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术前或术后给予卡洛芬对接受卵巢子宫切除术的犬预防疼痛的疗效和动力学。

Efficacy and kinetics of carprofen, administered preoperatively or postoperatively, for the prevention of pain in dogs undergoing ovariohysterectomy.

作者信息

Lascelles B D, Cripps P J, Jones A, Waterman-Pearson A E

机构信息

Department of Clinical Veterinary Science, Langford House, Bristol, UK.

出版信息

Vet Surg. 1998 Nov-Dec;27(6):568-82. doi: 10.1111/j.1532-950x.1998.tb00533.x.

Abstract

OBJECTIVE

To determine what effect the timing of carprofen administration has on the severity of postoperative pain in dogs undergoing ovariohysterectomy and to investigate the pharmacokinetics of carprofen under these conditions.

STUDY DESIGN

A prospective, randomized, double-blind, clinical trial.

ANIMALS

Sixty-two adult bitches weighing between 10 and 25 kgs, undergoing elective ovariohysterectomy.

METHODS

Examinations were performed for 20 hours postoperatively using subjective visual assessment scoring systems (DIVAS) and objective mechanical nociceptive threshold measurements. Forty dogs were assigned to one of three groups: (1) preoperative carprofen; (2) postoperative carprofen; and (3) no analgesics (saline injections). The dose of carprofen was 4.0 mg/kg subcutaneously. In another 22 bitches, the pharmacokinetics of carprofen given preoperatively or postoperatively at the same dose were examined.

RESULTS

The dogs given carprofen preoperatively had lower pain scores than the other groups, significantly so at 2 hours postextubation (P < .01 and P < .05, Kruskal-Wallis and post hoc Dunn's). Mechanical pain thresholds measured at the distal tibia showed the development of hyperalgesia at 12 and 20 hours postextubation; this was prevented by both the preoperative (P < .05 at 12 and 20 hours, Kruskal-Wallis) and postoperative (P < .05 at 20 hours, Kruskal-Wallis) administration of carprofen. Mechanical pain threshold testing at the wound showed a significant analgesic effect of carprofen. Plasma concentrations of carprofen were not directly related to analgesia; maximum plasma concentration, the area under the curve to the last data point, and area under the first moment curve up to the last data point were all significantly higher in the dogs given carprofen postoperatively (P < .05, Mann-Whitney).

CONCLUSION

Preoperative administration of carprofen has a greater analgesic effect than postoperative administration in the early postoperative period in dogs undergoing ovariohysterectomy. Plasma levels of carprofen are not related to the degree of analgesia achieved.

CLINICAL RELEVANCE

Carprofen provides effective analgesia after canine ovariohysterectomy. The timing of analgesic administration is important to optimize the control of postoperative pain.

摘要

目的

确定卡洛芬给药时间对接受卵巢子宫切除术的犬术后疼痛严重程度的影响,并研究在此条件下卡洛芬的药代动力学。

研究设计

一项前瞻性、随机、双盲临床试验。

动物

62只体重在10至25千克之间、接受择期卵巢子宫切除术的成年母犬。

方法

术后20小时使用主观视觉评估评分系统(DIVAS)和客观机械性伤害性感受阈值测量进行检查。40只犬被分为三组之一:(1)术前给予卡洛芬;(2)术后给予卡洛芬;(3)不使用镇痛药(注射生理盐水)。卡洛芬剂量为4.0毫克/千克皮下注射。在另外22只母犬中,研究了术前或术后给予相同剂量卡洛芬的药代动力学。

结果

术前给予卡洛芬的犬疼痛评分低于其他组,拔管后2小时差异显著(Kruskal-Wallis检验和事后Dunn检验,P <.01和P <.05)。在胫骨远端测量的机械性疼痛阈值显示,拔管后12小时和20小时出现痛觉过敏;术前(12小时和20小时,Kruskal-Wallis检验,P <.05)和术后(20小时,Kruskal-Wallis检验,P <.05)给予卡洛芬均可预防。在伤口处进行的机械性疼痛阈值测试显示卡洛芬有显著镇痛效果。卡洛芬的血浆浓度与镇痛效果无直接关系;术后给予卡洛芬的犬的最大血浆浓度、至最后一个数据点的曲线下面积以及至最后一个数据点的一阶矩曲线下面积均显著更高(Mann-Whitney检验,P <.05)。

结论

在接受卵巢子宫切除术的犬术后早期,术前给予卡洛芬的镇痛效果优于术后给药。卡洛芬的血浆水平与所达到的镇痛程度无关。

临床意义

卡洛芬在犬卵巢子宫切除术后提供有效的镇痛作用。镇痛药物的给药时间对于优化术后疼痛控制很重要。

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