REVISTA

Analgesia postoperatoria tras la anestesia con alfaxalona o ketamina/medetomidina en gatas

Descripción: La combinación de medetomidina y ketamida proporciona mejor analgesia postoperatoria que la alfaxalona en gatas

TITULO FUENTE ORIGINAL:

Alfaxalone or ketamine-medetomidine in cats undergoing ovariohysterectomy: a comparison of intra-operative parameters and post-operative pain.

AUTORES:

Kalchofner Guerrero KS, Reichler IM, Schwarz A, Jud RS, Hässig M, Bettschart-Wolfensberger R.

REVISTA ABREV.:

Vet Anaesth Analg.

AÑO:

2014

REFERENCIA:

Mar 28.

DOI:

10.1111/vaa.12157.

RESUMEN ORIGINAL:

OBJECTIVE:
To compare post-operative pain in cats after alfaxalone or ketamine- medetomidine anaesthesia for ovariohysterectomy (OHE) and physiologic parameters during and after surgery.
STUDY DESIGN:
Prospective 'blinded' randomized clinical study.
ANIMALS:
Twenty-one healthy cats.
METHODS: + Leer más

OBJECTIVE:
To compare post-operative pain in cats after alfaxalone or ketamine- medetomidine anaesthesia for ovariohysterectomy (OHE) and physiologic parameters during and after surgery.
STUDY DESIGN:
Prospective 'blinded' randomized clinical study.
ANIMALS:
Twenty-one healthy cats.
METHODS:
Cats were assigned randomly into two groups: Group A, anaesthesia was induced and maintained with alfaxalone [5 mg kg-1 intravenously (IV) followed by boli (2 mg kg-1 IV); Group MK, induction with ketamine (5 mg kg-1 IV) after medetomidine (30 μg kg-1 intramuscularly (IM)], and maintenance with ketamine (2 mg kg-1 IV). Meloxicam (0.2 mg kg-1 IV) was administered after surgery. Basic physiological data were collected. At time T = -2, 0, 0.5, 1, 2, 4, 6, 8, 12, 16, 20, and 24 hours post-operatively pain was assessed by three methods, a composite pain scale (CPS; 0-24 points), a visual analogue scale (VAS 0-100 mm), and a mechanical wound threshold (MWT) device. Butorphanol (0.2 mg kg-1 IM) was administered if CPS was scored ≥13. Data were analyzed using a general linear model, Kruskal-Wallis analyses, Bonferroni-Dunn test, unpaired t-test and Fisher's exact test as relevant. Significance was set at p < 0.05.
RESULTS:
VASs were significantly higher at 0.5, 1, 2, 4, and 20 hours in group A; MWT values were significantly higher at 8 and 12 hours in group MK. Post-operative MWT decreased significantly compared to baseline in both groups. There was no difference in CPS at any time point. Five cats required rescue analgesia (four in A; one in MK).
CONCLUSION AND CLINICAL RELEVANCE:
Anaesthesia with ketamine-medetomidine was found to provide better post-surgical analgesia than alfaxalone in cats undergoing OHE; however, primary hyperalgesia developed in both groups. Alfaxalone is suitable for induction and maintenance of anaesthesia in cats undergoing OHE, but administration of additional sedative and analgesic drugs is highly recommended.

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