1
|
He C, Fan K, Hao Z, Tang N, Li G, Wang S. Prevalence, Risk Factors, Pathophysiology, Potential Biomarkers and Management of Feline Idiopathic Cystitis: An Update Review. Front Vet Sci 2022; 9:900847. [PMID: 35812890 PMCID: PMC9257190 DOI: 10.3389/fvets.2022.900847] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Abstract
Feline idiopathic cystitis is a widespread disease in small animal clinics, which mainly presents with urinary signs like dysuria, stranguria, hematuria, pollakiuria, and periuria. The etiopathogenesis of the disease may involve interactions between the environmental stressors, neuroendocrine system and bladder of affected cats. Diagnostic biomarkers have not been tested in clinical studies though they are theoretically feasible, and since the clinical signs of the disease assemble those of other feline lower urinary diseases, its diagnosis is a procedure of exclusion. The primary treatment of the disease is long-term multimodal environmental modification (or enrichment) while anti-anxiety drugs and nutritional supplements are recommended for chronic recurrent cases. Still, many medicines need to be evaluated for their efficacy and safety. This review aims to provide readers with a comprehensive understanding of feline idiopathic cystitis by summarizing and updating studies concerning the prevalence, risk factors, etiological hypotheses, diagnostic procedures, possible treatments, and prognosis of the disease.
Collapse
|
2
|
DiGeronimo PM, Balko JA. Sedation and Anesthesia of Amphibians. Vet Clin North Am Exot Anim Pract 2021; 25:31-47. [PMID: 34823696 DOI: 10.1016/j.cvex.2021.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Amphibians commonly are managed under human care for research, education, conservation, and companionship and frequently are in need of sedation, anesthesia, or end-of-life care involving euthanasia. Objective investigation of sedative and anesthetic protocols in these taxa still is in its infancy, but knowledge of current best practices is paramount to appropriate care. Tricaine methanesulfonate delivered via immersion (bath) is the most common anesthetic agent in amphibians, but several other effective techniques have been identified. This summary provides a comprehensive review of the current evidence-based literature regarding amphibian sedative, anesthetic, and euthanasia techniques.
Collapse
Affiliation(s)
- Peter M DiGeronimo
- Adventure Aquarium, 1 Riverside Drive, Camden, NJ 08103, USA; Animal & Bird Health Care Center, 1785 Springdale Road, Cherry Hill, NJ 08003, USA.
| | - Julie A Balko
- College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA
| |
Collapse
|
3
|
Bharthi Sekar E, Vijayaraghavan U, Sadiqbasha AM. Effect of Intravenous Dexmedetomidine on Spinal Anesthesia. Cureus 2021; 13:e15708. [PMID: 34277292 PMCID: PMC8285763 DOI: 10.7759/cureus.15708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2021] [Indexed: 11/15/2022] Open
Abstract
Background Subarachnoid block (SAB) with hyperbaric bupivacaine is routinely administered for abdominal and lower limb surgeries. Various agents have been used intrathecally as adjuvants to local anesthetic to increase efficacy and prolong the duration of SAB, among which opioids and α2 agonists are most commonly used. Intravenously administered dexmedetomidine has also been shown to prolong the duration of sensory and motor blockade obtained with subarachnoid block. Methods A total of 212 adult patients scheduled to undergo abdominal or lower limb surgeries were enrolled in this prospective, double-blind, randomized study. They were divided into two equal groups to receive either intravenous dexmedetomidine (group D) 1μg/kg loading followed by maintenance at 0.5μg/kg or intravenous normal saline (group C) after 15 mins of subarachnoid block; no other intraoperative sedatives were used. The onset of sensory block and motor block, and the highest level of sensory block attained were assessed. The time taken for sensory regression to L1, Modified Bromage scale 0, and rescue analgesia requirement were assessed. Results Patients receiving intravenous dexmedetomidine showed no significant change in terms of onset and level of sensory block (P-0.774) and the onset of motor block (P-0.738). The time taken for sensory regression to L1 was significantly prolonged (P-0.000). Also, the time taken to achieve Modified Bromage scale of 0 and time taken for rescue analgesia was significantly prolonged (P-0.000). Conclusion Intravenous dexmedetomidine prolonged the duration of sensory and motor block, and also appears to provide sedation with easy arousability and analgesia postoperatively while maintaining hemodynamic stability with no significant side effects.
