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Utilização da escala multidimensional composta para avaliação de dor aguda pós-cirúrgica em gato para comparação de eficácia de três protocolos analgésicos no modelo cirúrgico de ovariohisterectomia eletiva felina
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Resumo(s)
O alívio da dor pericirúrgica é uma temática essencial em Medicina Veterinária, não só pela
promoção do bem-estar dos animais, como de uma melhor recuperação da anestesia. O
gato (Felis silvestris catus) é uma das espécies sobre as quais há um menor domínio do
reconhecimento e do controlo da dor. Recentemente, foi desenvolvida a “Escala
Multidimensional Composta Para Avaliação de Dor Aguda Pós-Cirúrgica em Gato”, que
constitui uma nova ferramenta no maneio da dor felina.
O presente estudo teve como objetivo a utilização da referida escala para comparar a
eficácia de três protocolos analgésicos, administrados em gatas saudáveis (n=30),
submetidas a ovariohisterectomia eletiva. Para efeitos de avaliação de dor peri-cirúrgica
consideraram-se as pontuações de dor no pré-cirúrgico (T0) e às 1h (T1), 2h (T2), 3h (T3),
4h (T4), 24h (T24) e 48h (T48) após a recuperação anestésica.
Os grupos de estudo – GR, GB e GRB – foram, respetivamente, pré-medicados com
robenacoxib (SC, 2mg/Kg) (n=10), buprenorfina (EV, 0.02mg/Kg) (n=10) e a combinação de
ambos os fármacos (n=10), 30-45 minutos antes da cirurgia. Durante o procedimento,
monitorizaram-se variáveis fisiológicas, como a pressão arterial sistólica, a frequência
cardíaca e a frequência respiratória. No pós-cirúrgico, pontuações de dor iguais ou
superiores a 8, com avaliação clínica concordante, remetiam para analgesia de resgate
(buprenorfina IM, 0,02mg/Kg). A análise estatística foi realizada com o software SAS 9.3
(SAS Institute, 2004), com recurso à análise de variância “One Way ANOVA”, ao teste de
comparação de médias, utilizando um teste t, e ao teste de qui-quadrado.
Os resultados revelaram pontuações de dor mais elevadas no grupo GB, seguido do GR e,
finalmente, do GRB. Quanto às analgesias de resgate, foram efetuadas em 2 gatas do grupo
GR, 3 do grupo GB e 0 do grupo GRB. Ainda que não se tivesse encontrado diferença
significativa entre os protocolos analgésicos, quando se analisaram as repetições das
analgesias de resgate, verificou-se maior exigência das mesmas no grupo GB. Da análise
das variáveis fisiológicas, retirou-se que apenas para a pressão arterial sistólica houve
diferenças significativas entre grupos.
Concluiu-se que a analgesia multimodal se mostrou mais eficiente, embora ambos os
protocolos com robenacoxib se tenham mostrado eficazes. Podemos também referir que a
presente escala de dor permitiu uma pontuação fidedigna e uma abordagem à dor póscirúrgica
do gato bem-sucedida.
