human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To evaluate the sedative and analgesic effects of intramuscular buprenorphine with either dexmedetomidine or acepromazine , administered as premedication to cats and dogs undergoing elective surgery . STUDY DESIGN Prospect i ve , r and omized , blinded clinical study . ANIMALS Forty dogs and 48 cats . METHODS Animals were assigned to one of four groups , according to anaesthetic premedication and induction agent : buprenorphine 20 μg kg(-1 ) with either dexmedetomidine ( dex ) 250 μg m(-2 ) or acepromazine ( acp ) 0.03 mg kg(-1 ) , followed by alfaxalone ( ALF ) or propofol ( PRO ) . Meloxicam was administered preoperatively to all animals and anaesthesia was always maintained using isoflurane . Physiological measures and assessment s of pain , sedation and mechanical nociceptive threshold ( MNT ) were made before and after premedication , intraoperatively , and for up to 24 hours after premedication . Data were analyzed with one-way , two-way and mixed between-within subjects anova , Kruskall-Wallis analyses and Chi squared tests . Results were deemed significant if p ≤ 0.05 , except where multiple comparisons were performed ( p ≤ 0.005 ) . RESULTS Cats premedicated with dex were more se date d than cats premedicated with acp ( p < 0.001 ) and ALF doses were lower in dex cats ( 1.2 ± 1.0 mg kg(-1 ) ) than acp cats ( 2.5 ± 1.9 mg kg(-1 ) ) ( p = 0.041 ) . There were no differences in sedation in dogs however PRO doses were lower in dex dogs ( 1.5 ± 0.8 mg kg(-1 ) ) compared to acp dogs ( 3.3 ± 1.1 mg kg(-1 ) ) ( p < 0.001 ) . There were no differences between groups with respect to pain scores or MNT for cats or dogs . CONCLUSION Choice of dex or acp , when given with buprenorphine , caused minor , clinical ly detectable , differences in various characteristics of anaesthesia , but not in the level of analgesia . CLINICAL RELEVANCE A combination of buprenorphine with either acp or dex , followed by either PRO or ALF , and then isoflurane , accompanied by an NSAID , was suitable for anaesthesia in dogs and cats undergoing elective surgery . Choice of sedative agent may influence dose of anaesthetic induction agent OBJECTIVE To evaluate the sedative and antinociceptive effects of combinations of dexmedetomidine and buprenorphine in cats . STUDY DESIGN Experimental r and omized study . ANIMALS Twelve purpose -bred neutered domestic short-hair cats ( 4 male and 8 female ) weighing 4.6 kg ( range 3.7 - 5.5 kg ) aged from 2 to 5 years . METHODS Six cats per group were administered buprenorphine ( B ) at 10 ( B10 ) or 20 microg kg(-1 ) ( B20 ) or dexmedetomidine ( D ) at 20 ( D20 ) or 40 microg kg(-1 ) ( D40 ) or a combination of B10/D20 . A feline thermal nociceptive threshold testing device was used to evaluate the antinociceptive effects of the drugs before and up to 24 hours after drug treatment . Sedation was scored using a 100 mm visual analogue scale ( VAS ) . RESULTS Thermal thresholds increased significantly after administration of all but D20 . Area under the curve ( AUC , hours degrees C ) for the first 6 hours ( mean + /- SD ) for B20 ( 281 + /- 17.8 ) was significantly greater than B10 ( 260 + /- 11.4 ) , D20 ( 250 + /- 7.9 ) and D40 ( 255 + /- 11.4 ) . The AUC for B10/D20 ( 273 + /- 12.2 ) was significantly greater than D20 but not the other treatments . No sedation was seen after administration of B10 or B20 and maximal sedation was seen for all animals in the D40 and B10/D20 groups and most animals in the D20 group . CONCLUSIONS D20 alone had the smallest analgesic effect ; B10 alone provided no sedation but their combination gave good sedation with analgesia comparable with B20 . CLINICAL RELEVANCE This combination could be a useful multimodal sedative/analgesic regimen in cats BACKGROUND There are no vali date d systems for measuring pain from osteoarthritis in cats . HYPOTHESIS Owner subjective assessment s and an activity monitor ( AM ) can be used to detect pain in cats with osteoarthritis and to assess efficacy of treatments . ANIMALS Thirteen cats