Multimodal Acute Pain Management in Cats and Dogs: A Scoping Review

Year 2023, Volume: 2 Issue: 2, 36 - 44, 05.11.2024

Mehmet Cem Kolbaşı , Yalçın Alper Özturan , İbrahim Akın

Abstract

Background: Multimodal analgesia (MMA) is a promising and scientifically proven method for effective pain management. By combining different pain-relief techniques to target multiple pain pathways, MMA has demonstrated superior efficacy compared to unimodal treatments. However, there's a crucial need to standardize studies in this field for better analysis and comparison. Thoroughly mapping the literature on MMA in veterinary medicine is vital for advancing our understanding and improving pain management for animals.
Objective: The present scoping review aims to systematically examine the current literature on multimodal analgesia in dogs and cats, focusing on identifying gaps in reviews, case reports, and clinical trials. We aim to improve future MMA literature by giving suggestions, identifying gaps, and helping standardize case reports regarding analgesia. Thereby informing future studies aimed at improving multimodal analgesic strategies in veterinary medicine.
Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews guidelines, a literature search was conducted using PubMed. Search terms related to multimodal analgesia, pain management, cats, and dogs were combined using Boolean operators. Inclusion criteria focused on acute multimodal analgesia studies in cats and dogs, encompassing review articles, case reports, case series and clinical trials. Data extraction and synthesis were performed to analyze key characteristics and findings of the included studies.
Results: The literature search yielded 63 articles, 19 reviews, 10 case reports and series, and 8 original article in total of 37 articles were met the inclusion criteria. The synthesis revealed a growing body of literature of the use of multimodal analgesia in veterinary medicine, with various study designs, use and combinations of drugs.
Conclusion: This scoping review highlights the increasing adoption of multimodal analgesia in acute pain management for cats and dogs. While the evidence base for its effectiveness is expanding, further systematic investigations are needed to address gaps and uncertainties, particularly regarding standardized study designs and reporting guidelines. Multimodal analgesia proves effective, surpassing single pain-relieving methods.

Keywords

Analgesia, Cat, Dog, Multimodal Therapy, Multimodal Pain Management

Kedi ve Köpeklerde Multimodal Akut Ağrı Yönetimi: Bir Kapsam Derlemesi

Abstract

Arkaplan: Multimodal analjezi (MMA), etkili ağrı yönetimi için umut verici ve bilimsel olarak kanıtlanmış bir yöntemdir. Çoklu ağrı yollarını hedeflemek için farklı ağrı kesici tekniklerini birleştiren MMA, tek yöntem içeren tedavilere kıyasla üstün etkinlik göstermiştir. Ancak daha iyi analizler ve karşılaştırmalar yapılabilmesi için bu alandaki çalışmaların standartlaştırılmasına ihtiyaç vardır. Veteriner hekimliğinde MMA ile ilgili literatürün kapsamlı bir şekilde incelenmesi, hayvanlar için ağrı yönetimini geliştirmek açısından hayati öneme sahiptir.
Amaç: Mevcut kapsam derlemesi, köpeklerde ve kedilerde multimodal analjezi ile ilgili mevcut literatürü sistematik olarak incelemeyi, incelemeler, vaka raporları ve klinik araştırmalardaki boşlukları belirlemeye odaklanmayı amaçlamaktadır. Önerilerde bulunarak, literatürlerdeki boşlukları belirleyerek ve analjezi ile ilgili vaka raporlarının gelişmesine yardımcı olarak gelecekteki MMA literatürünü geliştirmeyi amaçlıyoruz. Böylece veteriner hekimlikte multimodal analjezik stratejilerini geliştirmeyi amaçlayan gelecekteki çalışmalara ışık tutuyor.
Yöntemler: Sistematik İncelemeler ve Meta-Analizler için Tercih Edilen Raporlama Öğeleri (PRISMA) Kapsam Belirleme İncelemeleri için Uzantı kılavuzunun ardından, PubMed kullanılarak bir literatür taraması yapıldı. Multimodal analjezi, ağrı yönetimi, kediler ve köpeklerle ilgili arama terimleri Boolean operatörleri kullanılarak birleştirildi. Çalışmaya dahil etme kriterleri, inceleme makalelerini, vaka raporlarını, vaka serilerini ve klinik deneyleri kapsayan, kedi ve köpeklerde akut multimodal analjezi çalışmalarına odaklandı. Dahil edilen çalışmaların temel özelliklerini ve bulgularını analiz etmek için veri çıkarma ve sentez yapıldı.
Bulgular: Literatür taraması sonucunda 63 makale elde edildi. 19 derleme, 10 vaka sunumu ve seri ve 8 orijinal makale olmak üzere 37 makale çalışmaya dahil edildi. Sentez, çeşitli çalışma tasarımları, ilaç kullanımı ve kombinasyonları ile veteriner hekimlikte multimodal analjezinin kullanımına ilişkin giderek büyüyen bir literatür ortaya çıkardı.
Sonuç: Bu kapsamlı inceleme, kedi ve köpeklerde akut ağrı tedavisinde multimodal analjezinin giderek daha fazla benimsendiğini vurgulamaktadır. Etkinliğine ilişkin kanıt tabanı genişlerken, özellikle standartlaştırılmış çalışma tasarımları ve raporlama kılavuzlarıyla ilgili boşlukları ve belirsizlikleri gidermek için daha fazla sistematik araştırmaya ihtiyaç vardır. Multimodal analjezi, tek ağrı giderici yöntemleri geride bırakarak etkili olduğunu kanıtlıyor.

Keywords

Analjezi, Kedi, Köpek, Multimodal Terapi, Multimodal Ağrı Yönetimi

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