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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: What is the main finding and its importance?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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fig03: 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.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4340041&req=5

fig03: 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: What is the main finding and its importance?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