Collapse
|
4
|
|
5
|
Jin LJ, Wen LY, Zhang YL, Li G, Sun P, Zhou X. Thoracic paravertebral regional anesthesia for pain relief in patients with breast cancer surgery. Medicine (Baltimore) 2017; 96:e8107. [PMID: 28953631 PMCID: PMC5626274 DOI: 10.1097/md.0000000000008107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The present study aimed to assess the efficacy and safety of thoracic paravertebral regional anesthesia (TPVBRA) in patients with breast cancer surgery. METHODS In total, 72 patients undergoing breast cancer surgery were randomly divided into an intervention group and a control group; each group contained 36 subjects. Both groups received TPVBRA with 20 mL 0.25% bupivacaine. In addition, subjects in the intervention group also received an additional 1 μg/kg dexmedetomidine. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), pain intensity (measured by visual analogue scale, VAS), and analgesic consumption were assessed; adverse events were also recorded. RESULTS Significant differences were observed in HR (P < .05), SBP (P < .05), and DBP (P < .05) at the 30-minute point during surgery between the 2 groups. In addition, the time of the first administration of analgesia (P = .043) and the mean consumption of analgesic agents (P = .035) in the intervention group were much better than those in the control group. However, no significant differences in HR or VAS were found at any time point after surgery (P > .05). Furthermore, similar adverse events were detected in both groups (P > .05). CONCLUSION The results of this study showed that TPVBRA combined with bupivacaine and dexmedetomidine can enhance the duration and quality of analgesia without serious adverse events.
Collapse
Affiliation(s)
| | | | | | - Gang Li
- Department of Orthopaedics, The Affiliated Hongqi Hospital of Mudanjiang Medical University
| | - Ping Sun
- Department of Anatomy, Mudanjiang Medical University, Mudanjiang, China
| | | |
Collapse
|
6
|
Adami C, d'Ovidio D, Casoni D. Alfaxalone versus alfaxalone-dexmedetomidine anaesthesia by immersion in oriental fire-bellied toads (Bombina orientalis). Vet Anaesth Analg 2015. [PMID: 26220762 DOI: 10.1111/vaa.12290] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To determine a dexmedetomidine concentration, to be added to an alfaxalone-based bath solution, that will enhance the anaesthetic and analgesic effects of alfaxalone; and to compare the quality of anaesthesia and analgesia provided by immersion with either alfaxalone alone or alfaxalone with dexmedetomidine in oriental fire-bellied toads (Bombina orientalis). STUDY DESIGN Pilot study followed by a prospective, randomized, experimental trial. ANIMALS Fourteen oriental fire-bellied toads. METHODS The pilot study aimed to identify a useful dexmedetomidine concentration to be added to an anaesthetic bath containing 20 mg 100 mL(-1) alfaxalone. Thereafter, the toads were assigned to one of two groups, each comprising eight animals, to be administered either alfaxalone (group A) or alfaxalone-dexmedetomidine (group AD). After immersion for 20 minutes, the toads were removed from the anaesthetic bath and the righting, myotactic and nociceptive reflexes, cardiopulmonary variables and von Frey filaments threshold were measured at 5 minute intervals and compared statistically between groups. Side effects and complications were noted and recorded. RESULTS In the pilot study, a dexmedetomidine concentration of 0.3 mg 100 mL(-1) added to the alfaxalone-based solution resulted in surgical anaesthesia. The toads in group AD showed higher von Frey thresholds and lower nociceptive withdrawal reflex scores than those in group A. However, in group AD, surgical anaesthesia was observed in two out of eight toads only, and induction of anaesthesia was achieved in only 50% of the animals, as compared with 100% of the toads in group A. CONCLUSIONS AND CLINICAL RELEVANCE The addition of dexmedetomidine to an alfaxalone-based solution for immersion anaesthesia provided some analgesia in oriental fire-bellied toads, but failed to potentiate the level of unconsciousness and appeared to lighten the depth of anaesthesia. This limitation renders the combination unsuitable for anaesthetizing oriental fire-bellied toads for invasive procedures.
