*Ignacio Alvarez Gómez de Segura, José Ramón García, Ramón Esteban, Ignacio Cabello, Antonio García Cantalapiedra, Jordi Manubens
During the last decade the importance of adequate analgesia in the veterinary field has increased, accompanied with a better understanding of the consequences of pain and the development of newer, more efficacious analgesics. These changes can be observed in surveys from North American and UK veterinarians in the nineties. However, the opinion of Spanish professionals is relatively unknown and might justify informational campaigns in pain therapy in this country. The aim was to assess the attitudes of Spanish veterinarians to pain in surgical patients and compare them to other countries where similar enquires have been performed.
In 2001 a questionnaire was sent to 1,204 practicing veterinarians in charge of small animal clinics to assess their attitudes to postoperative pain in dogs and cats. The questionnaire was designed to be completed within 10 minutes to facilitate responses and included two sets of questions. The first set included anonymously personal data (age, sex, etc). The second included the drugs used to provide analgesia, pain assessment in common types of surgery and their treatment of pain.
A response rate of 23% (n=274) was obtained. Most veterinarians (67%) were aged between 31 and 40 years old and only 2% were over 50 years old. According to their answers, all vets (100%) use non-steroidal anti-inflammatory drugs (NSAID) in their practice and 88% opioids, mainly newer drugs with low-to-moderate analgesic potency like buprenorphine or butorphanol. Potent opioids were not widely employed, despite the importance given to their analgesic potency by respondents. Preoperatively, 66% of the respondents gave an opioid alone and 15% combined with a NSAID. Most veterinarians (91%) use analgesics in the postoperative period although some (7%) still do not. Accordingly, most vets agreed that analgesics were advisable (83%) and provided better recovery from surgery (88%) for both dogs and cats. However, discrepancies arose when determining the need for analgesics by species, where the number of respondents not giving analgesics to cats was double that for dogs for most surgeries except for most painful procedures analysed, i.e., orthopaedic surgery. Pain score was as follows (1 lowest, 5 highest): orthopaedic (4.7) > Abdominal (3.9) > ovariohysterectomy (3.7) > Dental extraction (3.3) > Orquiectomy (2.9). Duration of the analgesic therapy in the postoperative period correlated with pain score.
Most veterinarians have incorporated relatively newer drugs to their therapeutic arsenal, and these are widely employed to alleviate perioperative pain. However some veterinarians are still reluctant to use them, but generally speaking, the attitudes of Spanish veterinarians are like those reported in other developed countries in recent years. Preemptive analgesia is becoming common among veterinarians although polymodal analgesia is more rarely employed. Most veterinarians are highly sensitive to pain in their patients. Nevertheless, further studies should determine whether this data accurately corresponds to the Spanish veterinary population or only reflects the veterinarians who are more sensitive to pain in their patients.