Multimodal analgesia for treatment of allodynia and hyperalgesia after major trauma in a cat
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Fecha
2019
Profesor/a Guía
Facultad/escuela
Idioma
en
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Título del volumen
Editor
SAGE Publications Ltd
Nombre de Curso
Licencia CC
Licencia CC
Resumen
Case summary A 2-year-old polytraumatized male cat was admitted to a teaching hospital for correction of a defective inguinal herniorrhaphy. Upon arrival, the cat showed signs of neuropathic pain, including allodynia and hyperalgesia. Analgesic therapy was initiated with methadone and metamizole; however, 24 h later, the signs of pain continued. Reparative surgery was performed, and a multimodal analgesic regimen was administered (methadone, ketamine, wound catheter and epidural anesthesia). Postoperatively, the cat showed signs of severe pain, assessed using the UNESP-Botucatu multidimensional composite pain scale. Rescue analgesia was initiated, which included methadone, bupivacaine (subcutaneous wound-diffusion catheter) and transversus abdominis plane block. Because the response was incomplete, co-adjuvant therapy (pregabalin and electroacupuncture) was then implemented. Fourteen days after admission, the patient was discharged with oral tramadol and pregabalin for at-home treatment. Relevance and novel information Neuropathic pain is caused by a primary lesion or dysfunction in the nervous system and is a well-described complication following trauma, surgical procedures such as hernia repair, and inadequate analgesia. The aims of this report are to: (1) describe a presentation of neuropathic pain to highlight the recognition of clinical signs such as allodynia and hyperalgesia in cats; and (2) describe treatment of multi-origin, severe, long-standing, ‘mixed’ pain (acute inflammatory with a neuropathic component). The patient was managed using multiple analgesic strategies (multimodal analgesia), including opioids, non-steroidal anti-inflammatory drugs, locoregional anesthesia, co-adjuvant drugs and non-pharmacological therapy (electroacupuncture).
Notas
Indexación (Scopus)
Palabras clave
Allodynia, Electroacupuncture, Hyperalgesia, Inguinal herniorrhaphy, Multimodal analgesia, Neuropathic pain, Pregabalin
Citación
Journal of Feline Medicine and Surgery Open Reports Volume 5, Issue 1 2019
DOI
10.1177/2055116919855809