马整形外科手术后疼痛和痛苦评估方法的比较

M. Raekallio , P.M. Taylor , M. Bloomfield
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引用次数: 39

摘要

通过测量预先定义的行为和生理变量,对13匹马的术后疼痛进行了主观评估。其中12匹马接受了痛苦的整形外科手术,其中一匹马在全身麻醉下进行放射学检查后出现了麻醉后肌病和神经损伤。术前和术后72小时采集静脉血样进行儿茶酚胺、ß-内啡肽和皮质醇测定。麻醉前后,头部位置、抓地或手术腿的使用没有差异。麻醉后4小时的主观疼痛评分高于术前评分。麻醉后6小时和12小时,平均血浆ß-内啡肽浓度高于术前值。麻醉和手术没有改变平均血浆皮质醇浓度,但在48和72小时采集的样本中较低。血浆儿茶酚胺浓度存在相当大的个体差异。在某些时间点,儿茶酚胺的血浆浓度高于用药前,但肾上腺素、去甲肾上腺素和多巴胺的最大浓度并没有同时出现。心率在2小时和4小时增加,腹部声音在2小时减少。麻醉后2至12小时采集的样本中,压缩细胞体积减少。研究中测量的所有参数之间的相关性很差。主观疼痛评分和血浆ß-内啡肽浓度在几个时间点相互关联,但在术后不久没有。
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A comparison of methods for evaluation of pain and distress after orthopaedic surgery in horses

Post operative pain was evaluated in 13 horses subjectively and by measuring pre-defined behavioural and physiological variables. Twelve of the horses had undergone painful orthopaedic surgery and one had developed post anaesthetic myopathy and nerve damage after radiological examination under general anaesthesia. Venous blood samples were collected for catecholamine, ß-endorphin and cortisol assays before premedication and up to 72 h after surgery.

No differences were seen in head position, ground pawing or use of the operated leg between the pre-and post anaesthetic periods. The subjective pain score was higher at 4 h after anaesthesia than the pre-operative score. Mean plasma ß-endorphin concentration increased above pre-operative values at 6 and 12 h after anaesthesia. Anaesthesia and surgery did not change mean plasma cortisol concentration, but it was lower in samples collected at 48 and 72 h. There was considerable individual variation in plasma catecholamine concentrations. At some time points the plasma concentration of catecholamines was higher than before premedication, but the maximal concentrations for adrenaline, noradrenaline and dopamine did not occur simultaneously. Heart rate was increased at 2 and 4 h, and abdominal sounds were decreased at 2 h. Packed cell volume was decreased in samples taken 2 to 12 h after anaesthesia.

There was poor correlation between all the parameters measured in the study The subjective pain score and the plasma ß-endorphin concentration correlated with each other at several time points, but not during the immediate post operative period.

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