Efficacy of Anti-inflammatory Treatment Versus Rescue Analgesia After Arthroscopic Partial Meniscectomy in Nonarthritic Knees: A 3-Arm Controlled Study

Background: There is currently no consensus regarding the appropriate treatment for postoperative pain after arthroscopic partial meniscectomy (APM). Prescribing a mild non–anti-inflammatory protocol of rescue analgesia may be sufficient to avoid the side effects of opioids or anti-inflammatories. Purpose/Hypothesis: The purpose was to compare the efficacy of pain reduction after APM in nonarthritic knees using betamethasone or celecoxib as anti-inflammatory analgesics versus acetaminophen or tramadol as rescue analgesics. The hypothesis was that there is no advantage for anti-inflammatories in achieving postoperative immediate pain relief after APM in nonarthritic knees compared with a simple nonopioid treatment. Study Design: Cohort study; Level of evidence, 2. Methods: This 3-arm controlled study evaluated postoperative pain levels and analgesic consumption in patients who underwent primary APM (under general anesthesia) at a single institution from December 2018 to December 2019. Patients were prospectively divided into 3 treatment groups: (1) betamethasone injection at the end of the procedure, (2) oral celecoxib prescription, or (3) neither treatment (control). All groups were instructed to take supplementary acetaminophen as needed. Patients were also allowed to take tramadol as needed to evaluate the need for opioids. At postoperative weeks 1, 2, and 3, patients completed the Knee injury and Osteoarthritis Outcome Score (KOOS) Pain subscale, and results were compared between time points and groups. Results: A total of 99 patients were included in the treatment groups: betamethasone group (32 patients), celecoxib group (30 patients), and control group (37 patients). At baseline, there were no statistically significant differences between the groups in age, sex, body mass index, level of activity, comorbidities, or surgical findings. KOOS Pain scores improved at every time point for all 3 groups ( P < .001), and no differences in scores were observed among groups. The consumption of acetaminophen or tramadol as rescue analgesia throughout the follow-up period was negligible among groups. Conclusion: During the first 3 postoperative weeks after APM in nonarthritic knees, pain was efficiently controlled by betamethasone or celecoxib; however, pain was also efficiently controlled by minimal consumption of acetaminophen with negligible use of tramadol. Therefore, acetaminophen could be prescribed as an effective first-line postoperative analgesic after APM.

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Role of Preoperative Pregabalin in Reducing Inhalational Anaesthetic Requirements in Abdominal Hysterectomy: Randomized Controlled Trial

10.21203/rs.2.183/v1 ◽

2019 ◽

Author(s):

Ahmed Abdalla Mohamed ◽

Gehan Helmy Ibrahim ◽

Nesrine Abd Elrahman El Refai ◽

Tamer Mousaad Abdelhamid Gamaleldin ◽

Reham Ali Abdelrahman Abdelrahman ◽

...

Keyword(s):

Postoperative Pain ◽

General Anaesthesia ◽

Bispectral Index ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Neurological Dysfunction ◽

Hypoglycemic Agents ◽

Controlled Study ◽

Control Group ◽

Rescue Analgesia

Abstract Background: preoperative oral pregabalin controls postoperative pain & decreases anesthetic requirements in total intravenous anaesthesia . In this study, we hypothesized that preoperative pregabalin reduces inhaled isoflurane requirements. Methods: Study was conducted in a university hospital, included 50 women (18-60 yrs.), ASA I or II, admitted to undergo elective abdominal hysterectomy under general anaesthesia. Time of study: June to September 2017. Exclusion criteria were allergy or hypersensitivity to pregabalin; patients on calcium channel blockers, antiepileptic drugs, antidepression drugs, any analgesics or sedatives, or oral hypoglycemic agents; and patients with severe cardiovascular, renal, hepatic or neurological dysfunction. Interventions: giving either oral pregabalin 150 mg or placebo to patients of both groups. Primary outcome measures: inhaled isoflurane requirements to maintain haemodynamics ± 20% of baseline& bispectral index (BIS) of 40 - 60, measured using MAQUET Flow-I anaesthetic machine. Secondary outcomes : attenuation of pressor response to intubation, postoperative pain, first time for rescue analgesia, total anaglesics and adverse effects. Results: Isoflurane consumption was significantly less in pregabalin group (7.80 ± 1.27ml h -1) versus (12.27 ± 2.49 ml h-1) in control group, (P= 0.00). Better haemodynamic stability was in pregabalin group after intubation. First postoperative hour :the mean VAS score was significantly higher in control group (7.10 ± 1.20) compared to pregabalin group (4.50 ± 1.70), P<0.001. All patients in control group received pethidine intramuscular. More patients in pregabalin group suffered dizziness. Conclusion: preoperative pregabalin 150 mg ,1 h before total abdominal hysterectomy has an inhaled anaesthetic-sparing effect, maintain haemodynamics and optimizes postoperative analgesia. Keywords: Gabapentinoids, Pregabalin; Inhalation Anaesthetics, Isoflurane; Monitoring, Bispectral Index; Surgery, Abdominal Hysterectomy Objectives: We aimed to investigate the effectiveness and safety of preoperative oral pregabalin 150 mg in women undergoing elective total abdominal hysterectomy under general anaesthesia. Design: A prospective, randomized, double-blind, controlled study. Trial Registry Number: ClinicalTrials.gov: NCT 03302208

