Title USPOREDBA PREDOPERACIJSKE I POSLIJEOPERACIJSKE ANALGEZIJE PRIMJENOM KARPROFENA PRI LAPAROTOMSKIM I LAPAROSKOPSKIM OPERACIJAMA U KUJA
Title (english) COMPARATION OF PREOPERATIVE AND POSTOPERATIVE ANALGESIA USING CARPROFEN IN LAPAROTOMIC AND LAPAROSCOPIC SURGERY IN BITCHES
Author Srećko Solina
Mentor Darko Capak (mentor)
Committee member Dražen Vnuk (predsjednik povjerenstva)
Committee member Frane Božić (član povjerenstva)
Committee member Slavko Davila (član povjerenstva)
Granter University of Zagreb Faculty of Veterinary Medicine (Surgery, Orthopaedics and Ophtalmology Clinic) Zagreb
Defense date and country 2018-02-08, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Veterinary Medicine Veterinary Clinical Sciences
Universal decimal classification (UDC ) 636.09 - Veterinary science
Abstract Analgezija zauzima središnje mjesto stalne brige veterinara za dobrobit pacijenta.
Pravodobna, djelotvorna i multimodalna perioperacijska analgezija ključna je za prevenciju
poslijeoperacijske boli koja je danas u samom vrhu istraživačkog interesa veterinarske struke.
Kastracija kuja kao najizvođeniji operacijski zahvat na zdravim životinjama u praksi se izvodi
klasičnom laparotomskom tehnikom, a u novije vrijeme i laparoskopski. Ove se operacijske
tehnike ne razlikuju samo koncepcijski već i prema invazivnosti kirurškog pristupa odnosno
veličini traume. Istraživanja akutne traumatske boli radi dobrobiti životinja najčešće se
provode upravo u obliku procjene učinka kirurške traume na pacijenta. Stoga je važno pronaći
zadovoljavajući stupanj predoperacijske i poslijeoperacijske analgezije primjenom
odgovarajućeg analgetika. Bol se u životinja liječi ili suzbija farmakološki ili fizikalnim
metodama. Karprofen je nesteroidni protuupalni lijek iz skupine derivata 2-arilpropionske
kiseline koji očituje analgetski, protuupalni i antipiretski učinak te se osim kao analgetik pri
akutnim i kroničnim poremećajima mišićno-koštanog sustava koristi i za ublažavanje znakova
upale i poslijeoperacijskih bolova nakon kirurških zahvata. U životinja bol je neugodno
emocionalno ili osjetilno iskustvo nakon ili u očekivanju bolnog podražaja koji pokreće
obrambenu motoričku aktivnost, pamti se pa je životinja uči izbjegavati, a može mijenjati i
vrsno specifične obrasce ponašanja. Bihevioralne i fiziološke promjene pokazuju da je bol
također svijest o akutnoj ili kroničnoj neugodi različitog stupnja koja može biti posljedica
ozljede, bolesti ili patnje.
U veterinarskoj medicini stupanj bolnosti procjenjuje se na temelju vokalizacije, stupnja
aktivnosti, stupnja hromosti – ako se radi o lokomotornom aparatu i reakcije na dodir i
manipulaciju. Zbog izostanka verbalne komunikacije između veterinara i pacijenta teško je
procijeniti stupanj poslijeoperacijske boli pa su sva ta mjerila podložna brojnim vanjskim
utjecajima i u velikoj su mjeri subjektivna. Takvo subjektivno tumačenje reakcije pacijenta u
velikoj mjeri nam ograničavaju istraživanja i procjenu stupnja boli. Do danas nije razvijena
dovoljno osjetljiva metoda koja bi uključivala sve relevantne parametre. Stoga je opće
prihvaćeno da se bol u životinja najbolje može procijeniti multimodalnim pristupom gdje više
metoda međusobnom korekcijom osigurava najveću točnost.
