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Opioidi kasutus koertel: äge pankreatiit, võõrkeha seedekulglas ja sooletuppumus

Opioid use in dogs: acute pancreatitis, gastrointestinal foreign body and intestinal intussusception
Authors: Edula, Triin;

Opioidi kasutus koertel: äge pankreatiit, võõrkeha seedekulglas ja sooletuppumus

Abstract

Kõige sagedamini pöördutakse koertega esmaabisse seedekulgaga seotud haigusseisundite tõttu. Sageli on kliinilised sümptomid ebamäärased ja võimalikke põhjuseid mitmeid. Esmaabis keskendutakse elutähtsate näitajate stabiliseerimisele. Üheks eluliseks näitajaks peetakse valu, mida saab ravida opioididega, mis kuuluvad kõige tugevamate farmakoloogiliste valuravivõtete hulka. Kahjuks võivad opioidide kasutusega kaasneda ka kõrvaltoimeid. Hetkel ei ole üldtunnustatud konkreetseid ravisoovitusi, kuidas valida opioide teatud seedekulglaga seotud haigusjuhtumi korral. Antud lõputöö on 2019. aasta Eesti Maaülikooli Väikeloomakliiniku andmetele tuginev retrospektiivne uurimustöö. Viimase eesmärgiks on hinnata opioidide kasutust ja valu hindamist esmaabisse pöördunud kolme erineva diagnoosiga (äge pankreatiit, võõrkeha seedekulglas ja sooletuppumine) koertel. Opioidi kasutati üle pooltel esmaabisse pöördnud koertel. Valu hindamiseks kasutati ühemõõtmelist sõnadega kirjeldatavat skaalat. Loomaarstid lähtusid opioidi kasutamise otsusel oma valuhinnangust antud koeral (p<0,001), loomaomanikud aga tihti ei tuvastanud valu. Teadaolevalt on see üks esimesi uurimusi Eestis, mille tulemuste alusel saab järeldada, et loomaomanikud alahindavad koertel ägeda valu esinemist. Kõige rohkem esines valu sooletuppumusega koertel. Tugevat valu märgiti ägeda pankreatiidi korral. Kõige vähem märgiti valutundvateks koeri, kellel oli võõrkeha seedekulglas. Lõpuöö tulemusena selgus, et kõige tõhusam opioid valuvaigistamiseks ägeda pankreatiidi korral on buprenorfiin, võõrkeha esinemisel seedekulglas metadoon ja sooletuppumusega korral fentanüül. Töös kasutatud doosid vastasid tõenduspõhiselt rahvusvahelistele üldistele valuravijuhistele.

The most frequent emergencies in dogs are related to gastrointestinal tract. Clinical signs are frequently non-specific caused by multiple diseases. The focus at the emergency is to stabilize the vital signs, including pain, which can be treated with one of the most effective analgesics, opioids. There are various side effects caused by opioids. At the moment there are no valid guidelines for opioid usage for gastrointestinal emergencies. This study is retrospective, based on the data of the year 2019 in t Small Animal Clinic of the Estonian University of Life Sciences. The aim of this study is to evaluate the use of opioids and pain assessment in dogs with acute pancreatitis, foreign body in gastrointestinal tract and intestinal intussusception. Opioids were used in half of the emergency cases. Pain was assessed using unidimensional verbal descriptive scale. Veterinarians selected an opioid depending on their own pain scoring skills (p<0,001), frequently the pet owners did not identify pain. This is one of the first studies in Estonia, which could conclude, that owners are not sufficiently aware of pain levels of their pets. Pain was the most common with intestinal intussusception, the less with intestinal foreign body. Acute pancreatitis was determined as very painful. As a result of this study, the most effective opioid for pain management with acute pancreatitis was buprenorphine, methadone for gastrointestinal foreign body and fentanyl for intestinal intussusception. Doses used in this study were according to the general international pain management guidelines.

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Estonia
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Keywords

valuvaigistid, valu, seedekulgla, magistritööd, väikeloomad

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selected citations
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This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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