ABSTRACT - Perioperative pain relief is a major subject in veterinary practice as it determines the level of well being of the animals and provides a better anesthetic recovery. Nowadays there is still lack of knowledge about pain detection and management in the domestic cat (Felis silvestris catus). Recently a multidimensional composite scale for use in assessing acute postoperative pain in cats was developed and represents a new tool for feline pain management. The purpose of the present study was to use this new pain scale in order to compare three different analgesic protocols in thirty healthy female cats (n=30) after ovariohysterectomy. Pain scores were considered before surgery (T0) and 1h (T1), 2h (T2), 3h (T3), 4h (T4), 24h (T24) and 48h (T48) after anesthetic recovery. Study groups – GR, GB e GRB – were respectively pre-medicated 30-45 minutes before surgery with robenacoxib (SC, 2mg/Kg) (n=10), buprenorphine (EV, 0.02mg/Kg) (n=10) and their combination (n=10). Physiologic variables as respiratory rate, heart rate and systolic arterial blood pressure were continuously monitored during the procedure. After surgery cats would be having rescue analgesia (buprenorphine IM, 0,02mg/Kg) if pain scores were equal to or greater than 8. Statistical analysis of the present study was performed with statistical software SAS 9.3 (SAS Institute, 2004) using the analysis of variance "One way ANOVA", the t test and the chi-square test. The results showed higher scores in GB group, followed by GR group and GRB group. Two cats needed rescue analgesia in GR group, three were rescued in GB group and none o the cats needed rescue analgesia in GRB group. We can’t safely say that there are statistical significant differences among analgesic protocols as we had p=0,06. However GB group was the only one showing need to repeat rescue analgesia. Statistic analysis of the physiologic variables revealed statistical differences among groups only for systolic arterial blood pressure. We concluded that multimodal analgesia was more effective. Nevertheless both protocols with robenacoxib were efficient. Thus we can accomplish that the multidimensional composite scale for use in assessing acute postoperative pain in cats is a reliable pain scoring method and allowed a satisfactory approach to feline postoperative pain.
ABSTRACT - Perioperative pain relief is a major subject in veterinary practice as it determines the level of well being of the animals and provides a better anesthetic recovery. Nowadays there is still lack of knowledge about pain detection and management in the domestic cat (Felis silvestris catus). Recently a multidimensional composite scale for use in assessing acute postoperative pain in cats was developed and represents a new tool for feline pain management. The purpose of the present study was to use this new pain scale in order to compare three different analgesic protocols in thirty healthy female cats (n=30) after ovariohysterectomy. Pain scores were considered before surgery (T0) and 1h (T1), 2h (T2), 3h (T3), 4h (T4), 24h (T24) and 48h (T48) after anesthetic recovery. Study groups – GR, GB e GRB – were respectively pre-medicated 30-45 minutes before surgery with robenacoxib (SC, 2mg/Kg) (n=10), buprenorphine (EV, 0.02mg/Kg) (n=10) and their combination (n=10). Physiologic variables as respiratory rate, heart rate and systolic arterial blood pressure were continuously monitored during the procedure. After surgery cats would be having rescue analgesia (buprenorphine IM, 0,02mg/Kg) if pain scores were equal to or greater than 8. Statistical analysis of the present study was performed with statistical software SAS 9.3 (SAS Institute, 2004) using the analysis of variance "One way ANOVA", the t test and the chi-square test. The results showed higher scores in GB group, followed by GR group and GRB group. Two cats needed rescue analgesia in GR group, three were rescued in GB group and none o the cats needed rescue analgesia in GRB group. We can’t safely say that there are statistical significant differences among analgesic protocols as we had p=0,06. However GB group was the only one showing need to repeat rescue analgesia. Statistic analysis of the physiologic variables revealed statistical differences among groups only for systolic arterial blood pressure. We concluded that multimodal analgesia was more effective. Nevertheless both protocols with robenacoxib were efficient. Thus we can accomplish that the multidimensional composite scale for use in assessing acute postoperative pain in cats is a reliable pain scoring method and allowed a satisfactory approach to feline postoperative pain.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Gato Ovariohisterectomia Dor Buprenorfina Robenacoxib Cat Ovariohysterectomy Pain Buprenorphine
Contexto Educativo
Citação
Sousa, S.P.T. (2014). Utilização da escala multidimensional composta para avaliação de dor aguda pós-cirúrgica em gato para comparação de eficácia de três protocolos analgésicos no modelo cirúrgico de ovariohisterectomia eletiva felina. Dissertação de Mestrado. Universidade de Lisboa, Faculdade de Medicina Veterinária, Lisboa
Editora
Universidade de Lisboa. Faculdade de Medicina Veterinária