Comparative study of the effects of tramadol, codeine, ketoprofen and combinations on postoperative pain and on levels of blood glucose, serum cortisol and interleukin-6 in dogs undergoing maxillectomy and mandibulectomy

Although there are many clinical studies evaluating analgesics and pain control in dogs, very few were carried out in animals with cancer pain, and submitted to oncologic surgery with tumor resections such as maxillectomy and mandibulectomy. This clinical, prospective, randomized, simple blinded study was performed with the purpose of evaluating analgesic efficacy of different treatments in the postoperative period in dogs submitted to maxillectomy or mandibulectomy. Forty-two client-owned dogs with oral tumor were used in the study. Dogs were premedicated with acepromazine (0.05mg kg-1) and meperidine (2mg kg-1) by the intramuscular route and anesthesia was induced with intravenous propofol in a dose sufficient to allow intubation (2.3-6.5mg-1). Isoflurane was used for maintenance of anesthesia. Thirty minutes prior to the end of surgery, dogs were randomly allocated in one of 5 different groups for postoperative analgesia: tramadol 2mg kg-1 (Tra), codeine 2mg kg-1 (Co), ketoprofen 2mg kg-1 (Ke), tramadol 2mg kg-1 + ketoprofen 2mg kg-1 (TraKe) or codeine 2mg kg-1 + ketoprofen 2mg kg-1 (CoKe), subcutaneously. Heart (HR) and respiratory (RR) rates, systolic (SBP), median (MBP) and diastolic (DBP) blood pressures, blood glucose, serum cortisol and interleukin-6 (IL-6) and degree of sedation were recorded for 24 hours, and degree of analgesia were evaluated until 120 hours of the start of analgesic administration (MBL, M1, M2, M3, M4, M5, M24, M48, M72, M96 and M120), being that treatments were maintained for 5 days as follows: codeine or tramadol every 8 hours and the ketoprofen every 24 hours orally. Analgesic rescue was delivered to animals with pain scores equal or superior to 4 at any time of the study (dypirone 25mg -1 and morphine 0,1mg-1). Statistical analyses were performed by means of the Kruskal-Wallis, Friedmann for repeated measures, ANOVA and 2 tests. Graphics boxplot or box diagrams represents dates of distribution. Values of p<0.05 were...