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SHOULD THE ERECTOR SPINAE PLANE BLOCK BE APPLIED IN THE PAIN MANAGEMENT OF PERCUTANEOUS NEPHROLITHOTOMY?

10.22541/au.162210869.97761018/v1 ◽

2021 ◽

Author(s):

Şeyma Ünal ◽

Semih Başkan ◽

Betül GÜVEN AYTAÇ ◽

İsmail Aytaç

Keyword(s):

Pain Management ◽

Postoperative Pain ◽

Percutaneous Nephrolithotomy ◽

Length Of Hospital Stay ◽

Postoperative Pain Management ◽

Erector Spinae ◽

Controlled Study ◽

Control Group ◽

Rescue Analgesia ◽

Erector Spinae Plane Block

The Aim: This prospective, randomised controlled study aimed to investigate the efficacy and respiratory effects of postoperative pain management with erector spinae plane block (ESPB) in patients undergoing percutaneous nephrolithotomy surgery. Methods: A total of 60 ASA I-II patients aged 18–65 years, scheduled to undergo percutaneous nephrolithotomy (PCNL) were included. Patients were randomized either to the ESPB or control group. Ultrasound-guided ESPB with 15mL 0.5% bupivacaine at the T11 level was performed preoperatively using the in-plane technique in the ESP group. In both groups, 1gr of intravenous paracetamol was administered intraoperatively. Postoperative pain and agitation was evaluated using VAS, Dynamic VAS at 0, 6 and 24 hours and the Riker sedation-agitation scale at 0th Hours after surgery. Peak expiratory flow rate(PEFR) and SPO2 were measured in preoperative examination and at the 0th, 6th, 24th hours postoperatively. In the postoperative period, intravenous tramadol (100mg) was administered as a rescue analgesic when VAS ≥ 4. Time and number of the rescue analgesias, mobilization time and length of hospital stay were also recorded and analyzed. Results: A significantly lower VAS and DVAS were observed at 0th, 6th, 24th hours in the ESPB group (p < 0.05 for each timepoint). Also number of and time to rescue analgesia decreased in the ESPB group (p< 0.05 and 0.01 respectively). Postoperative/preoperative PEFR ratio was lower and there were more agitated patients in control group (p<0.05). Conclusion: ESPB may have additional clinical advantages while providing effective analgesia in patients who underwent PCNL comparing to intravenous analgesia.

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The efficacy of intraarticular viscosupplementation after arthroscopic partial meniscectomy: a randomized controlled trial

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04990-3 ◽

2022 ◽

Vol 23 (1) ◽

Author(s):

