[국내논문]개에서 난소자궁절제술과 난소절제술 후 나타나는 통증 행동과 스트레스 반응의 비교 Comparison of Ovariectomy and Ovariohysterectomy in Terms of Postoperative Pain Behavior and Surgical Stress in Dogs원문보기
본 연구는 개에서 난소자궁절제술과 난소절제술의 실시가 동물의 통증행동과 스트레스에 미치는 영향을 비교하고, 임상적용 가능성을 평가하기 위하여 실시되었다. 13 마리의 건강한 암컷 중 (4.2-5.5 kg) 6 마리의 개에서 난소절제술이 행하여졌고, 7 마리에서 난소자궁절제술이 이루어졌다. 술 후 두 그룹 간에 수술 시간, 마취 시간, 복벽의 절개 길이를 비교하였다. 또한 술 전과 술 후 1, 2, 4, 6, 12, 24 시간째에 Short form of composite measure pain scale (CMPS-SF) 를 사용하여 통증 점수를 측정하였고 혈중 glucose 와 creatine kinase 그리고 cortisol 수치를 측정하였다. 난소자궁절제술을 시행한 그룹에서는 난소절제술을 시행한 그룹에 비해 유의적으로 (p < 0.05) 긴 수술 시간, 마취 시간, 복벽 절개 길이를 나타내었다. Two-way ANOVA test 결과 CMPS-SF에 의한 통증점수가 두 그룹 간에 유의적 (p < 0.05) 차이를 보였으며 술 후 1, 2, 4, 6 시간째 난소절제술을 행한 그룹에서 유의적으로 낮은 수치를 나타내었다. Glucose 의 경우 난소자궁절제술을 행한 그룹에서는 술 전과 비교해 유의적 (p < 0.05) 농도 증가가 술 후 1 시간째에 나타났으나 난소절제술을 행한 그룹에서는 술 후 전체 관찰기간 동안 유의적 농도 증가가 관찰 되지 않았다. Creatine Kinase 의 경우 난소자궁절제술을 행한 그룹에서는 술 전과 비교하여 술 후 1, 2, 4, 6, 12 시간째에 유의적 (p < 0.05) 농도 증가를 나타내었으나 난소절제술 그룹의 경우 술 후 4, 6, 12 시간째에만 술 전과 비교하여 유의적 (p < 0.05) 농도 증가를 나타내었다. Cortisol 의 경우 두 그룹 모두 술 후 1, 2 시간째에 유의적인 (p < 0.05) 농도 상승을 나타내었다. 본 연구 결과 난소절제술을 이용한 암캐의 중성화 수술 방법은 난소자궁절제술에 비해 짧은 복벽 절개, 수술 시간, 마취 시간을 요하며, 적은 술 후 통증과 스트레스를 유발하므로 난소절제술을 시행하는 것이 환자에게 바람직할 것으로 판단된다.
