by urea and creatinine levels.
本研究的目的是在双盲随机方案下，使用阴性和阳性对照，滴定卡洛芬单剂量使用时缓解术后疼痛的最佳剂量。通过筛查血浆尿素和肌酐来评估肾脏耐受性。在60只接受卵巢子宫切除术的猫中，使用动态交互式视觉模拟评分系统对术前和术后的疼痛及镇静情况进行评估。这些猫被随机分为六组：(1)皮下注射1.0mg/kg卡洛芬；(2)皮下注射2.0mg/kg卡洛芬；(3)皮下注射4.0mg/kg卡洛芬；(4)肌肉注射5.0mg/kg哌替啶；(5)肌肉注射10.0mg/kg哌替啶；(6)不使用镇痛药（注射生理盐水）。所有注射均在术后气管拔管时进行，并采用双盲方式给药。评估持续至拔管后20小时。在诱导前和拔管后20小时采集血样，进行尿素和肌酐含量的实验室分析，以检查对肾功能是否有任何不良影响。给予哌替啶的猫似乎并不比接受卡洛芬或生理盐水的组更镇静。接受卡洛芬的猫术后总体疼痛较轻，4.0mg/kg是最有效的剂量率（在拔管后4小时和8小时明显优于其他剂量的卡洛芬）。在拔管后两小时内，最高剂量的哌替啶提供的镇痛效果明显优于最高剂量的卡洛芬，但在拔管后两小时至20小时，4.0mg/kg的卡洛芬提供的镇痛效果明显优于哌替啶。根据尿素和肌酐水平测量，没有一种镇痛方案似乎对肾功能有不良影响。