Kyoung Ho Yoon ◽

Woo Seung Wan ◽

Yoon-Seok Kim ◽

Jae-Young Park

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Arthroscopic Surgery ◽

Partial Meniscectomy ◽

Control Group ◽

Arthroscopic Partial Meniscectomy ◽

Level Of Evidence ◽

Randomized Controlled ◽

Link Type ◽

Post Surgery

Abstract Background This study aimed to evaluate the efficacy of viscosupplementation after arthroscopic partial meniscectomy. Method A randomized controlled trial of 47 patients who underwent arthroscopic partial meniscectomy was conducted between March 2020 and March 2021. Patients were randomized into two groups: a viscosupplementation group (n = 23) and a control group (n = 24). A single-dose intraarticular hyaluronic acid injection was used as viscosupplementation. The 100 mm visual analogue scale (VAS) for pain assessment was measured at baseline and at 1 day, 2 weeks, 6 weeks, and 3 months post-surgery. The International Knee Documentation Committee (IKDC), Tegner, Lysholm, and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores and range of motion (ROM) of the knee were measured at baseline, 2 weeks, 6 weeks, and 3 months. Results The 100 mm VAS score for pain was significantly lower in the viscosupplementation group at 2 weeks post-surgery (27.5 mm vs. 40.7 mm, P = 0.047). ROM was significantly greater in the viscosupplementation group than in the control group at 2 weeks (131.5° vs. 121.0°, P = 0.044) post-surgery. No significant differences were observed in the IKDC or in the Tegner, Lysholm, and WOMAC scores between the two groups. Conclusions Viscosupplementation after arthroscopic partial meniscectomy significantly reduced pain at 2 weeks post-surgery and improved ROM of the knee at 2 weeks post-surgery. There might be some benefits in terms of pain and functional recovery of viscosupplementation after arthroscopic surgery. Study design Randomized controlled trial; Level of evidence, 1. Trial registration This randomized controlled trial was registered at cris.nih.go.kr #KCT0004921.

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Postoperative analgesia by adding acupuncture to conventional therapy, a non-randomized controlled trial

Journal of Complementary and Integrative Medicine ◽

10.1515/jcim-2018-0028 ◽

2018 ◽

Vol 16 (2) ◽

Cited By ~ 2

Author(s):

Ilana Levy ◽

Samuel Attias ◽

Lior Cohen ◽

Nadav Stoppelmann ◽

Dan Steinberger ◽

...

Keyword(s):

Side Effects ◽

Postoperative Pain ◽

Analgesic Effect ◽

Pain Treatment ◽

Standard Of Care ◽

Acupuncture Group ◽

Controlled Study ◽

Control Group ◽

Pain Level ◽

Randomized Controlled

Abstract Background Postoperative pain is common in patients hospitalized in surgical departments, yet it is currently not sufficiently controlled by analgesics. Acupuncture, a complementary medical practice, has been evaluated for its benefits in postoperative pain with heterogeneous results. We tested the feasibility of a controlled study comparing the postoperative analgesic effect of acupuncture together with standard-of-care to standard-of-care only. Methods In this pilot non-randomized controlled study conducted at a tertiary medical center in Israel, patients received either acupuncture with standard-of-care pain treatment (acupuncture group) or standard-of-care treatment only (control group) following surgery. Visual Analogue Scale (VAS) ratings for pain level at rest and in motion were evaluated both at recruitment and two hours after treatment. Acupuncture-related side effects were reported as well. Results We recruited 425 patients; 336 were assigned to the acupuncture group and 89 to the control group. The acupuncture group exhibited a decrease of at least 40% in average level of pain both at rest (1.8±2.4, p<0.0001) and in motion (2.1±2.8, p<0.0001) following acupuncture, whereas the control group exhibited no significant decrease (p=0.92 at rest, p=0.98 in motion). Acupuncture's analgesic effect was even more prominent in reducing moderate to severe pain at baseline (VAS ≥4), with a decrease of 49% and 45% of pain level at rest and in motion respectively (p<0.001), compared with no significant amelioration in the control group (p=0.20 at rest, p=0.12 in motion). No major side effects were reported. Conclusion Integrating acupuncture with standard care may improve pain control in the postoperative setting.

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Anti-Inflammatory Effect of Musa acuminata Stem

European Journal of Dentistry ◽

10.1055/s-0040-1709944 ◽

2020 ◽

Vol 14 (02) ◽

pp. 294-298

Author(s):

Maharani Laillyza Apriasari ◽

Selviana Rizky Pramitha ◽

Dewi Puspitasari ◽

Diah Savitri Ernawati

Keyword(s):

