Abstract / Summary
Abstract Background Effective perioperative pain management remains challenging in cats undergoing ovariohysterectomy (OVH), particularly in regions where access to full µ-opioid agonists is limited. Pregabalin has demonstrated analgesic and anxiolytic properties in both human and veterinary medicine, but its clinical efficacy as part of multimodal analgesia in feline OVH has not been established. This study aimed to evaluate the perioperative analgesic efficacy of oral pregabalin combined with butorphanol, dexmedetomidine, and meloxicam in cats undergoing OVH. Method This study evaluated the effects of pregabalin at 5 mg/kg on intraoperative hemodynamic variables and postoperative pain in cats undergoing OVH. Heart rate (HR), systolic blood pressure (SBP), respiratory rate (RR), and isoflurane vaporizer settings were recorded intraoperatively. From 1 to 10 h postoperatively, observer-assessed pain was evaluated using the UNESP-Botucatu Multidimensional Composite Pain Scale (UFEPS) and its short form (UFEPS-SF), while volunteer-perceived pain was assessed using a Visual Analogue Scale (VAS). The need for rescue analgesia and postoperative food intake was also recorded. Results Compared with the butorphanol–dexmedetomidine–meloxicam group (BDM group), cats in the pregabalin–butorphanol–dexmedetomidine–meloxicam (PBDM group) required a significantly lower propofol induction dose and lower isoflurane vaporizer setting, while maintaining more stable intraoperative systolic blood pressure during surgical stimulation ( P < 0.05). UFEPS scores were significantly lower in the PBDM group at all postoperative assessment time points ( P < 0.05), whereas UFEPS-SF scores were significantly lower from 4 to 10 h after extubation ( P < 0.05). The proportion of cats requiring rescue analgesia was significantly reduced ( P < 0.05), and the time to first rescue analgesia was significantly prolonged in the PBDM group (log-rank, P < 0.05). Food intake during the first 10 h after surgery was significantly greater in the PBDM group ( P < 0.05). In addition, volunteer-assessed VAS scores indicated lower subjectively perceived pain in cats receiving pregabalin. Conclusions Oral administration of pregabalin (5 mg/kg) 80 min before anesthesia, as part of a multimodal analgesic protocol including butorphanol, dexmedetomidine, and meloxicam, improved perioperative analgesia, reduced anesthetic requirements, decreased postoperative pain and rescue analgesia requirements, promoted postoperative food intake, and facilitated better recovery outcomes following feline OVH. This multimodal protocol may represent a safe and effective analgesic strategy for feline surgery, particularly in settings where access to full µ-opioid agonists is limited.