older than 10 years old , with owner-assessed decreases in activity , painful arthritic joints , and clinical ly normal blood work were included and evaluated for 3 weeks . METHODS A collar-mounted AM measured activity and a client-specific outcome measure ( CSOM ) question naire characterized the severity of impairment . Overall global quality of life was also evaluated for each treatment . In weeks 2 and 3 , meloxicam ( 0.1 mg/kg , day 1 ; 0.05 mg/kg , days 2 - 5 ) or a placebo was administered in a blinded , r and omized , cross-over manner to test the assessment systems . RESULTS The cats had a median of 4 arthritic appendicular joints .  Activity counts for the week when cats ( complete data on activity ; n=9 ) were administered meloxicam were significantly higher than at baseline ( P = .02 ) but not after placebo ( P = .06 ) . Baseline activity counts were not significantly different from placebo ( P = .6 ) . The CSOM data ( n=13 ) showed that owners considered their cats to be more active on meloxicam compared with baseline ( P = .001 ) and placebo ( P < .004 ) , and more active on placebo than at baseline ( P < .01 ) . Global quality of life improved significantly with meloxicam ( P < .042 ) . CONCLUSIONS AND CLINICAL IMPORTANCE Both an AM and a CSOM system can detect behavior associated with pain relief in cats that are arthritic . Objective activity data might allow subjective assessment systems to be vali date d for use in clinical studies OBJECTIVE To evaluate the ability of various subjective and objective measurements to determine the presence and degree of postoperative pain in cats . DESIGN R and omized controlled prospect i ve clinical study . ANIMALS 18 healthy client-owned cats . PROCEDURE Cats were r and omly assigned to 3 groups of 6 : control , tenectomy , and onychectomy . Jugular catheters were placed the day prior to surgery . All surgeries were performed by the same surgeon , and all observations were made by the same blinded trained observer . One hour prior to surgery and at assigned intervals for 36 hours after surgery , heart rate , respiratory rate , and rectal temperature were measured . Scores were assigned for 3 interaction responses , including response to palpation , by use of simple descriptive scales , and to 2 pain assessment s by use of visual analogue scales . Blood was collected to measure plasma beta-endorphin and cortisol concentrations .  Butorphanol was administered to all cats before surgery and to any cat subjectively assessed to be experiencing pain after surgery . RESULTS Only visual analogue scale scores and response to palpation scores differed significantly between control and surgical groups . CONCLUSIONS AND CLINICAL RELEVANCE Determination of the presence of pain in cats can be made on the basis of observation and interaction by a trained observer . Physiologic measurements , including plasma cortisol and beta-endorphin concentrations , did not differentiate between control cats and cats that underwent surgery OBJECTIVE To evaluate the clinical efficacy of dexmedetomidine as a preanesthetic medication administered prior to anesthetic induction with ketamine or propofol and with or without isoflurane for maintenance of anesthesia . DESIGN R and omized , blinded , controlled clinical trial . ANIMALS 184 client-owned cats . PROCEDURES Cats requiring general anesthesia for short or long procedures were assigned to receive 1 of 4 preanesthetic and induction drug combinations ( dexmedetomidine and ketamine , placebo [ saline { 0.9 % NaCl } solution ] and ketamine , dexmedetomidine and propofol , or placebo and propofol ) . Cats undergoing long procedures received isoflurane for maintenance of anesthesia . RESULTS Administration of dexmedetomidine prior to anesthetic induction with ketamine significantly increased the intubation success rate ( 57/64 [ 89 % ] ) , compared with the success rate for the placebo ( 4/37 [ 11 % ] ) ; significantly reduced the median induction dose of propofol ( ≤ 5.1 mg/kg [ 2.32 mg/lb ] ) , compared with that for the placebo ( ≤ 10.5 mg/kg [ 4.77 