Treatment Group ◽

Musa Acuminata ◽

Control Group ◽

Control Group Design ◽

Treatment Groups ◽

Tnf Α ◽

Significant Difference ◽

Anti Inflammatory ◽

Mucosal Wound ◽

Inflammatory Effect

Abstract Objective This study was designed to assess the anti-inflammatory effect of Musa acuminata through the expression of tumor necrosis factor-α (TNF-α) and nuclear factor kappa β (NF-κB) after 3 days of application of Musa acuminata stem extract (MASE) gel on oral mucosal wound. Materials and Methods An experimental study with post-test only control group design was conducted. Twenty male Rattus norvegicus (Wistar) were injured on their left buccal mucosa and treated three times a day with MASE gel of varying concentrations: 0% (as control), MASE 25%, MASE 37.5%, and MASE 50%. On day 3, a biopsy was performed on each mucosal wound for later immunohistochemical analysis for the expressions of TNF-α and NF-κB. Results The highest expression of TNF-α was observed in the control group (13.20 ± 1.79), while the lowest was in the treatment group using 50% MASE (6.40 ± 1.14). Meanwhile the comparison between treatment groups did not highlight any significant difference (p > 0.05). The highest expression of NF-κB was observed in the control group (13.20 ± 1.30), whereas the lowest was in the treatment group using MASE 50% (6.40 ± 1.14). NF-κB was significantly lower in the treatment group using MASE 50% when compared with other treatment groups (p < 0.05). Conclusion Application of MASE on mucosal wound reduces the expression of TNF-α and NF-κB at all concentrations. The anti-inflammatory effect of MASE 50% was the strongest one.

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Effect of Sphenopalatine Ganglion Block With Bupivacaine on Postoperative Pain in Patients Undergoing Endoscopic Sinus Surgery

Allergy & Rhinology ◽

10.1177/2152656718821282 ◽

2019 ◽

Vol 10 ◽

pp. 215265671882128 ◽

Cited By ~ 5

Author(s):

Ahmad Rezaeian ◽

Seyed Mostafa Hashemi ◽

Zeinab Sadat Dokhanchi

Keyword(s):

Postoperative Pain ◽

Endoscopic Sinus Surgery ◽

Intervention Group ◽

Sinus Surgery ◽

Control Group ◽

Sphenopalatine Ganglion ◽

Ganglion Block ◽

Rescue Analgesia ◽

Sphenopalatine Ganglion Block ◽

And Control

Background Postoperative pain is one of the most complications in endoscopic sinus surgery. We aimed to evaluate the effect of the sphenopalatine ganglion block (SPGB) with bupivacaine on postoperative pain in patients undergoing endoscopic sinus surgery. Methods and Materials: In this clinical trial, 40 patients who indicated functional endoscopic sinus surgery were selected and then divided into 2 parallel groups as intervention and control. The intervention group was received 1.5 mL of bupivacaine 0.5% (injected to sphenopalatine ganglion) and while control was injected 1.5 mL of normal saline at the same injection site. Also, the visual analogue scale (VAS) was recorded immediately after anesthesia, along with 6, 12, 24, 48 h, 7 days, and 21 days after the operation for all patients. Results Immediately after anesthesia, as well as 6, 12, and 24 h after the operation, VAS in the intervention group was significantly lower than in the control group ( P < .05, for all). However, there were no significant differences between the 2 groups regarding VAS 48 h as well as 7 and 21 days after surgery ( P > .05, for both). Also, the rescue analgesia in the intervention group was significantly lower than in the control group ( P = .01). Conclusion SPGB with bupivacaine 0.5% (1.5 mL) was a simple, effective, safe, and noninvasive method for the management of postoperative pain in the patients undergoing endoscopic sinus surgery.

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Determining the Patient Acceptable Symptomatic State for Patients Undergoing Arthroscopic Partial Meniscectomy in the Knee

The American Journal of Sports Medicine ◽

10.1177/0363546520904017 ◽

2020 ◽

Vol 48 (4) ◽

pp. 847-852 ◽

Cited By ~ 1

Author(s):

Tim Dwyer ◽

Thomas Zochowski ◽

Darrell Ogilvie-Harris ◽

John Theodoropoulos ◽

Daniel Whelan ◽

...

Keyword(s):