Collapse
Affiliation(s)
- Chiara Adami
- Anaesthesiology and Pain Therapy Division, Department of Veterinary Clinical Science, Vetsuisse Faculty, University of Berne, Berne, Switzerland
| | | | - Daniela Casoni
- Anaesthesiology and Pain Therapy Division, Department of Veterinary Clinical Science, Vetsuisse Faculty, University of Berne, Berne, Switzerland
| |
Collapse
|
7
|
Köksal E, Karakaya D, Can B, Bozkurt A, Barış S, Bilge SS, Ustün YB. Intracerebroventricular Application of Dexmedetomidine Produces Antinociception and Does not Cause Neurotoxicity in Rats. Balkan Med J 2013; 30:355-61. [PMID: 25207141 DOI: 10.5152/balkanmedj.2013.7747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 07/31/2013] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Alpha2 agonists contribute to pain control at the level of the medulla spinalis. Alpha2 agonists are generally added to local anaesthetics to prolong spinal or epidural anaesthesia time. AIMS In the present study, we aimed to evaluate the antinociceptive and neurotoxic effects of dexmedetomidine given intracerebroventricularly for 5 days. STUDY DESIGN Animal experimentation. METHODS After intraventricular cannulation, rats (n=32) were divided into two groups (n=16 each). Rats in the dexmedetomidine group (Group D, n=16) received 3 µg (0.03 mL) dexmedetomidine and the control group (Group C, n=16) received 0.03 mL physiological serum through an intracerebroventricular catheter once a day, for 5 days. Antinociceptive, sedative, and motor effects were evaluated before the injection and for 90 min after injection. The tail-flick and hot plate tests were used to assess thermal nociceptive threshold. For histopathological evaluation, half of the rats in both groups were sacrificed on the 6(th) day and the remaining rats were sacrificed on the 21(st) day. Then the perfusion fixation method was applied. The first tissue section was obtained from the cervical spinal cord 1 cm distal to the proximal end of the spinal cord. The second sample was retrieved from the region 1 cm distal from the thoracic 13-lumbar 1 vertebra. On morphological evaluation, nonspecific changes like edema and gliosis, signs of neuronal degeneration demonstrating a severe reaction, and density of inflammatory cells were examined. RESULTS In dexmedetomidine-administered rats, on the first day reaction times at 5, 10, and 20 min and on the other days, reaction times at 5, 10, 20, and 30 min in hot plate tests were significantly longer compared with baseline values (p<0.05). In dexmedetomidine-administered rats, on the 1(st), 4(th), and 5(th) days reaction times at 5, 10, 20, 30, and 40 min and on the 2(nd) and 3(rd) days reaction times at 5, 10, 20, and 30 min in tail-flick tests were significantly longer compared with baseline values (p<0.05). First-degree sedation lasting for 60 min and first-degree motor block lasting for 30-40 min were observed in the dexmedetomidine group. Similar rates of nonspecific changes such as edema and gliosis were seen in both groups. Signs of severe reactions such as neuronal degeneration and diffuse inflammatory cell infiltration were not encountered in any group. There was no significant difference between groups according to morphological findings of the spinal cord on the 6(th) and 21(st) days (p>0.05). CONCLUSION We observed that intracerebroventricular administration of 3 μg dexmedetomidine produced antinociception and did not cause neurotoxicity.
Collapse
Affiliation(s)
- Ersin Köksal
- Department of Anesthesiology and Reanimation, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Deniz Karakaya
- Department of Anesthesiology and Reanimation, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Bilge Can
- Department of Pathology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Ayhan Bozkurt
- Department of Physiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Sibel Barış
- Department of Anesthesiology and Reanimation, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Süleyman Sırrı Bilge
- Department of Pharmacology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Yasemin Burcu Ustün
- Department of Anesthesiology and Reanimation, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| |
Collapse
|
8
|
Işgüzar O, Barış S, Bozkurt A, Can B, Bilge S, Türe H. Evaluation of antinociceptive and neurotoxic effects of intrathecal dexmedetomidine in rats. Balkan Med J 2012; 29:354-7. [PMID: 25207033 DOI: 10.5152/balkanmedj.2012.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 05/04/2012] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Dexmedetomidine has been reported to produce analgesia after intrathecal administration. In the present study the α2-adrenoceptor agonist dexmedetomidine was evaluated for its potential spinal neurotoxic effects. MATERIAL AND METHODS Three days after intrathecal cannulation, rats were administered either dexmedetomidine (3 μg/30 μL, i.t.) or saline (30 μL, i.t.). Antinociceptive, sedative and motor effects of intrathecal administrations of dexmedetomidine or saline were evaluated during 90 min. The tail-flick and hot plate tests were used to assess the thermal nociceptive threshold. Seven days after drug administration, animals were sacrified and spinal cords were evaluated for histopathological changes by light microscopy. RESULTS Dexmedetomidine administered intrathecally produced antinociception. Antinociception was accompanied by immediate sedation and loss of placing-stepping reflexes that lasted over 40 min in all dexmedetomidine administered rats. In all rats, microscopic examination revealed mild gliosis and minimal infiltration of inflamatory r cells in posterior white matter. Mild (total score 4-6) histopathologic lesions were seen in four animals in dexmedetomidine adminisered rats, but there was no statistically significant difference when compared with the saline administered rats. CONCLUSION We observed that intrathecal injections of dexmedetomidine at the dose of 3 μg/30 μL produce antinociception but did not cause any histopathological sign of injury in the spinal cord.
