BEVA primary care clinical guidelines: Analgesia

Area of Science:

• Veterinary Medicine
• Animal Pain Management
• Pharmacology

Background:

• Primary care guidelines are essential for evidence-based veterinary practice.
• A modified GRADE framework (vetGRADE) was developed for assessing equine analgesic research.
• Clinical scenarios involving equine analgesia were evaluated.

Purpose of the Study:

• To provide evidence-based guidelines for equine pain management.
• To assess the efficacy and safety of various analgesic agents in horses.
• To inform clinical decision-making for common equine procedures and conditions.

Main Methods:

• Systematic literature review and expert clinical opinion.
• Application of the vetGRADE framework to assess evidence certainty.
• Evaluation of analgesic protocols for castration, laminitis, joint pain, and colic.

Main Results:

• Intratesticular local anesthesia and pre-operative NSAIDs are recommended for castration (high certainty).
• Butorphanol and buprenorphine are not recommended as sole analgesics for castration (high certainty).
• Phenylbutazone showed superior analgesia for hoof pain compared to meloxicam and firocoxib (moderate certainty).
• Flunixin and firocoxib are more effective for colic pain than meloxicam or phenylbutazone (moderate certainty).

Conclusions:

• Analgesia should continue for 3 days post-castration (moderate certainty).
• All analgesics require veterinary supervision due to potential adverse events.
• A validated composite pain score for horses is needed for robust medication comparison.