Dynamic Interactive Visual Analogue Scale Research Articles

The effects of an intravenous bolus of dexmedetomidine following extubation in a mixed population of dogs undergoing general anaesthesia and surgery

An observer blinded, placebo controlled study evaluated the effects of 62.5μg/m2 dexmedetomidine administered IV on recovery from isoflurane anaesthesia in dogs. Forty-four healthy dogs, weighing 1.8–19.95kg, presented for surgery that was expected to cause mild to moderate pain were studied. All were premedicated with 125μg/m2 dexmedetomidine and 20μg/kg buprenorphine IM. Anaesthesia was induced with propofol and maintained with isoflurane. Non-steroidal anti-inflammatory drugs and local anaesthetics were administered as appropriate. Immediately prior to extubation dogs were treated with dexmedetomidine 62.5μg/m2 (group D) or an equivalent volume of heparinised saline (S). Assessments of heart rate, respiratory rate, pain (short form Glasgow composite pain scale [SF-GCPS], dynamic interactive visual analogue scale [DIVAS]), sedation (simple descriptive scale [SDS], DIVAS) and mechanical nociceptive threshold (MNT) were performed immediately before premedication, 20min later, at the time of test drug administration (T0) and at 15–30min intervals for four hours (T240min). Recovery quality was scored 0 – 3 (SDS). Data were analysed with Student’s t and Mann–Whitney U tests, two-way ANOVA and Fisher’s exact test.Significantly fewer poor quality recoveries were observed in group D (D 2 [1–3]; S 2 [0–3]; P=0.02), however, sedation was increased in group D compared to group S from T15 to T150min (P=0.0001). Pain scores were lower in group D compared to group S from T15 to T120min (P=0.001), but the requirement for additional analgesia in the first 4h following extubation was not different between groups. Dexmedetomidine may decrease the incidence of poor quality anaesthetic recoveries in dogs.

Comparison of premedication with buprenorphine or methadone with meloxicam for postoperative analgesia in dogs undergoing orthopaedic surgery

To determine whether methadone, administered before orthopaedic surgery, results in improved postoperative analgesia compared to buprenorphine. Thirty-eight dogs undergoing orthopaedic surgeries (the majority being tibial tuberosity advancement or elbow arthrotomy) were premedicated with 0 · 03 mg/kg acepromazine and either 20 µg/kg buprenorphine or 0 · 5 mg/kg methadone, intramuscularly, allocated randomly. Anaesthesia was induced with propofol intravenously to effect and maintained with isoflurane in oxygen. 0 · 2 mg/kg meloxicam was administered at anaesthetic induction. Sedation was assessed by means of a dynamic interactive visual analogue and simple descriptive scales and pain by dynamic interactive visual analogue and the short form Glasgow composite pain scales, by a single observer blinded to treatment group at intervals for 8 hours following premedication. Sedation scores were higher than baseline in both groups following premedication until the end of the assessment period (P = 0 · 0001), with no differences between groups. Pain scores were lower overall in dogs premedicated with methadone (dynamic interactive visual analogue scale P = 0 · 048; short form Glasgow composite pain scale P = 0 · 0045), and these dogs required less additional analgesia (42%, compared to 79% premedicated with buprenorphine, P = 0 · 045). At the doses investigated, methadone produced superior analgesia to buprenorphine for 8 hours postoperatively in dogs undergoing orthopaedic surgery.

Postoperative analgesic effects of dexketoprofen, buprenorphine and tramadol in dogs undergoing ovariohysterectomy

The objective of this study was to compare the postoperative analgesic effects of dexketoprofen, tramadol, and buprenorphine in dogs undergoing ovariohysterectomy. Seventy-five adult female dogs were randomly assigned to receive an intravenous injection (IV) of 1mg/kg of dexketoprofen (D), 0.02mg/kg of buprenorphine (B) or 2mg/kg of tramadol (T). Pain assessment was performed during 48h after ovariohysterectomy using a dynamic interactive visual analogue scale (DIVAS) and Glasgow composite measure pain scale (CMPS-SF). Rescue analgesia was required in 43%, 21%, and 5% of dogs in the B, T, and D groups, respectively, with significant differences between B and D (p=0.010) groups. The DIVAS and CMPS-SF values of the B group were significantly higher than those of the T and D groups. The most common undesirable effect was dysphoria in dexketoprofen group. Tramadol and dexketoprofen provide superior postoperative analgesia compared with buprenorphine in dogs undergoing ovariohysterectomy.

