Comparison of Flunixin Meglumine, Meloxicam and Ketoprofen on Mild Visceral Post-Operative Pain in Horses.
Authors: Lemonnier Louise C, Thorin Chantal, Meurice Antoine, Dubus Alice, Touzot-Jourde Gwenola, Couroucé Anne, Leroux Aurélia A
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary Following inguinal castration under general anaesthesia, meloxicam and ketoprofen demonstrated comparable analgesic efficacy to the established flunixin meglumine standard in managing mild post-operative visceral pain, according to this 2022 randomised controlled trial. Thirty horses (aged 6.2 ± 4.9 years, predominantly warmbloods) received one of three NSAIDs intravenously two hours pre-operatively and again at 24 hours post-op, with pain assessed using the modified post-abdominal surgery pain assessment scale at baseline, 24 hours, and 48 hours. All three drugs produced similar pain trajectories: baseline scores around 1.1–1.6 increased significantly to 4.6–5.3 at the 24-hour mark (p < 0.001), before declining to 2.9–3.0 at 48 hours for flunixin and meloxicam (no significant reduction observed for ketoprofen at this timepoint). Critically, no statistically significant differences emerged between the three NSAIDs in overall analgesic effect, suggesting meloxicam and ketoprofen represent viable alternatives to flunixin meglumine in mild visceral pain scenarios—a finding with potential implications for prescribing flexibility and cost considerations in equine post-operative management. Practitioners should note that assessor experience significantly influenced pain scoring reliability (senior scores 5.56 ± 0.54 versus junior 3.22 ± 0.62, p = 0.005), highlighting the importance of standardised evaluation protocols in clinical settings.
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Practical Takeaways
- •Meloxicam and ketoprofen are viable alternatives to flunixin meglumine for managing post-castration pain in horses, offering similar efficacy
- •This finding expands pain management options and may be useful when flunixin meglumine is unavailable or contraindicated
- •The modified PASPAS pain assessment tool appears to require experienced evaluators; junior staff may overestimate pain scores by approximately 2.3 points
Key Findings
- •Meloxicam and ketoprofen provided equivalent analgesia to flunixin meglumine for mild visceral pain following inguinal castration
- •No statistically significant differences in pain scores between the three NSAIDs across all time points
- •Pain scores increased significantly from baseline (T0) to 24 hours post-operatively (T1) for all three drugs (p < 0.001)
- •Pain scores decreased significantly from T1 to 48 hours (T2) for flunixin meglumine and meloxicam (p < 0.001 and p = 0.0325 respectively)