U ovom radu usporedili smo predoperacijsko stanje i stupanj poslijeoperacijske analgezije
primjenom karprofena pri laparotomskim i laparoskopskim operacijama u kuja, prikazujući ih
kroz biokemijske krvne parametre, odnosno kroz predoperacijsko i poslijeoperacijska
mjerenja u prva tri dana koncentracije glukoze, kortizola, kreatin fosfokinaze, C-reaktivnog
proteina i ukupnog broja leukocita, kroz određivanje stupnja bolnosti prema modificiranoj
skali Glasgowske ljestvice boli u skraćenom obliku (Short Form of the Glasgow Composite
Pain Scale), uz standardiziranje protokola injekcijske primjene karprofena, te smo usporedili i
vrijednosti temperature, bila i disanja tijekom oporavka kod dviju operacijskih tehnika, a radi
što objektivnije procjene i određivanja stupnja bolnosti izazvanih kirurškom traumom trbušne
stjenke. Dobiveni rezultati pokazuju opravdanost prijeoperacijske i poslijeoperacijske
primjene karprofena kao analgetika u prevenciji i liječenju bolnosti kirurški traumatizirane
trbušne stjenke u pasa.
Abstract (english) INTRODUCTION
Analgesia is central in constant care of a veterinary surgeon for the benefit of patients.
Timely, effective and multimodal perioperative analgesia is the key element for preventing
postoperative pains. Today, it is close to being of utmost interest in any research in veterinary
profession. Castration of female dogs is the most frequent operation performed on healthy
animals through standard laparotomy or laparoscopy in recent time. The two operational
procedures differ both in concept and the invasiveness of surgical approach i.e. trauma
intensity. For the benefit of animals, acute traumatic pain is the most frequently investigated
to evaluate the effect of surgical trauma on the patient. Therefore, it is important to establish
the preoperative and postoperative levels of analgesia through adequate analgesics. Pain in
animals can be treated or combat through pharmacological or physical methods.
MATERIAL AND METHODS
Carprofen is a non-steroidal anti-inflammatory analgetic drug in the class of 2-aril propionic
acid derivatives providing analgetic, anti-inflammatory and antipyretic effect. As an analgetic
in acute and chronic muscle-and-bone system disorders it is also used to reduce both
inflammation and postoperative signs of pain following surgical procedures. In animals pain
is an unpleasant emotional and sensorial experience after or in expectation of a painful
stimulant initiating defensive motor activity. An animal remembers and tries to avoid it. It can
also change its species related specific behavioural patterns. Behaviouristic and physical
changes indicate that pain represents at the same time awareness of an acute or chronic
unpleasant situation various in degree as a result of injury, illness or suffering.
RESULTS
This paper compares the levels of preoperative and postoperative analgesia through the use of
carprofen in laparotomic and laparoscopic operations in female dogs. It is disclosed in the
form of biochemical blood parameters, i.e. preoperative and postoperative measurements in
the first three days of concentration in glucose, cortisol, creatinin phosphokinase, C-reactive
protein and total number of leukocytes and through determining the level of painfulness
according to the modified Short Form of the Glasgow Composite Pain Scale along with the
standardisation of the protocol of injection-based application of carprofen and measuring the
values of temperature, pulse rate and respiratory rate as well as the recovery rate in the two
surgical procedures; all this for an as best possible objective evaluation and definition of the
level of painfulness caused by surgical trauma in abdominal walls.
CONCLUSIONS
In veterinary medicine the degree of painfulness is evaluated based on vocalization, activity
and lameness levels-the-latter-if related to locomotor system and reaction to touch and
manipulation. Because of no verbal communication between a vet and his/her patient is
possible, it is hard to assess the level of postoperative pain. So, all such criteria are subject to
numerous external influences and subjective to a large extent. Correspondingly such
subjective explanation of patient‘s reactions limits greatly boath investigation and evaluation
of degree of pain. To this day no sufficiently susceptible method to include all-inclusive
relevant parameters has been developed. It is generally accepted therefore that pain in animals
can be best evaluated through the multimodal approach including a set of methods providing
the most exact accuracy by applaying interacting corrections. The obtained results justify the
preoperative and postoperative application of carprofen as an analgetic drug in a surgicaly
traumatized abdominal wall.
Keywords
analgezija
procjena boli
laparotomija
laparoskopija
kastracija
kuje
karprofen
Keywords (english)
analgesia
pain assessment
laparotomy
laparoscopy
castration
bitches
carprofen
Language croatian
URN:NBN urn:nbn:hr:178:016948
Promotion 2018
Study programme Title: integrated undergraduate and graduate university study of veterinary medicine Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica veterinarske medicine (doktor/doktorica veterinarske medicine)
Type of resource Text
Extent 88
File origin Born digital
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Created on 2021-02-17 10:17:30