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Evaluation and comparison of postoperative analgesic effects of dexketoprofen and methadone in dogs
- Gutiérrez-Bautista, Álvaro J., Morgaz, Juan, Granados, María del Mar, Gómez-Villamandos, Rafael J., Dominguez, Juan M., Fernandez-Sarmiento, José A., Aguilar-García, Daniel, Navarrete-Calvo, Rocío
- Veterinary anaesthesia and analgesia 2018 v.45 no.6 pp. 820-830
- adverse effects, analgesia, analgesic effect, anesthesia, cortisol, dexmedetomidine, dogs, intravenous injection, isoflurane, methadone, orthopedics, oxygen, pain, statistical models, surgery
- To evaluate and compare the analgesic efficacy and adverse effects of dexketoprofen and methadone using a noninferiority trial, during the first 24 postoperative hours in dogs undergoing orthopaedic surgery.Randomized, blinded clinical study.A total of 38 healthy dogs undergoing orthopaedic surgery.Dogs were premedicated with dexmedetomidine [1 μg kg–1 intravenously (IV)] followed by dexketoprofen (1 mg kg–1 IV; group DK) or methadone (0.2 mg kg–1 IV; group M). Anaesthesia was induced with propofol and maintained with isoflurane in 60% oxygen. Postoperatively, dexketoprofen was administered every 8 hours (group DK) and methadone every 4 hours (group M). Analgesia was assessed at baseline and at 1, 2, 4, 6, 18 and 24 hours after extubation using a dynamic and interactive visual analogue scale (DIVAS), the short form of the Glasgow Composite Measure Pain Scale (CMPS-SF), mechanical wound thresholds (MWTs) and plasma cortisol levels. If CMPS-SF score was ≥5, rescue analgesia was administered. Data were analysed using a general linear mixed model, Mann–Whitney U test and chi-squared test as appropriate; a p value <0.05 was considered significant.The CMPS-SF and DIVAS scores were significantly higher in group M compared with group DK and remained higher for a longer period in group M, although the differences were not clinically significant. No significant differences were found in MWT assessment between groups. Plasma cortisol level significantly increased 2 hours after extubation, without significant differences between treatments. Rescue analgesia was administered to three animals (one in group DK; two in group M).We conclude that 1 mg kg–1 IV dexketoprofen administered every 8 hours during the first 24 hours postoperatively is noninferior to methadone in controlling pain after orthopaedic surgery in dog, although frequent pain assessments are recommended to adjust the analgesia plan.