본 연구는 개에서 난소자궁절제술과 난소절제술의 실시가 동물의 통증행동과 스트레스에 미치는 영향을 비교하고, 임상적용 가능성을 평가하기 위하여 실시되었다. 13 마리의 건강한 암컷 중 (4.2-5.5 kg) 6 마리의 개에서 난소절제술이 행하여졌고, 7 마리에서 난소자궁절제술이 이루어졌다. 술 후 두 그룹 간에 수술 시간, 마취 시간, 복벽의 절개 길이를 비교하였다. 또한 술 전과 술 후 1, 2, 4, 6, 12, 24 시간째에 Short form of composite measure pain scale (CMPS-SF) 를 사용하여 통증 점수를 측정하였고 혈중 glucose 와 creatine kinase 그리고 cortisol 수치를 측정하였다. 난소자궁절제술을 시행한 그룹에서는 난소절제술을 시행한 그룹에 비해 유의적으로 (p < 0.05) 긴 수술 시간, 마취 시간, 복벽 절개 길이를 나타내었다. Two-way ANOVA test 결과 CMPS-SF에 의한 통증점수가 두 그룹 간에 유의적 (p < 0.05) 차이를 보였으며 술 후 1, 2, 4, 6 시간째 난소절제술을 행한 그룹에서 유의적으로 낮은 수치를 나타내었다. Glucose 의 경우 난소자궁절제술을 행한 그룹에서는 술 전과 비교해 유의적 (p < 0.05) 농도 증가가 술 후 1 시간째에 나타났으나 난소절제술을 행한 그룹에서는 술 후 전체 관찰기간 동안 유의적 농도 증가가 관찰 되지 않았다. Creatine Kinase 의 경우 난소자궁절제술을 행한 그룹에서는 술 전과 비교하여 술 후 1, 2, 4, 6, 12 시간째에 유의적 (p < 0.05) 농도 증가를 나타내었으나 난소절제술 그룹의 경우 술 후 4, 6, 12 시간째에만 술 전과 비교하여 유의적 (p < 0.05) 농도 증가를 나타내었다. Cortisol 의 경우 두 그룹 모두 술 후 1, 2 시간째에 유의적인 (p < 0.05) 농도 상승을 나타내었다. 본 연구 결과 난소절제술을 이용한 암캐의 중성화 수술 방법은 난소자궁절제술에 비해 짧은 복벽 절개, 수술 시간, 마취 시간을 요하며, 적은 술 후 통증과 스트레스를 유발하므로 난소절제술을 시행하는 것이 환자에게 바람직할 것으로 판단된다.
This study was conducted to evaluate the clinical relevance and effectiveness of ovariectomy (OVE) and ovariohysterectomy (OVH) in terms of postoperative pain behavior and surgical stress. Thirteen healthy intact mongrel purpose-bred female dogs were used in this study. OVE was performed in six dogs...
This study was conducted to evaluate the clinical relevance and effectiveness of ovariectomy (OVE) and ovariohysterectomy (OVH) in terms of postoperative pain behavior and surgical stress. Thirteen healthy intact mongrel purpose-bred female dogs were used in this study. OVE was performed in six dogs whereas OVH was performed in seven dogs. Prior to, 1, 2, 4, 6, 12, and 24 h after surgery, pain assessment was performed by using the Short form of Composite Measure Pain Scale (CMPS-SF) and blood analysis for the determination of glucose, creatine kinase (CK), and cortisol were done. Also, surgical time, duration of anesthesia, and incision length were compared between two groups. As a result, OVH group as opposed to OVE group showed significantly longer in surgical time, duration of anesthesia, and incision length. Also, based on the two-way ANOVA test, the CMPS-SF had significant differences (p < 0.05) between two groups, with the OVE dogs having lower values at 1, 2, 4, and 6 h postoperatively. In addition, in terms of CK, the value at 1, 2, 4, 6, and 12 h were significantly (p < 0.05) increased from the baseline value for the OVH group. However, as for CK in OVE group, the values at 4, 6, and 12 h were significantly increased from the baseline value. As for blood glucose, a significant (p < 0.05) increase from the baseline was shown at 1 h postoperatively in OVH group and no significant increase was shown in OVE group. In terms of serum cortisol level, the values at the 1 and 2 h were significantly (p < 0.05) increased from the baseline value for both groups. In conclusion, our study has shown that OVE can be considered as a superior choice in terms of sterilization technique in female dogs, considering shorter incision length, surgical time, duration of anesthesia along with lower pain and surgical stress response than OVH.