Collapse
Affiliation(s)
- Ozgü Işgüzar
- Department of Anesthesiology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Sibel Barış
- Department of Anesthesiology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Ayhan Bozkurt
- Department of Physiology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Bilge Can
- Department of Pathology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Sırrı Bilge
- Department of Pharmacology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Hatice Türe
- Department of Anesthesiology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| |
Collapse
|
9
|
Abstract
Preclinical studies of analgesia in amphibians or recommendations for clinical use of analgesics in amphibian species are extremely limited. This article briefly reviews the issues surrounding the use of analgesics in amphibians, starting with common definitions of pain and analgesia when applied to nonhuman animals. Nociceptive and endogenous opioid systems in amphibians are reviewed, and results of preclinical research on opioid and nonopioid analgesics summarized. Recommended opioid and nonopioid analgesics are summarized, and practical recommendations made for their clinical use.
Collapse
Affiliation(s)
- Craig W Stevens
- Department of Pharmacology & Physiology, Oklahoma State University-Center for Health Sciences, 1111 West 17th Street, Tulsa, OK 74107, USA.
| |
Collapse
|
10
|
Saadawy I, Boker A, Elshahawy MA, Almazrooa A, Melibary S, Abdellatif AA, Afifi W. Effect of dexmedetomidine on the characteristics of bupivacaine in a caudal block in pediatrics. Acta Anaesthesiol Scand 2009; 53:251-6. [PMID: 19076110 DOI: 10.1111/j.1399-6576.2008.01818.x] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dexmedetomidine (DEX) is a highly selective alpha(2)-adrenoceptor agonist that has been used increasingly in children. However, the effect of caudal DEX has not been evaluated before in children. This prospective randomized double-blinded study was designed to evaluate the analgesic efficacy of caudal DEX with bupivacaine in providing pain relief over a 24-h period. METHODS Sixty children (ASA status I) aged 1-6 years undergoing unilateral inguinal hernia repair/orchidopexy were allocated randomly to two groups (n = 30 each). Group B received a caudal injection of bupivacaine 2.5 mg/ml, 1 ml/kg; Group BD received the same dose of bupivacaine mixed with DEX 1 microg/kg during sevoflurane anesthesia. Processed electroencephalogram (bispectral index score), heart rate, blood pressure, pulse oximetry and end-tidal sevoflurane were recorded every 5 min. The characteristics of emergence, objective pain score, sedation score and quality of sleep were recorded post-operatively. Duration of analgesia and requirement for additional analgesics were noted. RESULTS The end-tidal sevoflurane concentration and the incidence of agitation were significantly lower in the BD group (P < 0.05). The duration of analgesia was significantly longer (P < 0.001) and the total consumption of rescue analgesic was significantly lower in Group BD compared with Group B (P < 0.01). There was no statistically significant difference in hemodynamics between both groups. However, group BD had better quality of sleep and a prolonged duration of sedation (P < 0.05). CONCLUSION Caudal DEX seems to be a promising adjunct to provide excellent analgesia without side effects over a 24-h period. It has the advantage of keeping the patients calm for a prolonged time. Implications statement: Caudally administered DEX (1 microg/kg), combined with bupivacaine, was associated with an extended duration of post-operative pain relief.
Collapse
MESH Headings
- Adjuvants, Anesthesia/administration & dosage
- Adjuvants, Anesthesia/pharmacology
- Adrenergic alpha-Agonists/pharmacokinetics
- Adrenergic alpha-Agonists/therapeutic use
- Analgesics, Non-Narcotic/therapeutic use
- Anesthesia, Caudal/methods
- Anesthetics, Local/administration & dosage
- Anesthetics, Local/pharmacology
- Bupivacaine/administration & dosage
- Bupivacaine/pharmacology
- Child
- Child, Preschool
- Dexmedetomidine/administration & dosage
- Dexmedetomidine/pharmacology
- Double-Blind Method
- Drug Synergism
- Hernia, Inguinal/surgery
- Humans
- Hypnotics and Sedatives/administration & dosage
- Hypnotics and Sedatives/pharmacology
- Infant
- Male
- Pain, Postoperative/drug therapy
- Prospective Studies
- Psychomotor Agitation/prevention & control
- Receptors, Adrenergic, alpha-2/drug effects
- Sleep/drug effects
Collapse
Affiliation(s)
- I Saadawy
- Department of Anesthesia, Cairo University, Cairo, Egypt.
