Efficacy of tramadol for postoperative pain management in dogs: systematic review and meta-analysis

Donati, Pablo; Tarragona, Lisa; Franco, Juan Víctor Ariel; Kreil, V.; Fravega, Rodrigo; Díaz, Alcira Ofélia; Verdier, Natalí; Otero, Pablo E.

doi:10.1016/j.vaa.2021.01.003

Cited by 16 publications

(15 citation statements)

References 36 publications

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“…However, tramadol was used most frequently in the present study, possibly due to its non-narcotic properties and the fact that it is legally available and widely used in the Korean veterinary community. Nonetheless, there are some controversies regarding the efficacy of tramadol in dogs [ 33 ]. As snakebites are usually associated with pain [ 3 11 25 ], warranted analgesics should be used.…”

Section: Discussionmentioning

confidence: 99%

Clinical features and management of snake bites in 70 dogs in Korea

Kim

Kim²,

Kim³

et al. 2022

J Vet Sci

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Background Snakebites remain a devastating and life-threatening environmental hazard. While the management of snakebites has been well described in humans, few clinical data and guidelines exist for dogs, especially in Korea. Objectives This retrospective study evaluated the clinical features of 70 dogs with snakebite wounds in Korea. Methods The medical records of 72 dogs that presented to three animal hospitals from June 2008 to July 2021 were reviewed; among these, 70 dogs that met the inclusion criteria were enrolled. Their signalment, history, clinical signs, physical examination, blood analysis, treatment, and prognosis were also evaluated. Results Of 70 dog owners, 35 (50%) witnessed the bite, with a mean time between bite and hospital presentation of 9.7 ± 4.1 h in 58 dogs. Blood smears were evaluated in 45 dogs, of which 28 (62%) showed echinocytosis. Anemia and acute kidney injury were found in 21 (29%) and 2 dogs (3%), respectively. A total of 37 dogs (53%) were hospitalized, 5 (7%) of which died. Conclusions The most significant finding was the high prevalence of echinocytosis. The data from this retrospective study could inform the management of dogs bitten by snakes in Korea.

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Section: Discussionmentioning

confidence: 99%

Clinical features and management of snake bites in 70 dogs in Korea

Kim

Kim²,

Kim³

et al. 2022

J Vet Sci

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“…[27][28][29] NSAIDs were of interest because: (1) inflammation plays an important role in cancer progression; 30 (2) longterm NSAID use may alter the biology of some tumours; 31 (3) perioperative NSAID administration may be associated with lower risk of local recurrence, delayed metastasis and/or prolonged survival for certain human cancers; [32][33][34] and (4) for dogs, NSAIDs provide more predictable and potent postoperative analgesia as compared with other drugs that are suitable for outpatient use (e.g.,tramadol, gabapentin, and amantadine). [35][36][37][38] Perhaps due to small effect size, or because there simply may have been no biological difference to measure, we identified no significant associations between survival and either local anaesthetic usage, or postoperative administration of NSAIDs when assessed separately.…”

Section: Discussionmentioning

confidence: 76%

Intensity of perioperative analgesia but not pre‐treatment pain is predictive of survival in dogs undergoing amputation plus chemotherapy for extremity osteosarcoma

Nolan

Uzan

Green

et al. 2022

Vet Comparative Oncology

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The purpose of this bi‐institutional retrospective study was to determine whether, in dogs treated with limb amputation and adjunctive chemotherapy for osteosarcoma, oncologic outcomes are impacted by either: (1) baseline cancer pain severity, or (2) the approaches used for perioperative pain management. Data were extracted from the medical records of 284 dogs that underwent both limb amputation and chemotherapy (carboplatin and/or doxorubicin) between 1997 and 2017 for localized (non‐metastatic) osteosarcoma of the appendicular skeleton. Kaplan–Meier survival curves and Cox proportional hazard (PH) models were used to determine the impact that retrospectively scored baseline pain levels (high vs. low) and various analgesic and local anaesthetic treatments had on both metastasis‐free survival and all‐cause mortality. For the entire population, the median disease free interval and median overall survival times were 253 and 284 days, respectively. Baseline pain was rated as “low” in 84 dogs, and “high” in 190 dogs; pain severity had no detectable effect on either metastasis‐free survival or all‐cause mortality. When accounting for the potential influences of known prognostic factors, dogs treated with what was characterized as a high‐intensity perioperative analgesic plan (including both a non‐steroidal anti‐inflammatory drug [NSAID] and a bupivacaine‐eluting soaker catheter placed at the amputation site) had a higher probability of survival than dogs treated with a low‐intensity perioperative analgesic plan (neither an NSAID, nor a soaker catheter); the median overall survival times were 252 and 378 days, respectively (hazard ratio: 2.922; p = .020).

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“…In dogs, the subtherapeutic concentration of M1, given the abundance and type of liver enzymes necessary for its metabolization [ 48 ], implies that tramadol monotherapy is unlikely to have meaningful benefits for pain control in this species [ 51 ]. A recent meta-analysis published by Donati et al [ 54 ] documented a substantially low certainty of the evidence in terms of its analgesic action for managing postoperative pain. However, the results of multiple studies using the surgical model of ovariohysterectomy (OVH) in bitches, a procedure where tramadol is commonly administered during the perioperative period or as rescue analgesia [ 55 ], revealed divergent conclusions.…”

Section: Therapeutic Efficacy Of Tramadol In Dogsmentioning

confidence: 99%

Clinical pharmacology of tramadol and tapentadol, and their therapeutic efficacy in different models of acute and chronic pain in dogs and cats

Domínguez-Oliva¹,

Casas-Alvarado²,

Miranda-Cortés³

et al. 2021

J Adv Vet Anim Res

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Opioids are considered the gold standard to manage acute or chronic or mild to severe pain. Tramadol is a widely prescribed analgesic drug for dogs and cats; it has a synthetic partial agonism on μ-opioid receptors and inhibits the reuptake of norepinephrine and serotonin. However, the biotransformation and resultant metabolites differ between species and depend on cytochrome P450 interactions. Dogs mainly produce the inactive N-desmethyl tramadol metabolite, whereas cats exhibit an improved antinociceptive effect owing to rapid active O-desmethyltramadol metabolite production and a longer elimination half-life. Tapentadol, a novel opioid with dual action on μ-receptors and noradrenaline reuptake inhibitory activity, is a promising option in dogs, as it is less reliant on metabolic activation and is unaffected by cytochrome polymorphisms. Although scientific evidence on the analgesic activity of tapentadol in both species remains limited, experimental studies indicate potential benefits in animals. This review summarizes and compares the pharmacology, pharmacokinetics, and therapeutic efficacy of tramadol and tapentadol in dogs and cats with different pain conditions. According to the available data, tramadol seems a more suitable therapeutic option for cats and should preferably be used as a component of multimodal analgesia in both species, particularly dogs. Tapentadol might possess a superior analgesic profile in small animals, but additional studies are required to comprehensively evaluate the activity of this opioid to manage pain in dogs and cats.

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Efficacy of tramadol for postoperative pain management in dogs: systematic review and meta-analysis

Cited by 16 publications

References 36 publications

Clinical features and management of snake bites in 70 dogs in Korea

Clinical features and management of snake bites in 70 dogs in Korea

Intensity of perioperative analgesia but not pre‐treatment pain is predictive of survival in dogs undergoing amputation plus chemotherapy for extremity osteosarcoma

Clinical pharmacology of tramadol and tapentadol, and their therapeutic efficacy in different models of acute and chronic pain in dogs and cats

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