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Refinement of analgesia following thoracotomy and experimental myocardial infarction using the Mouse Grimace Scale.

Faller KM, McAndrew DJ, Schneider JE, Lygate CA - Exp. Physiol. (2015)

Bottom Line: Low-level pain, responsive to analgesia, was detected by MGS but not standard methods.The MGS was scored from multiple photographs by two independent blinded observers with good correlation (r = 0.98).In conclusion, the use of a multi-observer, post hoc version of the MGS is a sensitive tool to assess the efficacy of postsurgical analgesic protocols.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiovascular Medicine, Radcliffe Department of Medicine, British Heart Foundation Centre of Research Excellence and Wellcome Trust Centre for Human Genetics, University of Oxford, UK; School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK.

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Effect of buprenorphine analgesia on pain assessed at 24 h postsurgeryAssessments were made before and 30 min after s.c. injection using the following three methods: a welfare scoring sheet (Aa, Ab and Ac); the average MGS score of two blinded observers (Ba, Bb and Bc); and the mode of the MGS score to represent a single ‘on‐the‐spot’ examination (Ca, Cb and Cc). All scoring systems identified a significant improvement following administration of analgesia when all mice (n = 13) were analysed together (Aa, Ba and Ca) or when only mice readily identifiable as ‘in pain’ were included (n = 7), i.e. welfare score ≥3 (Ab, Bb and Cb). However, only the average MGS method detected an improvement in mice that were otherwise not considered in pain (n = 6), i.e. welfare score <3 (Ac, Bc and Cc). All data were analysed using a Wilcoxon matched pairs signed rank test. ‘n.s.’ denotes non‐significant; *P < 0.05 and **P < 0.01. For all graphs, the single points represent single mice, unless otherwise stated. The bars are means ± 95% confidence intervals.
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eph1572-fig-0003: Effect of buprenorphine analgesia on pain assessed at 24 h postsurgeryAssessments were made before and 30 min after s.c. injection using the following three methods: a welfare scoring sheet (Aa, Ab and Ac); the average MGS score of two blinded observers (Ba, Bb and Bc); and the mode of the MGS score to represent a single ‘on‐the‐spot’ examination (Ca, Cb and Cc). All scoring systems identified a significant improvement following administration of analgesia when all mice (n = 13) were analysed together (Aa, Ba and Ca) or when only mice readily identifiable as ‘in pain’ were included (n = 7), i.e. welfare score ≥3 (Ab, Bb and Cb). However, only the average MGS method detected an improvement in mice that were otherwise not considered in pain (n = 6), i.e. welfare score <3 (Ac, Bc and Cc). All data were analysed using a Wilcoxon matched pairs signed rank test. ‘n.s.’ denotes non‐significant; *P < 0.05 and **P < 0.01. For all graphs, the single points represent single mice, unless otherwise stated. The bars are means ± 95% confidence intervals.

Mentions: Mice were compared before and 30 min after administration of buprenorphine, which was given regardless of clinical need. Analysis of all mice showed a significant improvement in scores regardless of the assessment system. The average welfare score decreased by 33% (Fig. 3Aa) and the average MGS score by 40% (P = 0.003; Fig. 3Ba). Subgroup analysis showed that this was driven mainly by improvements in mice that were deemed to be ‘in pain’ prior to analgesia (Fig. 3Ab and Bb). Mice ‘not in pain’ did not show any benefit from analgesia when scored using the welfare system (Fig. 3Ac), but the same mice improved significantly when assessed by MGS (average decrease of 48%, P = 0.04; Fig. 3Bc). This suggests that the low‐level pain detected by this type of MGS is real, because it is treatable by analgesia. More typically, the MGS would be scored by a single observer in real time as an on‐the‐spot pain assessment tool, and to simulate these conditions we re‐analysed our data using the mode of the observers’ scores. In these conditions, an improvement was observed only in mice that were previously identified as ‘in pain’ (Fig. 3Ca and Cb), and the technique was not sensitive enough to identify an improvement in the ‘not in pain’ group (Fig. 3Cc).