| | | | | | | | | | | | | |
Collapse
|
11
|
Stevens CW, Martin KK, Stahlheber BW. Nociceptin produces antinociception after spinal administration in amphibians. Pharmacol Biochem Behav 2009; 91:436-40. [PMID: 18804120 PMCID: PMC2662521 DOI: 10.1016/j.pbb.2008.08.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2008] [Revised: 08/15/2008] [Accepted: 08/25/2008] [Indexed: 11/23/2022]
Abstract
Nociceptin, also known as orphanin FQ, is a opioid-like neuropeptide that mediates its effects at the nociceptin receptor, a member of the G protein-coupled receptor superfamily. In mammals, nociceptin produces analgesia after spinal administration, however the role of nociceptin and nociceptin receptors in the modulation of noxious stimuli in non-mammalian species has not been examined. In an amphibian pain model using the acetic acid test with Rana pipiens, nociceptin and nociceptin1-13 amide produced dose-dependent antinociception (1-100 nmol), blocked by the nociceptin antagonist, [Nphe1]-nociceptin1-13 amide (30 nmol), but not the opioid antagonist, naltrexone (100 nmol/g, s.c.). Conversely, the antinociceptive effects of micro, delta, and kappa opioid receptor agonists were not blocked by the nociceptin antagonist. Nociceptin and nociceptin1-13 amide were the least potent of the opioid agonists tested. These studies demonstrate that spinal nociceptin receptors and not opioid receptors mediate the antinociceptive effect of nociceptin. Considered with previous findings, these behavioral data supports a role for nociceptin inhibition of spinal nociception in amphibians and perhaps all vertebrates.
Collapse
Affiliation(s)
- Craig W Stevens
- Department of Pharmacology and Physiology, Oklahoma State University-Center for Health Sciences, College of Osteopathic Medicine, Tulsa, OK 74107-1898, USA.
| | | | | |
Collapse
|
12
|
Abstract
The proteins that mediate the analgesic and other effects of opioid drugs and endogenous opioid peptides are known as opioid receptors. Opioid receptors consist of a family of four closely-related proteins belonging to the large superfamily of G-protein coupled receptors. The three types of opioid receptors shown unequivocally to mediate analgesia in animal models are the mu (MOR), delta (DOR), and kappa (KOR) opioid receptor proteins. The role of the fourth member of the opioid receptor family, the nociceptin or orphanin FQ receptor (ORL), is not as clear as hyperalgesia, analgesia, and no effect was reported after administration of ORL agonists. There are now cDNA sequences for all four types of opioid receptors that are expressed in the brain of six species from three different classes of vertebrates. This review presents a comparative analysis of vertebrate opioid receptors using bioinformatics and data from recent human genome studies. Results indicate that opioid receptors arose by gene duplication, that there is a vector of opioid receptor divergence, and that MOR shows evidence of rapid evolution.
Collapse
Affiliation(s)
- Craig W Stevens
- Department of Pharmacology and Physiology, Oklahoma State University-Center for Health Sciences, Tulsa, OK, USA.
| |
Collapse
|
13
|
Newby NC, Stevens ED. The effects of the acetic acid “pain” test on feeding, swimming, and respiratory responses of rainbow trout (Oncorhynchus mykiss). Appl Anim Behav Sci 2008. [DOI: 10.1016/j.applanim.2007.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
14
|
|
15
|
Abstract
This article should help the veterinarian to assess pain in small mammals and birds. The focus is on a multimodal approach to anesthesia and analgesia using opioids, nonsteroidal anti-inflammatory drugs, alpha(2)-agonists, dissociatives, and local anesthetics as injectables, constant rate infusions, local blocks, and epidurals. Drugs used for induction, intubation techniques, and inhalant anesthesia are discussed. Protocols for critical patients and doses of common analgesics are covered.
Collapse
|
16
|
Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al Jazzar MD, Alameddine MM, Al-Yaman R, Bulbul M, Baraka AS. Effect of low-dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal block. Acta Anaesthesiol Scand 2006; 50:222-7. [PMID: 16430546 DOI: 10.1111/j.1399-6576.2006.00919.x] [Citation(s) in RCA: 245] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The purpose of this study was to compare the onset and duration of sensory and motor block, as well as the hemodynamic changes and level of sedation, following intrathecal bupivacaine supplemented with either dexmedetomidine or clonidine. METHODS In a prospective, double-blind study, 60 patients undergoing transurethral resection of prostate or bladder tumor under spinal anesthesia were randomly allocated to one of three groups. Group B received 12 mg of hyperbaric bupivacaine, group D received 12 mg of bupivacaine supplemented with 3 microg of dexmedetomidine and group C received 12 mg of bupivacaine supplemented with 30 microg of clonidine. The onset times to reach peak sensory and motor levels, and the sensory and motor regression times, were recorded. Hemodynamic changes and the level of sedation were also recorded. RESULTS Patients in groups D and C had a significantly shorter onset time of motor block and significantly longer sensory and motor regression times than patients in group B. The mean time of sensory regression to the S1 segment was 303 +/- 75 min in group D, 272 +/- 38 min in group C and 190 +/- 48 min in group B (B vs. D and B vs. C, P < 0.001). The regression of motor block to Bromage 0 was 250 +/- 76 min in group D, 216 +/- 35 min in group C and 163 +/- 47 min in group B (B vs. D and B vs. C, P < 0.001). The onset and regression times were not significantly different between groups D and C. The mean arterial pressure, heart rate and level of sedation were similar in the three groups intra-operatively and post-operatively. CONCLUSIONS Dexmedetomidine (3 microg) or clonidine (30 microg), when added to intrathecal bupivacaine, produces a similar prolongation in the duration of the motor and sensory block with preserved hemodynamic stability and lack of sedation.