Roc Analysis ◽

Characteristic Curve ◽

Case Series ◽

International Knee Documentation Committee ◽

Partial Meniscectomy ◽

Consecutive Series ◽

Evaluation Tool ◽

Arthroscopic Partial Meniscectomy ◽

Level Of Evidence ◽

Patient Reported

Background: Arthroscopic partial meniscectomy is one of the most common procedures in orthopaedic surgery. The patient acceptable symptomatic state (PASS), which defines a level of symptoms above which patients consider themselves well, remains to be well-defined in this population. Purpose: Using an anchor-based approach, our goal was to determine the 1-year PASS for the Knee injury and Osteoarthritis Outcome Score (KOOS), the International Knee Documentation Committee (IKDC) Subjective Knee Form, the Western Ontario Meniscal Evaluation Tool (WOMET), and the Marx Activity Scale (MAS) in patients who were treated with partial knee meniscectomy. Study Design: Case series; Level of evidence, 4. Methods: A consecutive series of patients with knee meniscal tears and a Kellgren-Lawrence grade of 0 to 2 treated with arthroscopic partial meniscectomy were eligible. The KOOS (0-100), IKDC (0-100), WOMET (0-100), and MAS (0-16) were administered at baseline and 12 months postoperatively. An external anchor question at 1 year postoperatively was used to determine PASS values. A receiver operating characteristic curve (ROC) analysis was used to determine the PASS value at which patients considered their status to be satisfactory. Results: The study included 110 patients (mean ± SD age, 53.8 ± 12.0 years), 57.3% were male, and the follow-up rate was 82%. In total, 70% of patients had an Outerbridge arthroscopic grade of 2 or lower. Based on ROC analysis, the 1-year postoperative PASS values (sensitivity, specificity) were 64.3 (47.8, 100.0) for KOOS Symptoms, 81.6 (71.6, 100.0) for KOOS Pain, 82.4 (82.1, 86.4) for KOOS Function in Daily Living, 71.0 (62.7, 81.8) for KOOS Function in Sport and Recreation, 51.0 (83.6, 95.5) for KOOS Knee-Related Quality of Life, 56.2 (82.1, 100.0) for IKDC, 58.5 (79.1, 100.0) for WOMET, and 7.0 (44.8, 68.2) for MAS. Baseline scores did not affect the PASS threshold across the different instruments. However, patients with higher baseline scores were more likely to achieve the PASS for the KOOS Symptoms (odds ratio [OR], 2.808; P = .047), IKDC (OR, 4.735; P = .006), and WOMET (OR, 2.985; P = .036). Age, sex, and cartilage status were not significantly related to the odds of achieving the PASS for any of the patient-reported outcome measures. Conclusion: These findings allow researchers and clinicians to determine whether partial meniscectomy is meaningful to patients at the individual level and will be helpful for responder analysis in future trials related to the treatment of meniscal abnormality.

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Postoperative Analgesia for Haemorrhoid Surgery

Anaesthesia and Intensive Care ◽

10.1177/0310057x8301100106 ◽

1983 ◽

Vol 11 (1) ◽

pp. 27-30 ◽

Cited By ~ 16

Author(s):

D. A. Pybus ◽

B. E. D'Bras ◽

G. Goulding ◽

H. Liberman ◽

T. A. Torda

Keyword(s):

Postoperative Pain ◽

General Anaesthesia ◽

Postoperative Analgesia ◽

Normal Saline ◽

Morphine Sulphate ◽

Control Group ◽

Treatment Groups ◽

Number Of Patients ◽

Caudal Analgesia ◽

The Mean

Seventy patients undergoing haemorrhoidectomy under general anaesthesia were randomly allocated to one of five treatment groups in order to compare the effectiveness of various caudal agents in the control of postoperative pain. Four groups were given a caudal injection of either 2% lignocaine, 0.5% bupivacaine, 2% lignocaine + morphine sulphate 4 mg or normal saline + morphine sulphate 4 mg, while the fifth (control) group did not receive an injection. The number of patients requiring postoperative opiates was significantly higher in the lignocaine group than in the morphine (p <0.05) and morphine-lignocaine (p <0.05) groups. No agent significantly reduced the number requiring opiates. In those who received opiates, the mean analgesic period was 228 minutes in the control group, and was significantly longer following bupivacaine (577 min, p <0.01), morphine-lignocaine (637 min, p <0.05) and morphine (665 min, p <0.01). The mean analgesic period following lignocaine (349 min) was not significantly different from control. The incidence of catheterisation was lowest in those patients who did not receive caudal analgesia.

