title: Pain management in the neonatal piglet during routine management procedures. Part 2: grading the quality of evidence and the strength of recommendations.
abstract: Piglets reared in swine production in the USA undergo painful procedures that include castration, tail docking, teeth clipping, and identification with ear notching or tagging. These procedures are usually performed without pain mitigation. The objective of this project was to develop recommendations for pain mitigation in 1- to 28-day-old piglets undergoing these procedures. The National Pork Board funded project to develop recommendations for pain mitigation in piglets. Recommendation development followed a defined multi-step process that included an evidence summary and estimates of the efficacies of interventions. The results of a systematic review of the interventions were reported in a companion paper. This manuscript describes the recommendation development process and the final recommendations. Recommendations were developed for three interventions (CO2/O2 general anesthesia, non-steroidal anti-inflammatory drugs (NSAIDs), and lidocaine) for use during castration. The ability to make strong recommendations was limited by low-quality evidence and strong certainty about variation in stakeholder values and preferences. The panel strongly recommended against the use of a CO2/O2 general anesthesia mixture, weakly recommended for the use of NSAIDs and weakly recommended against the use of lidocaine for pain mitigation during castration of 1- to 28-day-old piglets.
authors.affiliation: Department of Veterinary Diagnostic and Production Animal Medicine,Iowa State University,Ames, Iowa,USA.
authors.forename: A
authors.initials: A
authors.lastname: O'Connor
authors.affiliation: Philosophy Department,University of Alaska Anchorage,Alaska,USA.
authors.forename: R
authors.initials: R
authors.lastname: Anthony
authors.affiliation: Department of Animal and Poultry Sciences,Virginia Tech,Blacksburg, Virginia,USA.
authors.forename: L
authors.initials: L
authors.lastname: Bergamasco
authors.affiliation: Department of Veterinary Diagnostic and Production Animal Medicine,Iowa State University,Ames, Iowa,USA.
authors.forename: J
authors.initials: J
authors.lastname: Coetzee
authors.affiliation: Department of Veterinary Diagnostic and Production Animal Medicine,Iowa State University,Ames, Iowa,USA.
authors.forename: S
authors.initials: S
authors.lastname: Gould
authors.affiliation: Department of Veterinary Diagnostic and Production Animal Medicine,Iowa State University,Ames, Iowa,USA.
authors.forename: A K
authors.initials: AK
authors.lastname: Johnson
authors.affiliation: Department of Veterinary Diagnostic and Production Animal Medicine,Iowa State University,Ames, Iowa,USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Karriker
authors.affiliation: USDA-ARS,Livestock Behavior Research Unit,West Lafayette, Indiana,USA.
authors.forename: J N
authors.initials: JN
authors.lastname: Marchant-Forde
authors.affiliation: National Veterinary School of Toulouse,Toulouse,France.
authors.forename: G S
authors.initials: GS
authors.lastname: Martineau
authors.affiliation: Department of Animal and Poultry Sciences,Virginia Tech,Blacksburg, Virginia,USA.
authors.forename: J
authors.initials: J
authors.lastname: McKean
authors.affiliation: Department of Veterinary Diagnostic and Production Animal Medicine,Iowa State University,Ames, Iowa,USA.
authors.forename: S T
authors.initials: ST
authors.lastname: Millman
authors.affiliation: National Pork Board,Des Moines, Iowa,USA.
authors.forename: S
authors.initials: S
authors.lastname: Niekamp
authors.affiliation: Production Animal Health,University of Calgary,Calgary,Canada.
authors.forename: E A
authors.initials: EA
authors.lastname: Pajor
authors.affiliation: Scotland'd Royal College (SRUC),Edinburgh,United Kingdom.
authors.forename: K
authors.initials: K
authors.lastname: Rutherford
authors.affiliation: American Association of Swine Veterinarians (AASV),Perry, Iowa,USA.
authors.forename: M
authors.initials: M
authors.lastname: Sprague
authors.affiliation: AgResearch Ltd, Ruakura Research Centre,Hamilton,New Zealand.
authors.forename: M
authors.initials: M
authors.lastname: Sutherland
authors.affiliation: Institute of Agricultural and Nutritional Sciences,Martin-Luther-University Halle-Wittenberg,Halle,Germany.
authors.forename: E
authors.initials: E
authors.lastname: von Borell
authors.affiliation: Department of Veterinary Diagnostic and Production Animal Medicine,Iowa State University,Ames, Iowa,USA.
authors.forename: R S
authors.initials: RS
authors.lastname: Dzikamunhenga
mesh_terms: D000768:Anesthesia, General / Q000662:veterinary; D000822:Animal Husbandry / Q000379:methods* / Q000592:standards; D000818:Animals; D000831:Animals, Newborn; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D055317:Evidence-Based Practice; D017408:Guidelines as Topic; D008012:Lidocaine / Q000008:administration & dosage; D059408:Pain Management / Q000592:standards / Q000662:veterinary*; D013552:Swine / Q000502:physiology*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D008012:Lidocaine