This study was conducted to evaluate the clinical relevance and effectiveness of ovariectomy (OVE) and ovariohysterectomy (OVH) in terms of postoperative pain behavior and surgical stress. Thirteen healthy intact mongrel purpose-bred female dogs were used in this study. OVE was performed in six dogs whereas OVH was performed in seven dogs. Prior to, 1, 2, 4, 6, 12, and 24 h after surgery, pain assessment was performed by using the Short form of Composite Measure Pain Scale (CMPS-SF) and blood analysis for the determination of glucose, creatine kinase (CK), and cortisol were done. Also, surgical time, duration of anesthesia, and incision length were compared between two groups. As a result, OVH group as opposed to OVE group showed significantly longer in surgical time, duration of anesthesia, and incision length. Also, based on the two-way ANOVA test, the CMPS-SF had significant differences (p < 0.05) between two groups, with the OVE dogs having lower values at 1, 2, 4, and 6 h postoperatively. In addition, in terms of CK, the value at 1, 2, 4, 6, and 12 h were significantly (p < 0.05) increased from the baseline value for the OVH group. However, as for CK in OVE group, the values at 4, 6, and 12 h were significantly increased from the baseline value. As for blood glucose, a significant (p < 0.05) increase from the baseline was shown at 1 h postoperatively in OVH group and no significant increase was shown in OVE group. In terms of serum cortisol level, the values at the 1 and 2 h were significantly (p < 0.05) increased from the baseline value for both groups. In conclusion, our study has shown that OVE can be considered as a superior choice in terms of sterilization technique in female dogs, considering shorter incision length, surgical time, duration of anesthesia along with lower pain and surgical stress response than OVH.
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제안 방법
Throughout the study, pre and postoperative pain was evaluated by a blinded observer who was not aware of which surgical procedure has been performed on the testing dogs. The observer used a short form of Glasgow Composite Measurement of Pain Scale (CMPS-SF) to increase the reliability and minimize the subjectivity of the pain scoring systems (26). Prior to the surgery, the pain assessment was done to use it as a baseline.
대상 데이터
Thirteen healthy intact mongrel purpose-bred female dogs (mean ± SD of OVH group, 4.8 ± 0.4 kg; OVE group, 4.4 ± 0.3 kg) were considered for inclusion in this study.
데이터처리
The group means of CMPS-SF and their corresponding 95% confidence intervals at each time point were recorded. A one-way ANOVA for repeated measures was used to compare differences within treatment groups for serum cortisol, CK, and glucose concentrations obtained at various times. If a significant effect was detected, the Dunnett multiple comparison test was used to compare baseline values with values obtained at each subsequent measurement point.
The incision length, and surgical time of two groups of dogs were compared by an unpaired t test. A two-way ANOVA for repeated measures was used to compare the effects of each treatment group and postoperative time on CMPS-SF. The group means of CMPS-SF and their corresponding 95% confidence intervals at each time point were recorded.
이론/모형
A one-way ANOVA for repeated measures was used to compare differences within treatment groups for serum cortisol, CK, and glucose concentrations obtained at various times. If a significant effect was detected, the Dunnett multiple comparison test was used to compare baseline values with values obtained at each subsequent measurement point. Statistical significance was based on a p value of 0.
성능/효과
Although the results of the present study showed statistically significant differences in CMPS-SF scores, the use of other pain assessment method may be necessary because a valid and reliable method for evaluating pain in animals is crucial despite the fact that there is no method for assessing pain that can be defined as “golden standard”.
As such, in this study, to increase the level of objectivity and reliability, all of the measurements were performed by the same observer who remained unaware of the procedures performed (26). In this study, CMPS-SF scores were relatively high in OVH group as opposed to OVE group. In addition, the CMPS-SF scores were shown to be significantly different between groups, which may indicate the presence of more severe pain from the procedure that may involve longer surgery time and incision length.
Since muscle trauma can be related to inflammation and pain, it may also be useful factor in evaluating patients in veterinary medicine (3). In this study, we found significantly increased CK at hour 1, 2, 4, 6, and 12 in OVH group compared to their baseline. On the other hand, we found steadily increased CK at 1 and 2 h which were followed by significantly increased CK at 4, 6, and 12 h in OVE group compared to their baseline.
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