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Nelson GR, Mama KR, Weiner D, McKemie DS, Kass PH, Steinmetz SJ, Knych HK. Pharmacokinetics, pharmacodynamics and antinociceptive effects of buprenorphine following transdermal administration to horses. Vet Anaesth Analg 2024; 51:520-530. [PMID: 38834387 DOI: 10.1016/j.vaa.2024.05.001] [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] [Received: 03/19/2024] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVE This study describes the pharmacokinetics and pharmacodynamics, including antinociceptive effects, of a transdermal buprenorphine solution in horses. It was hypothesized that transdermal application would lead to sustained blood concentrations and antinociceptive effects with fewer adverse effects compared with intravenous (IV) injection. STUDY DESIGN Prospective nonrandomized four-part parallel experimental study. ANIMALS A group of eight horses (three mares and five geldings) aged 6-12 years. METHODS Horses were administered incremental doses of 15, 30 and 45 μg kg-1 of buprenorphine transdermal solution and a single IV dose of 5 μg kg-1 of buprenorphine with a 2 week washout period between treatments. Concentrations of buprenorphine were determined in plasma using liquid chromatography-tandem mass spectrometry and modeled using a nonlinear mixed effects population pharmacokinetic model to determine pharmacokinetic parameters. Pharmacodynamic effects, including changes in locomotor activity, heart rate, body temperature, gastrointestinal borborygmi, thermal and mechanical nociceptive thresholds were recorded. Mixed effects analysis of variance and post hoc comparisons were performed using a Bonferroni multiple comparison adjustment to assess differences in pharmacodynamic parameters between baseline and each time point within each dose group and between dose groups at the same time point. RESULTS Transdermal application of buprenorphine resulted in low systemic concentrations relative to IV injection. Bioavailability after transdermal application was 11%. Thermal nociceptive thresholds were significantly (p < 0.05) increased (4.3-10.7% relative to baseline) for up to 72 hours in the IV dose group, but only sporadically in the transdermal dose groups (2.5-9.9% relative to baseline). Changes in locomotor activity, heart rate and borborygmi varied over time and with dose. CONCLUSIONS AND CLINICAL RELEVANCE Limited thermal antinociceptive effects were observed at the transdermal doses studied likely owing to limited absorption relative to IV dosing. Future studies may be directed toward investigating antinociceptive effects of higher transdermal doses and different application sites.
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Affiliation(s)
- Gabrielle R Nelson
- K.L. Maddy Equine Analytical Chemistry Laboratory (Pharmacology Section), School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Khursheed R Mama
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Dan Weiner
- Pharmacometrics Consultant, North Carolina, USA
| | - Dan S McKemie
- K.L. Maddy Equine Analytical Chemistry Laboratory (Pharmacology Section), School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Philip H Kass
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Stacy J Steinmetz
- K.L. Maddy Equine Analytical Chemistry Laboratory (Pharmacology Section), School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Heather K Knych
- K.L. Maddy Equine Analytical Chemistry Laboratory (Pharmacology Section), School of Veterinary Medicine, University of California, Davis, CA, USA; Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA, USA.