mg/lb ] ) ; and significantly reduced the isoflurane concentration ( 1.5 % ) required for anesthesia maintenance , compared with that for the placebo ( 3.0 % ) . Postoperatively , fewer cats receiving dexmedetomidine  required rescue analgesia , and cats had lower pain scores for at least 2 hours after surgery , compared with results for cats receiving the  placebo . Heart rate was lower during the procedure and respiratory rate and rectal temperature were lower during and after the procedure for cats receiving dexmedetomidine . More cats that received dexmedetomidine  had emesis and pale mucous membranes , compared with the number of cats with those signs that received placebo . CONCLUSIONS AND CLINICAL RELEVANCE Dexmedetomidine as a preanesthetic was efficacious for clinical use in cats requiring general anesthesia The objective of this study was to evaluate the efficacy and tolerability of robenacoxib , a selective cyclooxygenase-2 inhibitor , for the treatment of post-operative pain and inflammation in cats . The study was a prospect i ve , multi-centre , r and omised , blinded , non-inferiority design clinical study to compare robenacoxib to meloxicam .  Ninety-six cats undergoing surgery at eight centres in Japan were allocated r and omly to receive a single s.c . injection of robenacoxib ( 2 mg/kg , n=67 ) or meloxicam ( 0.3 mg/kg , n=29 ) shortly before induction of anaesthesia . Most cats underwent soft tissue surgery ( n=87 ) , mainly  ovariectomy  ( n=68 ) . Post-operative pain and inflammation were assessed at 3 , 8 and 22 h after recovery from anaesthesia using numerical rating scales . For the primary efficacy endpoint ( total clinician score ) , robenacoxib had significantly better efficacy than meloxicam , the relative efficacy ratio being 1.47 ( 95 % confidence interval 1.19 - 1.78 , P=0.0003 ) . For the secondary efficacy endpoints , robenacoxib was superior to meloxicam when assessed on the basis of posture , behaviour , pain on palpation and overall pain control , while meloxicam was superior with respect to wound heat . No cat in either group required rescue analgesia therapy . In tolerability assessment s , pain during injection and pain and inflammation at the injection site 22 h after recovery from anaesthesia were rated significantly less with robenacoxib compared to meloxicam . Both treatments were well tolerated on the basis of clinical observations and blood tests , with no significant differences between groups . In conclusion , single pre-operative administration of robenacoxib was well tolerated and had superior efficacy to meloxicam in reducing post-operative pain in cats The objective of the study was to evaluate the efficacy and tolerability of robenacoxib , a selective cyclooxygenase-2 inhibitor , for the treatment of acute pain and inflammation associated with musculoskeletal disorders in cats . The study was a prospect i ve , multi-centre , r and omised , blinded , non-inferiority design clinical trial comparing robenacoxib to ketoprofen . A total of 68 cats presenting with pain and inflammation associated with acute musculoskeletal disorders were recruited and allocated r and omly to receive , orally once daily for 5 - 6 days , either 1.0 - 2.4 mg/kg robenacoxib ( n=47 ) or 1mg/kg ketoprofen ( n=21 ) . The primary efficacy endpoint was the total clinician score , which was the sum of clinician numerical rating scale scores for pain , inflammation and mobility . Assessment s were made at baseline , on day 2 , and day 4 or 5 . For the total clinician score , non-inferior efficacy of robenacoxib was demonstrated with a relative efficacy of 1.151 ( 95 % confidence interval 0.872 - 1.494 ) . Non-inferior efficacy of robenacoxib was also demonstrated for the secondary endpoint of the total owner score .  Robenacoxib was superior ( P<0.05 ) to ketoprofen for the owner 's assessment of activity and 
    Output:
    
agent
Studies were primarily related to the assessment of pain in relation to surgical procedures , and no clear distinction was made concerning the onset of acute and chronic pain .
