Abstract
The concern with the treatment of postoperative pain is based on the prevention of unnecessary suffering of the patient, in addition to providing many physiological benefits. Post-surgical pain can be minimized more easily when preemptive analgesia is applied, that is, the administration of analgesics before tissue damage occurs. However, the association of non-steroidal anti-inflammatory drugs with opioids in anti-pain protocols is seen as a way to reduce the doses of each medication and ensure a greater coverage of inflammatory mediators. The modified Glasgow Scale (Short Form of the Glasgow Composite Pain Scale -CMPS-SF), allows the assessment of six behavioral categories. In view of this, the present study aims to evaluate and compare, by applying the modified Glasgow Scale, the effectiveness of two different preemptive analgesia protocols using transdermal fentanyl patch associated with two non-steroidal anti-inflammatory drugs (firocoxib and carprofen) for the control of postoperative pain in dogs undergoing mastectomy surgery. Thus, 16 bitches participated in the research and were randomly divided into two groups with 8 females constituting the 1 group and receiving preemptive analgesia with firocoxib associated with transdermal fentanyl patch and another 8 females constituting the 2 group receiving analgesia preemptive with carprofen associated with transdermal fentanyl. Postoperatively, patients were evaluated using the Glasgow Modified Scale in 5 steps (T1, T2, T3, T15 and T24). The analgesic rescue was only performed when the assessment exceeded 6 points on the scale. Among the 16 patients who participated in the research, 11 of them (68.75%) demonstrated adequate pain control, therefore, there was no need for rescue, 4 patients (25%) needed analgesic rescue and 1 patient (6.25%) was disqualified from the search. It was concluded that there was no difference in analgesic control with both protocols. The Glasgow Modified Scale is a useful method for assessing the degree of pain in bitches undergoing mastectomy. Transdermal fentanyl has demonstrated good performance in pain control simultaneously associated with both anti-inflammatory drugs, however it is of utmost importance that the patch is correctly attached to the skin for proper release of the active ingredient.
Highlights
V.14, n.6, a590, p.1-9, Jun., 2020 surgical pain can be minimized more when preemptive analgesia is applied, that is, the administration of analgesics before tissue damage occurs
Entre las 16 pacientes que participaron en la investigación, 11 de ellos (68.75%) demostraron un control adecuado del dolor, por lo tanto, no hubo necesidad de rescate, 4 pacientes (25%) necesitaron rescate analgésico y 1 paciente (6.25%) fue descalificada del estudio
ANEXO 1 – Escala modificada de Glasgow – Short form of the Glasgow Composite Pain Scale
Summary
O projeto foi desenvolvido na Clínica Veterinária Universitária – CLIVET da Pontifícia Universidade Católica do Paraná, campus Toledo e no Hospital Veterinário Aukmia, localizado na Rua Almirante Barroso, 2546, Centro de Toledo, Paraná. 16 fêmeas foram avaliadas no projeto (Figura 1), sendo que 8 pacientes participaram do grupo (G1), que recebeu analgesia preemptiva com firocoxibe na dose de 5mg/kg (Viana, 2014), associado ao adesivo de fentanil transdérmico (concentração de 25, 50, 75 ou 100 μg/hora) de acordo com o peso de cada paciente (25 μg/h para cães de 5 a 10 kg e para cães entre 10 e 20 kg, 50 μg/h). Decorrida a última avaliação pela Escala Modificada de Glasgow, o adesivo de fentanil transdérmico foi removido e as pacientes receberam alta com prescrição de amoxicilina + clavulanato de potássio, dipirona sódica e continuaram com a administração do antinflamatório por mais 3 dias.
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