Collapse
Affiliation(s)
- G E Kanazi
- Department of Anesthesiology, American University of Beirut-Medical Center, Beirut, Lebanon.
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Christina Haerdi-Landerer M, Schlegel U, Neiger-Aeschbacher G. The analgesic effects of intrathecal xylazine and detomidine in sheep and their antagonism with systemic atipamezole. Vet Anaesth Analg 2005; 32:297-307. [PMID: 16135211 DOI: 10.1111/j.1467-2995.2005.00214.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the analgesic and adverse side effects of intrathecal (IT) xylazine (XYL) and detomidine (DET) and the subsequent effects of two doses of intravenous (IV) atipamezole (ATI). STUDY DESIGN Prospective, randomized, cross-over. ANIMALS Five adult healthy female sheep with mean body mass of 55 +/- 2.3 kg. Material and methods Each sheep underwent four treatments: 1) 50 microg kg(-1) XYL IT and 5 microg kg(-1) ATI IV, 2) 50 microg kg(-1) XYL IT and 2.5 microg kg(-1) ATI IV, 3) 10 microg kg(-1) DET IT and 5 microg kg(-1) ATI IV, 4) 10 microg kg(-1) DET IT and 2.5 microg kg(-1) ATI IV. Pain threshold (TH) was tested by applying pulsed and stepwise incremental direct current to the skin overlying the pastern. The current at the point of foot lift was recorded as the TH. Heart rate (HR), mean arterial pressure, arterial oxygen (PO(2)) and carbon dioxide (PCO(2)) tensions were monitored. Outcomes were derived as differences between baseline assessment and measurements after treatment. Two-way anova was used to analyse drug effects, treatment differences between groups were examined with an F-test or Wilcoxon's rank sum test in case of non-parametric data distribution. p was set at 0.05. RESULTS Both drugs increased the pain TH, caused small increases in PCO(2), and small decreases in HR, the latter was only significant for XYL recipients. Xylazine produced a significantly higher TH, more rapidly and for longer than DET. Atipamezole only significantly affected PaCO(2) in the XYL group 2. The pain TH was not affected in either group after IV ATI. CONCLUSIONS At the doses used, IT XYL, and to a lesser extent DET, induced pastern analgesia. Atipamezole 5 microg kg(-1) IV antagonized some side effects without affecting analgesia. CLINICAL RELEVANCE Intrathecal XYL may be useful as an analgesic in sheep. Its safety is increased because IV ATI antagonizes side effects, but not analgesia.
Collapse
|
18
|
King EW, Audette K, Athman GA, Nguyen OXH, Sluka KA, Fairbanks CA. Transcutaneous electrical nerve stimulation activates peripherally located alpha-2A adrenergic receptors. Pain 2005; 115:364-373. [PMID: 15911163 DOI: 10.1016/j.pain.2005.03.027] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2004] [Revised: 01/31/2005] [Accepted: 03/14/2005] [Indexed: 11/29/2022]
Abstract
The alpha2A and alpha2C adrenergic receptor (AR) subtypes mediate antinociception when activated by the endogenous ligand norepinephrine. These receptors also produce antinociceptive synergy when activated concurrently with opioid receptor activation. The involvement of the opioid receptors in the mechanisms governing transcutaneous electrical nerve stimulation (TENS) has been well described. While spinal alpha-2 ARs do not appear to be involved in TENS antihyperalgesia in rats, the noradrenergic analgesic system also involves supraspinal and peripheral sites. Thus, a broader evaluation of the potential contribution of alpha-2 AR to TENS is warranted. The current study compared the antihyperalgesic efficacy of high (100 Hz) and low (4 Hz) frequency TENS in mutant mice lacking a functional alpha2A AR against their respective wildtype counterparts. The degree of secondary heat hyperalgesia induced by intra-articular injection of carrageenan/kaolin (3%) mixture did not differ among the experimental groups. However, the antihyperalgesia induced by both low and high frequency TENS was significantly diminished in alpha2A mutant mice compared to controls. The alpha2 adrenergic receptor selective antagonist, SK&F 86466, reversed TENS-mediated antihyperalgesia when delivered intra-articularly, but not when delivered intrathecally or intracerebroventricularly. These data suggest that peripheral alpha2 ARs contribute, in part, to TENS antihyperalgesia. This pharmacodynamic response is consistent with previous anatomical observations that alpha2A ARs are expressed on primary afferent neurons and macrophages near injured tissue.
