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首页> 外文期刊>Veterinary Anaesthesia and Analgesia >Efficacy and cost-effectiveness of transdermal fentanyl patches for the relief of post-operative pain in dogs after anterior cruciate ligament and pelvic limb repair
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Efficacy and cost-effectiveness of transdermal fentanyl patches for the relief of post-operative pain in dogs after anterior cruciate ligament and pelvic limb repair

机译：芬太尼透皮贴剂缓解犬前十字韧带和骨盆四肢修复术后疼痛的功效和成本效益

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OBJECTIVES: To determine whether transdermal fentanyl patches provided cost-effective post-operative analgesia in dogs with pelvic limb injuries. STUDY DESIGN: Prospective, randomized, blinded clinical trial. ANIMALS: Twenty-four dogs undergoing repair of ruptured cranial cruciate ligaments or pelvic limb fractures. METHODS: Dogs were randomly assigned to one of two groups: those receiving transdermal fentanyl patches (group F) and those receiving injectable morphine for control of post-operative pain (group M). Patients in both treatment groups were monitored for adequacy of analgesia and alterations in physiological variables. Plasma fentanyl concentrations were measured in Group F. Rescue morphine was given if a dog was deemed uncomfortable. The time of first rescue morphine, the total amount, and number of doses of morphine administered over 72 hours was quantified and compared for each group. RESULTS: There was no significant treatment effect on any of the parameters, except for serum cortisol concentration, which was significantly lower overall in group F (p = 0.01). Pain scores peaked at 6 hours post-extubation and were higher than baseline from 2 to 20 hours post-extubation. Cortisol concentrations were the highest at time 0 (extubation) and were significantly higher than baseline until 2 hours post-extubation. Pain scores correlated with fentanyl plasma concentrations (p = 0.0001 and p = 0.01, respectively), but the correlation was low (r = 0.26 and r = 0.16, respectively). No correlation was found between serum cortisol concentrations and pain scores in either group. Fentanyl cost and total cost for pain management were considerably higher for group F. CONCLUSIONS: Fentanyl patches did not provide better analgesia or a reduced requirement for rescue opioid compared with intramuscular morphine. CLINICAL RELEVANCE: When considering overall costs to the client for comparable analgesic intervention, fentanyl patches increased rather than decreased cost during the first 24 hours post-operatively.
机译：目的：确定经皮芬太尼贴剂是否可为骨盆四肢损伤的狗提供经济有效的术后镇痛。研究设计：前瞻性，随机，盲法临床试验。动物：二十四只狗正在接受颅骨交叉韧带破裂或骨盆四肢骨折的修复。方法：将狗随机分为两组之一：接受透皮芬太尼贴剂的狗（F组）和接受注射吗啡以控制术后疼痛的狗（M组）。监测两个治疗组的患者镇痛是否适当和生理变量的变化。在F组中测量血浆芬太尼浓度。如果认为狗不舒服，则给予救援吗啡。定量并比较每组在72小时内首次服用吗啡的时间，吗啡的总量和剂量。结果：除血清皮质醇浓度外，其他任何参数均无显着治疗效果，F组的总体皮质醇浓度明显降低（p = 0.01）。拔管后6小时疼痛评分达到峰值，拔管后2至20小时疼痛评分高于基线。皮质醇浓度在时间0（拔管）时最高，并且在拔管后2小时之前显着高于基线。疼痛评分与芬太尼血浆浓度相关（分别为p = 0.0001和p = 0.01），但相关性较低（分别为r = 0.26和r = 0.16）。两组中血清皮质醇浓度和疼痛评分之间均无相关性。 F组的芬太尼成本和疼痛治疗的总成本要高得多。结论：与肌肉内吗啡相比，芬太尼贴片不能提供更好的镇痛作用或阿片类药物的抢救需求减少。临床相关性：考虑到可比较的镇痛干预对客户的总成本时，芬太尼贴剂在术后头24小时内增加而不是减少了费用。

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