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Wednesday, 18 July 2018

Yamamoto New Scalp Acupuncture for postoperative pain management in cats undergoing ovariohysterectomy.

Vet Anaesth Analg. 2017 Sep;44(5):1236-1244. doi: 10.1016/j.vaa.2017.03.004. Epub 2017 Apr 13. Ribeiro MR1, de Carvalho CB1, Pereira RHZ1, Nicácio GM1, Brinholi RB1, Cassu RN2. Author information 1 Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of Western São Paulo, SP, Brazil. 2 Department of Veterinary Surgery and Anesthesiology, Faculty of Veterinary Medicine, University of Western São Paulo, SP, Brazil. Electronic address: renavarro@uol.com.br. Abstract OBJECTIVE: To evaluate the analgesic efficacy of Yamamoto New Scalp Acupuncture (YNSA) as an adjuvant for postoperative pain management in cats. STUDY DESIGN: Prospective, randomized, blinded, clinical study. ANIMALS: Twenty cats aged (mean ± standard deviation) 25 ± 9 months and weighing 2.7 ± 0.6 kg undergoing ovariohysterectomy. METHODS: The cats were sedated with intramuscular (IM) ketamine (5 mg kg-1), midazolam (0.5 mg kg-1) and tramadol (2 mg kg-1). The cats were randomly distributed before induction of anesthesia into two groups of 10 cats each: group YNSA, in which bilateral basic D points were stimulated with a dry needle from 20 minutes prior to anesthetic induction to the end of the surgery; group Control, in which no acupuncture was applied. Postoperative analgesia was assessed at 1, 2, 4, 8, 12, 18 and 24 hours postextubation using an Interactive Visual Analog Scale and Universidade Estadual Paulista-Botucatu Multidimensional Composite Pain Scale (UNESP-Botucatu MCPS). Rescue analgesia was provided with IM tramadol (2 mg kg-1), and the pain scores were reassessed 30 minutes after rescue intervention. If the analgesia remained insufficient, meloxicam (0.2 mg kg-1 as a single dose) was administered IM. Data were analyzed using Student t-test, Fisher exact test, Mann-Whitney U test and Friedman test (p < 0.05). RESULTS: Significantly lower pain scores were observed in YNSA when compared with Control at 1-4 hours based on the UNESP-Botucatu MCPS scores. Although significant differences were not identified between groups requiring rescue analgesia, additional postoperative analgesia was administered to four of 10 cats in Control and no cats in YNSA. CONCLUSION AND CLINICAL RELEVANCE: Perioperative YNSA resulted in decreased pain scores and a reduction in postoperative requirement for rescue analgesia in cats. This method should be considered a viable option as an adjuvant analgesic therapy for cats undergoing ovariohysterectomy. Copyright © 2017 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved. KEYWORDS: acupuncture; analgesia; feline; scalp; surgery PMID: 28888802 DOI: 10.1016/j.vaa.2017.03.004 [Indexed for MEDLINE]