Collapse
Affiliation(s)
- Ellen W King
- Department of Pharmaceutics, University of Minnesota, Minneapolis, MN 55455, USA Department of Pharmacology, University of Minnesota, Minneapolis, MN 55455, USA Department of Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA Center for Pain Research, University of Minnesota, Minneapolis, MN 55455, USA Graduate Program in Physical Therapy and Rehabilitation Science Graduate Program, University of Iowa, Iowa City, IA 52242-1190, USA Graduate Program in Neuroscience Graduate Program, University of Iowa, Iowa City, IA 52242-1190, USA Graduate Program in Pain Research Program, University of Iowa, Iowa City, IA 52242-1190, USA Graduate Program in College of Medicine, University of Iowa, Iowa City, IA 52242-1190, USA
| | | | | | | | | | | |
Collapse
|
19
|
Hostutler RA, Chew DJ, DiBartola SP. Recent concepts in feline lower urinary tract disease. Vet Clin North Am Small Anim Pract 2005; 35:147-70, vii. [PMID: 15627632 DOI: 10.1016/j.cvsm.2004.08.006] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This article presents and discusses recent concepts in feline lower urinary tract disease.
Collapse
Affiliation(s)
- Roger A Hostutler
- Department of Clinical Sciences, The Ohio State University, College of Veterinary Medicine, Columbus, OH 43210, USA.
| | | | | |
Collapse
|
20
|
Stevens CW. Opioid research in amphibians: an alternative pain model yielding insights on the evolution of opioid receptors. BRAIN RESEARCH. BRAIN RESEARCH REVIEWS 2004; 46:204-15. [PMID: 15464208 PMCID: PMC3069712 DOI: 10.1016/j.brainresrev.2004.07.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/07/2004] [Indexed: 11/20/2022]
Abstract
This review summarizes the work from our laboratory investigating mechanisms of opioid analgesia using the Northern grass frog, Rana pipiens. Over the last dozen years, we have accumulated data on the characterization of behavioral effects after opioid administration on radioligand binding by using opioid agonist and antagonist ligands in amphibian brain and spinal cord homogenates, and by cloning and sequencing opioid-like receptor cDNA from amphibian central nervous system (CNS) tissues. The relative analgesic potency of mu, delta, and kappa opioids is highly correlated between frogs and other mammals, including humans. Radioligand binding studies using selective opioid agonists show a similar selectivity profile in amphibians and mammals. In contrast, opioid antagonists that are highly selective for mammalian mu, delta, and kappa opioid receptors were not selective in behavioral and binding studies in amphibians. Three opioid-like receptor cDNAs were cloned and sequenced from amphibian brain tissues and are orthologs to mammalian mu, delta, and kappa opioid receptors. Bioinformatics analysis of the three types of opioid receptor cDNAs from all vertebrate species with full datasets gave a pattern of the molecular evolution of opioid receptors marked by the divergence of mu, delta, and kappa opioid receptor sequences during vertebrate evolution. This divergence in receptor amino acid sequence in later-evolved vertebrates underlies the hypothesis that opioid receptors are more type-selective in mammals than in nonmammalian vertebrates. The apparent order of receptor type evolution is kappa, then delta, and, most recently, the mu opioid receptor. Finally, novel bioinformatics analyses suggest that conserved extracellular receptor domains determine the type selectivity of vertebrate opioid receptors.
Collapse
Affiliation(s)
- Craig W Stevens
- Department of Pharmacology and Physiology, College of Osteopathic Medicine, Center for Health Sciences, Oklahoma State University, 1111 West 17th Street, Tulsa, OK 74107-1898, USA.
| |
Collapse
|
21
|
Abstract
Systemic administration of analgesics can lead to serious adverse side effects compromising therapeutic benefit in some patients. Information coding pain transmits along an afferent neuronal network, the first synapses of which reside principally in the spinal cord. Delivery of compounds to spinal cord, the intended site of action for some analgesics, is potentially a more efficient and precise method for inhibiting the pain signal. Activation of specific proteins that reside in spinal neuronal membranes can result in hyperpolarization of secondary neurons, which can prevent transmission of the pain signal. This is one of the mechanisms by which opioids induce analgesia. The spinal cord is enriched in such molecular targets, the activation of which inhibit the transmission of the pain signal early in the afferent neuronal network. This review describes the pre-clinical models that enable new target discovery and development of novel analgesics for site-directed pain management.