The metrics used within the tools appeared to focus primarily on the sensory aspect of pain , with no study clearly discriminating between the sensory and affective components of pain .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To evaluate the sedative and analgesic effects of intramuscular buprenorphine with either dexmedetomidine or acepromazine , administered as premedication to cats and dogs undergoing elective surgery . STUDY DESIGN Prospect i ve , r and omized , blinded clinical study . ANIMALS Forty dogs and 48 cats . METHODS Animals were assigned to one of four groups , according to anaesthetic premedication and induction agent : buprenorphine 20 μg kg(-1 ) with either dexmedetomidine ( dex ) 250 μg m(-2 ) or acepromazine ( acp ) 0.03 mg kg(-1 ) , followed by alfaxalone ( ALF ) or propofol ( PRO ) . Meloxicam was administered preoperatively to all animals and anaesthesia was always maintained using isoflurane . Physiological measures and assessment s of pain , sedation and mechanical nociceptive threshold ( MNT ) were made before and after premedication , intraoperatively , and for up to 24 hours after premedication . Data were analyzed with one-way , two-way and mixed between-within subjects anova , Kruskall-Wallis analyses and Chi squared tests . Results were deemed significant if p ≤ 0.05 , except where multiple comparisons were performed ( p ≤ 0.005 ) . RESULTS Cats premedicated with dex were more se date d than cats premedicated with acp ( p < 0.001 ) and ALF doses were lower in dex cats ( 1.2 ± 1.0 mg kg(-1 ) ) than acp cats ( 2.5 ± 1.9 mg kg(-1 ) ) ( p = 0.041 ) . There were no differences in sedation in dogs however PRO doses were lower in dex dogs ( 1.5 ± 0.8 mg kg(-1 ) ) compared to acp dogs ( 3.3 ± 1.1 mg kg(-1 ) ) ( p < 0.001 ) . There were no differences between groups with respect to pain scores or MNT for cats or dogs . CONCLUSION Choice of dex or acp , when given with buprenorphine , caused minor , clinical ly detectable , differences in various characteristics of anaesthesia , but not in the level of analgesia . CLINICAL RELEVANCE A combination of buprenorphine with either acp or dex , followed by either PRO or ALF , and then isoflurane , accompanied by an NSAID , was suitable for anaesthesia in dogs and cats undergoing elective surgery . Choice of sedative agent may influence dose of anaesthetic induction agent OBJECTIVE To evaluate the sedative and antinociceptive effects of combinations of dexmedetomidine and buprenorphine in cats . STUDY DESIGN Experimental r and omized study . ANIMALS Twelve purpose -bred neutered domestic short-hair cats ( 4 male and 8 female ) weighing 4.6 kg ( range 3.7 - 5.5 kg ) aged from 2 to 5 years . METHODS Six cats per group were administered buprenorphine ( B ) at 10 ( B10 ) or 20 microg kg(-1 ) ( B20 ) or dexmedetomidine ( D ) at 20 ( D20 ) or 40 microg kg(-1 ) ( D40 ) or a combination of B10/D20 . A feline thermal nociceptive threshold testing device was used to evaluate the antinociceptive effects of the drugs before and up to 24 hours after drug treatment . Sedation was scored using a 100 mm visual analogue scale ( VAS ) . RESULTS Thermal thresholds increased significantly after administration of all but D20 . Area under the curve ( AUC , hours degrees C ) for the first 6 hours ( mean + /- SD ) for B20 ( 281 + /- 17.8 ) was significantly greater than B10 ( 260 + /- 11.4 ) , D20 ( 250 + /- 7.9 ) and D40 ( 255 + /- 11.4 ) . The AUC for B10/D20 ( 273 + /- 12.2 ) was significantly greater than D20 but not the other treatments . No sedation was seen after administration of B10 or B20 and maximal sedation was seen for all animals in the D40 and B10/D20 groups and most animals in the D20 group . CONCLUSIONS D20 alone had the smallest analgesic effect ; B10 alone provided no sedation but their combination gave good sedation with analgesia comparable with B20 . CLINICAL RELEVANCE This combination could be a useful multimodal sedative/analgesic regimen in cats BACKGROUND There are no vali date d systems for measuring pain from osteoarthritis in cats . HYPOTHESIS