Analgesic effect of butorphanol in ponies following castration

In the UK butorphanol has a marketing authorisation for administration to horses for sedation in combination with detomidine, and at a higher dose (0.1 mg/kg bwt), for the alleviation of pain. There is only a limited number of clinical studies designed to examine the analgesic effects of butorphanol administration following surgery. To investigate the effect of premedication with butorphanol on post operative pain following castration under general anaesthesia in ponies. Ponies receiving butorphanol would experience less pain after castration than ponies that did not receive butorphanol. A randomised, observer blinded clinical study in which 20 ponies received butorphanol and detomidine (Group B) or detomidine alone (Group C). Anaesthesia was induced with ketamine and diazepam and open castration performed. Pain was assessed by one individual using a dynamic interactive visual analogue scale (DIVAS) 100 mm in length (0 = no pain, 100 mm the maximum possible pain for that procedure). 'Rescue' analgesia was administered when DIVAS >50 mm and was butorphanol i.v. On the second occasion DIVAS was >50 mm, flunixin was administered i.v. Data from the DIVAS were analysed using a Mann Whitney Test. Only one animal did not require rescue analgesia after surgery (Group C). DIVAS were not significantly different between groups (P = 0.063). Castration is sufficiently painful that administration of a single preoperative dose of butorphanol does not provide adequate post operative analgesia.

Comparison between analgesic effects of buprenorphine, carprofen, and buprenorphine with carprofen for canine ovariohysterectomy

ObjectiveTo compare the analgesic effects of buprenorphine, carprofen, and their combination in dogs undergoing ovariohysterectomy. Study designProspective, randomized blinded clinical study. Animals60 dogs. MethodsTreatments were buprenorphine 0.02 mg kg−1, intramuscularly (IM) (group B); carprofen 4 mg kg−1, subcutaneously (SC) (group C); or a combination of both (group CB). Anesthesia was induced with propofol and maintained with isoflurane. A Dynamic Interactive Visual Analog Scale (DIVAS, 0–100 mm) and the Glasgow Composite Pain Scale (GCMPS, 0–24) were used to evaluate comfort and sedation at baseline, 2, 4, 6, and 24 hours after extubation. Rescue analgesia was provided with buprenorphine (0.02 mg kg−1). Wound swelling measurements (WM) and a visual inflammation score (VIS) of the incision were made after surgery and 2, 4, 6, and 24 hours later. p < 0.05 was considered significant. ResultsGroup C required more propofol (5.0 ± 1.4 mg kg−1) compared with B (3.3 ± 1.1 mg kg−1) and CB (3.2 ± 0.7 mg kg−1); respectively, p = 0.0002 and 0.0001. Rescue analgesia was required in nine dogs. B had a higher GCMPS and DIVAS III score at 6 hours (2.6 ± 2.5) and (23 ± 22.5 mm) compared with C (1.0 ± 1.3, 6 ± 7.3 mm) and CB (1.5 ± 1.4, 8 ± 10.7 mm); respectively, p = 0.02 and 0.006. Group C had a lower sedation score at 2 hours (43 ± 23.6 mm) compared with B (68 ± 32.1 mm) and BC (69 ± 22.1 mm); respectively, p = 0.03 and 0.004. Group B had a higher WM score at 2 hours (3 ± 0.8 mm) compared with C (2 ± 0.6 mm) p = 0.01 and at 6 hours (3 ± 1 mm) compared with C (2 ± 0.8 mm) and CB (2 ± 0.8 mm); respectively, p = 0.01 and 0.008. VIS was not different between groups. Conclusion and clinical relevanceAll treatments provided satisfactory analgesia for the first 6 hours and at 24 hours. C and CB pain score and WS were superior to B at 6 hours. No superior analgesic effect was noted when the drugs were combined.

Effects of Various Anaesthetic Combinations on Pain Management After Ovariohysterectomy in Bitches

This study was carried out for the assessment of various anaesthetic combinations on pain management after ovariohysterectomy and to find out the best combination of premedication and anaesthetic drugs for prevention of pain in dogs during the period from May to October 2005 in the Department of Surgery and Obstetrics, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh-2202, Bangladesh. Twenty seven bitches were allocated into three equal groups. The treatment groups were the Atropine-Ketamine-Xylazine (AKX), Atropine-Diazepam-Thiopentone (ADT), and Atropine-Thiopentone-Xylazine (ATX). As local analgesic, 2% lignocaine hydrochloride was administered before closing the external skin wound during experiment in all groups. The levels of analgesia and wound tenderness were assessed by dynamic interactive visual analogue scale (DIVAS). Parametric variables were analyzed using Student's t-test, paired sample t-test and one-way ANOVA in the appropriate cases. Overall, postoperative pain and wound tenderness score increased significantly (p &lt; 0.01) irrespective of groups. Pain decreased significantly (p &lt; 0.01) in ADT group compared to other two groups. Similarly, wound tenderness decreased significantly (p &lt; 0.01) in ADT group at each observation compared to other two groups (ATX and AKX). No adverse event or reaction was observed through the courses of the study. It was demonstrated that Atropine-Diazepam-Thiopentone group provided an excellent analgesia compared to AKX and ATX. A multimodal approach of anaesthesia during ovariohysterectomy in bitches is suggested for prevention of pain. Key words: Anaesthetic, pain, ovariohysterectomy, bitch doi:10.3329/bjvm.v4i1.1525 Bangl. J. Vet. Med. (2006): 47-51