Analgesie bei viszeralen Schmerzen – Was hilft wann und wie lange?

Die Behandlung von Kolikern ist Routine in der Pferdepraxis, bringt jedoch mit jedem Patienten auch immer wieder offene Fragen mit sich. Welche Schmerzmedikation bietet sich bei diesem Fall an, kann ich beispielsweise Flunixin-Meglumin geben, obwohl ich noch keine Diagnose gestellt habe? Bringen Sie sich auf einen aktuellen Wissensstand rund um die Analgesie bei viszeralen Schmerzen.

• Literatur

• 1 Bennett RC, Steffey EP. Use of opioids for pain and anesthetic management in horses. Vet Clin North Am Equine Pract 2002; 18: 47-60
• 2 Boatwright CE, Fubini SL, Grohn YT. et al. A comparison of N-butylscopolammonium bromide and butorphanol tartrate for analgesia using a balloon model of abdominal pain in ponies. Can J Vet Res 1996; 60: 65-68
• 3 Brunson DB, Majors LJ. Comparative analgesia of xylazine, xylazine/morphine, xylazine/butorphanol, and xylazine/nalbuphine in the horse, using dental dolorimetry. Am J Vet Res 1987; 48: 1087-1091
• 4 Clark ES, Thompson SA, Becht JL. et al. Effects of xylazine on cecal mechanical activity and cecal blood flow in healthy horses. Am J Vet Res 1988; 49: 720-723
• 5 Clarke KW, Taylor PM. Detomidine: a new sedative for horses. Equine Vet J 1986; 18: 366-370
• 6 Cook VL, Blikslager AT. Use of systemically administered lidocaine in horses with gastrointestinal tract disease. J Am Vet Med Assoc 2008; 232: 1144-1148
• 7 Cook VL, Meyer CT, Campbell NB. et al. Effect of firocoxib or flunixin meglumine on recovery of ischemic-injured equine jejunum. Am J Vet Res 2009; 70: 992-1000
• 8 Doherty TJ, Andrews FM, Provenza MK. et al. The effect of sedation on gastric emptying of a liquid marker in ponies. Vet Surg 1999; 28: 375-379
• 9 Dönselmann im Sande P, Hopster K, Kästner S. Effects of morphine, butorphanol and levomethadone in different doses on thermal nociceptive thresholds in horses. Tierarztl Prax Ausg G Grosstiere Nutztiere 2017; 45: 98-106
• 10 Elfenbein JR, Sanchez LC, Robertson SA. et al. Effect of detomidine on visceral and somatic nociception and duodenal motility in conscious adult horses. Vet Anaesth Analg 2009; 36: 162-172
• 11 Kalpravidh M, Lumb WV, Wright M. et al. Effects of butorphanol, flunixin, levorphanol, morphine, and xylazine in ponies. Am J Vet Res 1984; 45: 217-223
• 12 Little D, Brown SA, Campbell NB. et al. Effects of the cyclooxygenase inhibitor meloxicam on recovery of ischemia-injured equine jejunum. Am J Vet Res 2007; 68: 614-624
• 13 MacAllister CG, Morgan SJ, Borne AT. et al. Comparison of adverse effects of phenylbutazone, flunixin meglumine, and ketoprofen in horses. J Am Vet Med Assoc 1993; 202: 71-77
• 14 Mair T, Divers T, Ducharme N. Etiology, risk factors, and pathophysiology of colic. In: Mair T, Divers T, Ducharme N. eds. Manual of equine gastroenterology. London: WB Saunders; 2002: 101-106
• 15 Milligan M, Beard W, Kukanich B. et al. The effect of lidocaine on postoperative jejunal motility in normal horses. Vet Surg 2007; 36: 214-220
• 16 Morton AJ, Varney CR, Ekiri AB. et al. Cardiovascular effects of N-butylscopolammonium bromide and xylazine in horses. Equine Vet J Suppl 2011; 39: 117-122
• 17 Nassini R, Fusi C, Materazzi S. et al. The TRPA1 channel mediates the analgesic action of dipyrone and pyrazolone derivatives. Br J Pharmacol 2015; 172: 3397-3411
• 18 Naylor RJ, Taylor AH, Knowles EJ. et al. Comparison of flunixin meglumine and meloxicam for post operative management of horses with strangulating small intestinal lesions. Equine Vet J 2014; 46: 427-434
• 19 Pierre SC, Schmidt R, Brenneis C. et al. Inhibition of cyclooxygenases by dipyrone. British journal of pharmacology 2007; 151: 494-503
• 20 Pritchett LC, Ulibarri C, Robertson MC. et al. Identification of potential physiological and behavioral indicators of post-operative pain in horses after exploratory celiotomy for colic. Appl Anim Behav Sci 2003; 80: 31-43
• 21 Sanchez LC, Merritt AM. Colorectal distention in the horse: visceral sensitivity, rectal compliance and effect of i.v. xylazine or intrarectal lidocaine. Equine Vet J 2005; 37: 70-74
• 22 Schoofs N, Riemer T, Bald LK. et al. [Methadone and levomethadone – dosage and side effects]. Psychiatr Prax 2014; 41: 82-87
• 23 Sellon DC, Roberts MC, Blikslager AT. et al. Effects of continuous rate intravenous infusion of butorphanol on physiologic and outcome variables in horses after celiotomy. J Vet Intern Med 2004; 18: 555-563
• 24 Tomlinson JE, Blikslager AT. Effects of cyclooxygenase inhibitors flunixin and deracoxib on permeability of ischaemic-injured equine jejunum. Equine Vet J 2005; 37: 75-80
• 25 Van Hoogmoed LM, Nieto JE, Snyder JR. et al. Survey of prokinetic use in horses with gastrointestinal injury. Vet Surg, 2004; 33: 279-285
• 26 VanDierendonck MC, van Loon P. Monitoring acute equine visceral pain with the Equine Utrecht University Scale for Composite Pain Assessment (EQUUS-COMPASS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP): A validation study. Vet J, 2016; 216: 175-177