Collapse
|
22
|
Sánchez-Camacho C, Marín O, Smeets WJ, Ten Donkelaar HJ, González A. Descending supraspinal pathways in amphibians. II. Distribution and origin of the catecholaminergic innervation of the spinal cord. J Comp Neurol 2001; 434:209-32. [PMID: 11331525 DOI: 10.1002/cne.1173] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Immunohistochemical studies with antibodies against tyrosine hydroxylase, dopamine, and noradrenaline have revealed that the spinal cord of anuran, urodele, and gymnophionan (apodan) amphibians is abundantly innervated by catecholaminergic (CA) fibers and terminals. Because intraspinal cells occur in all three orders of amphibians CA, it is unclear to what extent the CA innervation of the spinal cord is of supraspinal origin. In a previous study, we showed that many cell groups throughout the forebrain and brainstem project to the spinal cord of two anurans (the green frog, Rana perezi, and the clawed toad, Xenopus laevis), a urodele (the Iberian ribbed newt, Pleurodeles waltl), and a gymnophionan (the Mexican caecilian, Dermophis mexicanus). To determine the exact site of origin of the supraspinal CA innervation of the amphibian spinal cord, retrograde tracing techniques were combined with immunohistochemistry for tyrosine hydroxylase in the same sections. The double-labeling experiments demonstrated that four brain centers provide CA innervation to the amphibian spinal cord: 1.) the ventrolateral component of the posterior tubercle in the mammillary region, 2.) the periventricular nucleus of the zona incerta in the ventral thalamus, 3.) the locus coeruleus, and 4.) the nucleus of the solitary tract. This pattern holds for all three orders of amphibians, except for the CA projection from the nucleus of the solitary tract in gymnophionans. There are differences in the strength of the projections (based on the number of double-labeled cells), but in general, spinal functions in amphibians are controlled by CA innervation from brain centers that can easily be compared with their counterparts in amniotes. The organization of the CA input to the spinal cord of amphibians is largely similar to that described for mammals. Nevertheless, by using a segmental approach of the CNS, a remarkable difference was observed with respect to the diencephalic CA projections.
Collapse
Affiliation(s)
- C Sánchez-Camacho
- Departamento de Biología Celular, Facultad de Biología, Universidad Complutense, Madrid, Spain
| | | | | | | | | |
Collapse
|
23
|
Abstract
Pain perception and appropriate behavioral responses are important for survival. The conservation of the opioid ligand and receptor suggests evolution of opioid receptors mediating antinociception throughout vertebrate phylogeny. Fish, amphibians, and reptiles have appropriate neurologic components, display the appropriate behavior in response to a painful stimulus, and possess antinociceptive mechanisms to modulate pain. Because pain perception in these species is therefore likely to be analogous to that of mammals, invasive and painful procedures should always be accompanied by appropriate analgesia and anesthesia. Although specific doses have not been established in clinical trials, clinicians should attempt to provide lower vertebrates with appropriate analgesia during painful procedures. Further experimental and clinical investigations are necessary to expand the current veterinary literature in the area of pain and analgesia in lower vertebrates such as fish, amphibians, and reptiles.
Collapse
Affiliation(s)
- K L Machin
- Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. karen.machin@.usask.ca
| |
Collapse
|
24
|
Hamamoto DT, Forkey MW, Davis WL, Kajander KC, Simone DA. The role of pH and osmolarity in evoking the acetic acid-induced wiping response in a model of nociception in frogs. Brain Res 2000; 862:217-29. [PMID: 10799688 DOI: 10.1016/s0006-8993(00)02138-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Acetic acid applied to the hindlimb of a frog evokes a vigorous wiping of the exposed skin. The aim of this study was to determine if acetic acid evokes this wiping response by decreasing subepidermal pH. Because acetic acid is hyperosmolar, a second aim was to determine if the osmolarity of acetic acid contributed to evoking the wiping response. In behavioral experiments, different acids or acetic acid/sodium acetate buffers at different pHs were used to evoke the wiping response. In separate experiments, subepidermal pH was measured in vitro while these same solutions were applied to samples of skin from frogs. The wiping response evoked by acetic acid was associated with a decrease in subepidermal pH to a level that has been shown to activate nociceptors. Interestingly, formic, oxalic, sulfuric, and hydrochloric acid evoked the wiping response without decreasing subepidermal pH. The osmolarity of acetic acid contributed to evoking the wiping response because buffers at subthreshold pHs evoked the wiping response. Also, the osmolarity required to evoke the wiping response depended upon the pH of the buffer. Thus, acetic acid and the buffers at pH 2.97 and 4.67 could evoke the wiping response by decreasing subepidermal pH. In contrast, formic, oxalic, sulfuric, and hydrochloric acid, as well as the buffers at pH 5.17 and 5.67, evoked the wiping response through another mechanism, perhaps by increasing subepidermal osmolarity. These studies demonstrate that both pH and osmolarity may contribute to nociception produced by algesic chemicals and may be important in inflammatory pain.
Collapse
Affiliation(s)
- D T Hamamoto
- Department of Oral Science, University of Minnesota, 17-252 Moos Tower, 515 Delaware Street S.E., Minneapolis, MN, USA.
| | | | | | | | | |
Collapse
|