Owner subjective assessment s and an activity monitor ( AM ) can be used to detect pain in cats with osteoarthritis and to assess efficacy of treatments . ANIMALS Thirteen cats older than 10 years old , with owner-assessed decreases in activity , painful arthritic joints , and clinical ly normal blood work were included and evaluated for 3 weeks . METHODS A collar-mounted AM measured activity and a client-specific outcome measure ( CSOM ) question naire characterized the severity of impairment . Overall global quality of life was also evaluated for each treatment . In weeks 2 and 3 , meloxicam ( 0.1 mg/kg , day 1 ; 0.05 mg/kg , days 2 - 5 ) or a placebo was administered in a blinded , r and omized , cross-over manner to test the assessment systems . RESULTS The cats had a median of 4 arthritic appendicular joints .  Activity counts for the week when cats ( complete data on activity ; n=9 ) were administered meloxicam were significantly higher than at baseline ( P = .02 ) but not after placebo ( P = .06 ) . Baseline activity counts were not significantly different from placebo ( P = .6 ) . The CSOM data ( n=13 ) showed that owners considered their cats to be more active on meloxicam compared with baseline ( P = .001 ) and placebo ( P < .004 ) , and more active on placebo than at baseline ( P < .01 ) . Global quality of life improved significantly with meloxicam ( P < .042 ) . CONCLUSIONS AND CLINICAL IMPORTANCE Both an AM and a CSOM system can detect behavior associated with pain relief in cats that are arthritic . Objective activity data might allow subjective assessment systems to be vali date d for use in clinical studies OBJECTIVE To evaluate the ability of various subjective and objective measurements to determine the presence and degree of postoperative pain in cats . DESIGN R and omized controlled prospect i ve clinical study . ANIMALS 18 healthy client-owned cats . PROCEDURE Cats were r and omly assigned to 3 groups of 6 : control , tenectomy , and onychectomy . Jugular catheters were placed the day prior to surgery . All surgeries were performed by the same surgeon , and all observations were made by the same blinded trained observer . One hour prior to surgery and at assigned intervals for 36 hours after surgery , heart rate , respiratory rate , and rectal temperature were measured . Scores were assigned for 3 interaction responses , including response to palpation , by use of simple descriptive scales , and to 2 pain assessment s by use of visual analogue scales . Blood was collected to measure plasma beta-endorphin and cortisol concentrations .  Butorphanol was administered to all cats before surgery and to any cat subjectively assessed to be experiencing pain after surgery . RESULTS Only visual analogue scale scores and response to palpation scores differed significantly between control and surgical groups . CONCLUSIONS AND CLINICAL RELEVANCE Determination of the presence of pain in cats can be made on the basis of observation and interaction by a trained observer . Physiologic measurements , including plasma cortisol and beta-endorphin concentrations , did not differentiate between control cats and cats that underwent surgery OBJECTIVE To evaluate the clinical efficacy of dexmedetomidine as a preanesthetic medication administered prior to anesthetic induction with ketamine or propofol and with or without isoflurane for maintenance of anesthesia . DESIGN R and omized , blinded , controlled clinical trial . ANIMALS 184 client-owned cats . PROCEDURES Cats requiring general anesthesia for short or long procedures were assigned to receive 1 of 4 preanesthetic and induction drug combinations ( dexmedetomidine and ketamine , placebo [ saline { 0.9 % NaCl } solution ] and ketamine , dexmedetomidine and propofol , or placebo and propofol ) . Cats undergoing long procedures received isoflurane for maintenance of anesthesia . RESULTS Administration of dexmedetomidine prior to anesthetic induction with ketamine significantly increased the intubation success rate ( 57/64 [ 89 % ] ) , compared with the success rate for