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Multimodal analgesia for treatment of allodynia and hyperalgesia after major trauma in a cat

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; h...

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Autores principales: Goich, Mariela, Bascuñán, Alejandra, Faúndez, Patricio, Valdés, Alicia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6582303/
https://www.ncbi.nlm.nih.gov/pubmed/31245022
http://dx.doi.org/10.1177/2055116919855809
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author Goich, Mariela
Bascuñán, Alejandra
Faúndez, Patricio
Valdés, Alicia
author_facet Goich, Mariela
Bascuñán, Alejandra
Faúndez, Patricio
Valdés, Alicia
author_sort Goich, Mariela
collection PubMed
description 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).
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spelling pubmed-65823032019-06-26 Multimodal analgesia for treatment of allodynia and hyperalgesia after major trauma in a cat Goich, Mariela Bascuñán, Alejandra Faúndez, Patricio Valdés, Alicia JFMS Open Rep Case Report 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). SAGE Publications 2019-06-18 /pmc/articles/PMC6582303/ /pubmed/31245022 http://dx.doi.org/10.1177/2055116919855809 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report
Goich, Mariela
Bascuñán, Alejandra
Faúndez, Patricio
Valdés, Alicia
Multimodal analgesia for treatment of allodynia and hyperalgesia after major trauma in a cat
title Multimodal analgesia for treatment of allodynia and hyperalgesia after major trauma in a cat
title_full Multimodal analgesia for treatment of allodynia and hyperalgesia after major trauma in a cat
title_fullStr Multimodal analgesia for treatment of allodynia and hyperalgesia after major trauma in a cat
title_full_unstemmed Multimodal analgesia for treatment of allodynia and hyperalgesia after major trauma in a cat
title_short Multimodal analgesia for treatment of allodynia and hyperalgesia after major trauma in a cat
title_sort multimodal analgesia for treatment of allodynia and hyperalgesia after major trauma in a cat
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6582303/
https://www.ncbi.nlm.nih.gov/pubmed/31245022
http://dx.doi.org/10.1177/2055116919855809
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