A composite scale for pain assessment in rabbits has been previously designed and tested (CANCRS). The present study describes the refinement of the scale and the evaluation of its ability to detect pain variations over time. Furthermore, a comparison between the CANCRS and the Visual Analogue Scale (VAS) has been performed, to underline the differences between an objective (CANCRS) and a subjective (VAS) assessment of abdominal pain. In the first part of the study, 86 rabbits (n=47 heathy patients and n=39 patients with gastrointestinal stasis syndrome) underwent pain assessments with the VAS and the CANCRS. Thirty-two patients with gastrointestinal stasis syndrome participated to the second part of the study. These patients underwent four pain assessments with the CANCRS. The first assessment took place before meloxicam administration and the others after 30, 60 and 90 minutes. The CANCRS showed differences between healthy and diseased rabbits (P = 0.0001), median scores were 5 (IQR 4 - 6) and 9 (IQR 7 - 11) respectively. The VAS showed differences between healthy and diseased rabbits (P = 0.02), the median scores were 4 (IQR 2 - 5.35) and 5.3 (IQR 2.65 - 6.45) respectively. The cut-off scores for the CANCRS and for the VAS for differentiation between healthy and diseased patients were 7 (Sp 89%, Se 79%) and 4.4 (Sp 59%, Se 69%) respectively. Sensitivity and specificity for each parameter of the CANCRS were calculated, in order to obtain weighting factors. Accordingly, the evaluation of respiratory pattern and vocalizations should be excluded from the CANCRS, since their performances in pain evaluation are poor. Internal validity of the CANCRS was tested assessing pain before and after the analgesic treatment and the results showed significancy at each time point. The CANCRS showed better performances than the VAS and its responsiveness to pain variations has been verified.

中文翻译：

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兔腹部疼痛评估：使用CANCRS识别疼痛并随时间测试其内部有效性

先前已经设计和测试了用于兔子疼痛评估的综合量表（CANCRS）。本研究描述了量表的完善和评估其随时间变化疼痛的能力。此外，已经对CANCRS和视觉模拟量表（VAS）进行了比较，以强调客观（CANCRS）和主观（VAS）评估腹痛之间的差异。在研究的第一部分中，使用VAS和CANCRS对86只兔子（n = 47位健康的患者和n = 39位胃肠道淤滞综合征的患者）进行了疼痛评估。胃肠道淤积综合征的32例患者参加了研究的第二部分。这些患者接受了CANCRS的四次疼痛评估。第一次评估是在服用美洛昔康之前进行的，其他评估则是在30、60和90分钟后进行的。CANCRS显示健康兔子和患病兔子之间的差异（P = 0.0001），中位数分别为5（IQR 4-6）和9（IQR 7-11）。VAS显示健康兔子和患病兔子之间的差异（P = 0.02），中位数分别为4（IQR 2-5.35）和5.3（IQR 2.65-6.45）。在健康和患病患者之间进行区分的CANCRS和VAS的截止分数分别为7（Sp 89％，Se 79％）和4.4（Sp 59％，Se 69％）。计算CANCRS各个参数的敏感性和特异性，以获得加权因子。因此，由于CANCRS在疼痛评估中的表现较差，因此应排除对呼吸模式和发声的评估。测试了CANCRS的内部有效性，以评估止痛治疗前后的疼痛程度，结果在每个时间点均显示出显着性。CANCRS表现出比VAS更好的性能，并且已证实其对疼痛变化的响应能力。