the placebo ( 4/37 [ 11 % ] ) ; significantly reduced the median induction dose of propofol ( ≤ 5.1 mg/kg [ 2.32 mg/lb ] ) , compared with that for the placebo ( ≤ 10.5 mg/kg [ 4.77 mg/lb ] ) ; and significantly reduced the isoflurane concentration ( 1.5 % ) required for anesthesia maintenance , compared with that for the placebo ( 3.0 % ) . Postoperatively , fewer cats receiving dexmedetomidine  required rescue analgesia , and cats had lower pain scores for at least 2 hours after surgery , compared with results for cats receiving the  placebo . Heart rate was lower during the procedure and respiratory rate and rectal temperature were lower during and after the procedure for cats receiving dexmedetomidine . More cats that received dexmedetomidine  had emesis and pale mucous membranes , compared with the number of cats with those signs that received placebo . CONCLUSIONS AND CLINICAL RELEVANCE Dexmedetomidine as a preanesthetic was efficacious for clinical use in cats requiring general anesthesia The objective of this study was to evaluate the efficacy and tolerability of robenacoxib , a selective cyclooxygenase-2 inhibitor , for the treatment of post-operative pain and inflammation in cats . The study was a prospect i ve , multi-centre , r and omised , blinded , non-inferiority design clinical study to compare robenacoxib to meloxicam .  Ninety-six cats undergoing surgery at eight centres in Japan were allocated r and omly to receive a single s.c . injection of robenacoxib ( 2 mg/kg , n=67 ) or meloxicam ( 0.3 mg/kg , n=29 ) shortly before induction of anaesthesia . Most cats underwent soft tissue surgery ( n=87 ) , mainly  ovariectomy  ( n=68 ) . Post-operative pain and inflammation were assessed at 3 , 8 and 22 h after recovery from anaesthesia using numerical rating scales . For the primary efficacy endpoint ( total clinician score ) , robenacoxib had significantly better efficacy than meloxicam , the relative efficacy ratio being 1.47 ( 95 % confidence interval 1.19 - 1.78 , P=0.0003 ) . For the secondary efficacy endpoints , robenacoxib was superior to meloxicam when assessed on the basis of posture , behaviour , pain on palpation and overall pain control , while meloxicam was superior with respect to wound heat . No cat in either group required rescue analgesia therapy . In tolerability assessment s , pain during injection and pain and inflammation at the injection site 22 h after recovery from anaesthesia were rated significantly less with robenacoxib compared to meloxicam . Both treatments were well tolerated on the basis of clinical observations and blood tests , with no significant differences between groups . In conclusion , single pre-operative administration of robenacoxib was well tolerated and had superior efficacy to meloxicam in reducing post-operative pain in cats The objective of the study was to evaluate the efficacy and tolerability of robenacoxib , a selective cyclooxygenase-2 inhibitor , for the treatment of acute pain and inflammation associated with musculoskeletal disorders in cats . The study was a prospect i ve , multi-centre , r and omised , blinded , non-inferiority design clinical trial comparing robenacoxib to ketoprofen . A total of 68 cats presenting with pain and inflammation associated with acute musculoskeletal disorders were recruited and allocated r and omly to receive , orally once daily for 5 - 6 days , either 1.0 - 2.4 mg/kg robenacoxib ( n=47 ) or 1mg/kg ketoprofen ( n=21 ) . The primary efficacy endpoint was the total clinician score , which was the sum of clinician numerical rating scale scores for pain , inflammation and mobility . Assessment s were made at baseline , on day 2 , and day 4 or 5 . For the total clinician score , non-inferior efficacy of robenacoxib was demonstrated with a relative efficacy of 1.151 ( 95 % confidence interval 0.872 - 1.494 ) . Non-inferior efficacy of robenacoxib was also demonstrated for the secondary endpoint of the total owner score .  Robenacoxib was superior ( P<0.05 ) to ketoprofen for the owner 's assessment of activity and 
    Output:
    