Refinement of analgesia following thoracotomy and experimental myocardial infarction using the Mouse Grimace Scale.

Faller KM, McAndrew DJ, Schneider JE, Lygate CA - Exp. Physiol. (2015)

Effect of buprenorphine analgesia on pain assessed at 24 h postsurgeryAssessments were made before and 30 min after s.c. injection using the following three methods: a welfare scoring sheet (Aa, Ab and Ac); the average MGS score of two blinded observers (Ba, Bb and Bc); and the mode of the MGS score to represent a single ‘on‐the‐spot’ examination (Ca, Cb and Cc). All scoring systems identified a significant improvement following administration of analgesia when all mice (n = 13) were analysed together (Aa, Ba and Ca) or when only mice readily identifiable as ‘in pain’ were included (n = 7), i.e. welfare score ≥3 (Ab, Bb and Cb). However, only the average MGS method detected an improvement in mice that were otherwise not considered in pain (n = 6), i.e. welfare score <3 (Ac, Bc and Cc). All data were analysed using a Wilcoxon matched pairs signed rank test. ‘n.s.’ denotes non‐significant; *P < 0.05 and **P < 0.01. For all graphs, the single points represent single mice, unless otherwise stated. The bars are means ± 95% confidence intervals.
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eph1572-fig-0003: Effect of buprenorphine analgesia on pain assessed at 24 h postsurgeryAssessments were made before and 30 min after s.c. injection using the following three methods: a welfare scoring sheet (Aa, Ab and Ac); the average MGS score of two blinded observers (Ba, Bb and Bc); and the mode of the MGS score to represent a single ‘on‐the‐spot’ examination (Ca, Cb and Cc). All scoring systems identified a significant improvement following administration of analgesia when all mice (n = 13) were analysed together (Aa, Ba and Ca) or when only mice readily identifiable as ‘in pain’ were included (n = 7), i.e. welfare score ≥3 (Ab, Bb and Cb). However, only the average MGS method detected an improvement in mice that were otherwise not considered in pain (n = 6), i.e. welfare score <3 (Ac, Bc and Cc). All data were analysed using a Wilcoxon matched pairs signed rank test. ‘n.s.’ denotes non‐significant; *P < 0.05 and **P < 0.01. For all graphs, the single points represent single mice, unless otherwise stated. The bars are means ± 95% confidence intervals.
Mentions: Mice were compared before and 30 min after administration of buprenorphine, which was given regardless of clinical need. Analysis of all mice showed a significant improvement in scores regardless of the assessment system. The average welfare score decreased by 33% (Fig. 3Aa) and the average MGS score by 40% (P = 0.003; Fig. 3Ba). Subgroup analysis showed that this was driven mainly by improvements in mice that were deemed to be ‘in pain’ prior to analgesia (Fig. 3Ab and Bb). Mice ‘not in pain’ did not show any benefit from analgesia when scored using the welfare system (Fig. 3Ac), but the same mice improved significantly when assessed by MGS (average decrease of 48%, P = 0.04; Fig. 3Bc). This suggests that the low‐level pain detected by this type of MGS is real, because it is treatable by analgesia. More typically, the MGS would be scored by a single observer in real time as an on‐the‐spot pain assessment tool, and to simulate these conditions we re‐analysed our data using the mode of the observers’ scores. In these conditions, an improvement was observed only in mice that were previously identified as ‘in pain’ (Fig. 3Ca and Cb), and the technique was not sensitive enough to identify an improvement in the ‘not in pain’ group (Fig. 3Cc).

Bottom Line: Low-level pain, responsive to analgesia, was detected by MGS but not standard methods.The MGS was scored from multiple photographs by two independent blinded observers with good correlation (r = 0.98).In conclusion, the use of a multi-observer, post hoc version of the MGS is a sensitive tool to assess the efficacy of postsurgical analgesic protocols.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiovascular Medicine, Radcliffe Department of Medicine, British Heart Foundation Centre of Research Excellence and Wellcome Trust Centre for Human Genetics, University of Oxford, UK; School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK.

Show MeSH
Related in: MedlinePlus