Development of objective criteria of pain in animals.

制定动物疼痛的客观标准。

• 批准号: 15580286
• 负责人: NISHIMURA Ryohei
• 金额: $ 2.37万
• 依托单位: The University of Tokyo
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2003
• 资助国家: 日本
• 起止时间: 2003 至 2005
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-15580286/
• 关键词: cortisol; ACTH; pain; nociception; opioid; NSAIDs; blood pressure; heart rate; 麻薬; フェンタニル; ケタミン; リドカイン; 全静脈麻酔; 疼痛; 非ステロイド性抗炎症薬; オピオイド; カルプロフェン; VAS; 犬; 手術侵襲

First, the relationship between noxious stimulus and neurohormonal responses was evaluated in dogs. The changes in heart rate, blood pressure and plasma ACTH and cortisol levels were recorded during major surgeries. Heart rate and blood pressure did not change significantly during or after major surgical manipulation except for skin incision in many dogs. On the contrary, the plasma ACTH and cortisol levels changed in accordance to the degree of potency of surgical manipulation in most dogs. Cortisol was thought to be more valuable than ACTH because of its less individual differences and easy measurement protocol. In addition, the increase in plasma cortisol level induced by surgical manipulation was significantly suppressed by use of potent analgesics such as morphine or fentanyl.Second, antinociceptive effect of a non steroidal anti-inflammatory drug (NSAID) was compared with that of opioids by use of cortisol levels during and after surgery. Preemptive administration of NSAID suppressed the increase in plasma cortisol level caused by surgical manipulation and maintained it at similar level to that in dogs given opioids during and after operation. In addition, the changes in post-operative pain score determined by visual analog scale (VAS) were well correlated with the changes in plasma cortisol levels in both groups.Finally, the effect of high dose of opioid with or without adjunctive drugs on neurohormonal response caused by noxious stimulus was evaluated by use of cortisol level. High dose of fentanyl with ketamine and lidocaine exerted almost complete antinociceptive effects during surgery.In conclusion, plasma cortisol level is a valuable and objective criteria of pain in dogs.

首先，在狗中评价伤害性刺激和神经激素反应之间的关系。记录大手术期间心率、血压、血浆ACTH和皮质醇水平的变化。心率和血压在主要手术操作期间或之后没有显著变化，除了许多狗的皮肤切口。相反，大多数犬的血浆ACTH和皮质醇水平根据手术操作的效力程度而变化。皮质醇被认为比ACTH更有价值，因为它的个体差异小，测量方案简单。此外，血浆皮质醇水平的增加引起的手术操作显着抑制使用强效镇痛药，如吗啡或fentanyl.Second，抗伤害性作用的非甾体抗炎药（NSAID）与阿片类药物相比，通过使用皮质醇水平在手术过程中和手术后。预先给予NSAID抑制了手术操作引起的血浆皮质醇水平升高，并将其维持在与手术期间和手术后给予阿片类药物的犬相似的水平。此外，两组患者术后VAS疼痛评分的变化与血浆皮质醇水平的变化具有良好的相关性。最后，采用皮质醇水平评价大剂量阿片类药物联合或不联合镇痛药物对伤害性刺激引起的神经激素反应的影响。大剂量芬太尼、氯胺酮和利多卡因在手术过程中几乎完全发挥镇痛作用。总之，血浆皮质醇水平是一个有价值的和客观的疼痛指标。