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The Effects of Vibration and Pressure Treatments in the Early Postoperative Period of Rhinoplasty

Aesthetic Surgery Journal ◽

10.1093/asj/sjz226 ◽

2019 ◽

Vol 40 (6) ◽

pp. 605-616 ◽

Cited By ~ 2

Author(s):

Süleyman Taş

Keyword(s):

Postoperative Period ◽

Early Postoperative Period ◽

Control Group ◽

Level Of Evidence ◽

Vibration Treatment ◽

The Face ◽

Anti Inflammatory ◽

Group 2 ◽

A Prospective Study ◽

Nasal Cast

Abstract Background The early postoperative period can be distressing for the patients undergoing rhinoplasty since edema and ecchymosis are common complications. Objectives To analyze the effects of the vibration and pressure treatments in the early postoperative period of rhinoplasty. Methods Sixty patients, who had undergone rhinoplasty, were randomized into 3 groups: group 1 (control group, n = 20) received classic nasal casting, group 2 (n = 20) received nasal cast with an elastic bandage to hold it on the face, and group 3 (n = 20) received vibration treatment in addition to that in group 2 following the rhinoplasty. They were evaluated preoperatively and postoperatively at 3 and 7 days in a prospective study. The postoperative edema and ecchymosis were scored by 2 independent surgeons. The postoperative pain was measured using the visual analog scale, and the necessity of anti-inflammatory medication (and the dose needed) and the cast comfort was questioned. The sebaceous activity of the nose skin was examined. A preoperative and postoperative seventh day sonographic study was performed to evaluate the tissue edema objectively. Results The pressure treatment decreased the edema and ecchymosis significantly compared with the control group. The vibration treatment minimized edema, ecchymosis, sebaceous activity of the nose skin, pain score, and the need for anti-inflammatory medication, and increased the cast comfort significantly compared with the other groups (P < 0.0001). Conclusions Rapid regression of edema and ecchymosis may be achieved using the vibrating nasal cast technique that may minimize patient discomfort, pain, and sebaceous activity following rhinoplasty. Level of Evidence: 1

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Evaluation of postoperative pain and toxicological aspects of the use of dipyrone and tramadol in cats

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x19849969 ◽

2019 ◽

Vol 22 (6) ◽

pp. 467-475 ◽

Cited By ~ 2

Author(s):

Luciana G Teixeira ◽

Letícia R Martins ◽

Paula I Schimites ◽

Guilherme L Dornelles ◽

Graciane Aiello ◽

...

Keyword(s):

Postoperative Pain ◽

Complete Blood Count ◽

Venous Blood ◽

Serum Biochemistry ◽

Postoperative Treatment ◽

Control Group ◽

Rescue Analgesia ◽

Biochemical Variables ◽

Oxidative Markers ◽

Hematological And Biochemical Parameters

Objectives The aim of this study was to evaluate the effects of dipyrone and tramadol, used for 5 days, on postoperative pain, hematological and biochemical parameters, and oxidative markers on erythrocytes. Methods Twenty-eight healthy cats underwent ovariohysterectomy and were randomly allocated to four groups (each n = 7), according to the postoperative treatment administered intravenously: control (saline 1 ml q8h), DIP1 (dipyrone 25 mg/kg q24h), DIP2 (dipyrone 25 mg/kg q12h) and DIP3 (dipyrone 25 mg/kg q8h). All animals received tramadol (2 mg/kg q8h). Pain was assessed by visual analog (VAS), multidimensional UNESP and Glasgow pain scales for cats preoperatively and at 3, 6, 12, 24, 36 and 48 h after extubation. Venous blood was collected daily for 5 days, and on day 10, to perform a complete blood count (CBC) and determine the percentage of Heinz bodies (HBs). Serum biochemistry was evaluated preoperatively and on days 5 and 10; superoxide dismutase (SOD), catalase (CAT), myeloperoxidase (MPO) and lipoperoxidation were evaluated preoperatively and on days 3, 5 and 10. Results Control cats had higher pain scores than DIP3 cats by UNESP ( P = 0.0065), and DIP2 ( P = 0.0035) and DIP3 cats ( P = 0.0108) by VAS 3 h postoperatively. Rescue analgesia was required by two animals in the control group and one each in the DIP1 and DIP2 groups. There was no difference in SOD or CAT among groups. On day 5, MPO was more active in DIP2 than in DIP3 cats ( P = 0.0274). No difference in lipoperoxidation among treatment and control cats was found. CBC remained constant and without statistical difference among groups. Control, DIP2 and DIP3 cats presented a similar percentage of HBs on day 10. Biochemical variables were similar among groups and times. Conclusions and relevance The administration of dipyrone in cats, when used in combination with tramadol, did not ensure better analgesia than tramadol alone. Dipyrone did not significantly affect biochemical variables and oxidative markers, despite minimal, clinically irrelevant, hematological differences between groups.

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