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Paranjape VV, Knych HK, Berghaus LJ, Giancola S, Cathcart J, Reed RA. Plasma concentrations of buprenorphine administered via matrix-type transdermal patches applied at three different anatomical locations in healthy adult horses. FRONTIERS IN PAIN RESEARCH 2024; 5:1390322. [PMID: 38962712 PMCID: PMC11220193 DOI: 10.3389/fpain.2024.1390322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 06/06/2024] [Indexed: 07/05/2024] Open
Abstract
Background Anatomical location-dependent differences in transdermal opioid penetration are well described in human patients. Although this has been investigated in horses with fentanyl, there is no literature available on location-dependent plasma buprenorphine concentrations when administered as a transdermal matrix-type patch. Objective This study aims to compare the plasma concentrations achieved from the matrix-type transdermal buprenorphine patches placed at different anatomical sites (metacarpus, gaskin, and ventral tail base) in healthy adult horses. Study design This is a randomized experimental study with a Latin square design. Methods Six adult horses were given each of three treatments with a minimum 10-day washout period. For each treatment, two 20 μg h-1 matrix-type buprenorphine patches were applied to the ventral aspect of the tail base (TailTDP), metacarpus region (MetacarpusTDP), or gaskin region (GaskinTDP). Whole blood samples (for determination of buprenorphine concentration) and physiological variables were collected before (0 h) and at 0.5, 2, 4, 6, 8, 10, 12, 16, 24, 32, 48, 56, 72, 96 and 120 h after patches were applied. The patches were removed 96 h following placement and were analyzed for residual buprenorphine content. Buprenorphine concentrations were measured in plasma by LC-MS/MS. A mixed-effects model was used to analyze the physiological variables. Results Between the three treatment groups, there was no change in physiological variables across timepoints as compared to baseline and when compared to each other in a single horse and between horses (p > 0.3). When comparing all three locations, the buprenorphine uptake was observed to be more consistent with respect to measurable plasma concentrations >0.1 ng ml-1 when applied to the ventral aspect of the tail base. In the TailTDP group, the mean plasma buprenorphine concentrations were >0.1 ng ml-1 from 2 to 32 h. The highest group mean was 0.25 ng ml-1 noted at 4 h. Conclusions The metacarpal and gaskin regions presented more erratic and inconsistent buprenorphine uptake and plasma concentrations as compared to the ventral aspect of the tail base. Further research must be directed at investigating the optimal dose, achievable duration of analgesia, change in measurable plasma concentrations, and behavioral and systemic effects.
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Affiliation(s)
- Vaidehi V. Paranjape
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Heather K. Knych
- K. L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California-Davis, Davis, CA, United States
| | - Londa J. Berghaus
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Shyla Giancola
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Jessica Cathcart
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Rachel A. Reed
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
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Paranjape VV, Knych HK, Berghaus LJ, Cathcart J, Giancola S, Craig H, James C, Saksena S, Reed RA. Evaluation of physical variables, thermal nociceptive threshold testing and pharmacokinetics during placement of transdermal buprenorphine matrix-type patch in healthy adult horses. FRONTIERS IN PAIN RESEARCH 2024; 5:1373555. [PMID: 38529072 PMCID: PMC10961409 DOI: 10.3389/fpain.2024.1373555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 02/29/2024] [Indexed: 03/27/2024] Open
Abstract
Background Matrix type transdermal buprenorphine patches have not been investigated in horses and may provide an effective means of providing continuous pain control for extended period and eliminating venous catheterization. Objective Assessment of the physiological variables (heart rate, respiratory rate, body temperature) and thermal nociceptive threshold testing, and describing the pharmacokinetic profile of transdermal buprenorphine matrix-type patch (20 μg h-1 and 40 μg h-1 dosing) in healthy adult horses. Study design Randomised experimental study with a Latin-square design. Methods Six adult healthy horses received each of the three treatments with a minimum 10 day washout period. BUP0 horses did not receive a patch (control). BUP20 horses received one patch (20 μg h-1) applied on the ventral aspect of the tail base resulting in a dose of 0.03-0.04 μg kg-1 h-1. BUP40 horses received two patches placed alongside each other (40 μg h-1) on the tail base resulting in a dose of 0.07-0.09 μg kg-1 h-1. Whole blood samples (for determination of buprenorphine concentration), physiological variables and thermal threshold testing were performed before (0 h) and at 2, 4, 8, 12, 16, 24, 32, 40, 48, 56, 64, 72, and 96 h after patch application. The patches were removed 72 h following placement and were analyzed for residual buprenorphine content. Results Between the three groups, there was no change in physiological variables across timepoints as compared to baseline (p > 0.1). With the higher dose, there was a significant increase in thermal thresholds from baseline values from 2 h until 48 h and these values were significantly higher than the group receiving the lower patch dose for multiple timepoints up to 40 h. 40 μg h-1 patch led to consistent measurable plasma concentrations starting at 2 h up to 96 h, with the mean plasma concentrations of > 0.1 ng/ml from 4 h to 40 h. Conclusions 20 μg h-1 and 40 μg h-1 patch doses were well tolerated by all horses. At higher dose, plasma buprenorphine concentrations were more consistently measurable and blunted thermal thresholds for 48 h vs. 32 h with 20 μg h-1 dosing as compared to control.
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Affiliation(s)
- Vaidehi V. Paranjape
- Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Heather K. Knych
- K. L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California-Davis, Davis, CA, United States
| | - Londa J. Berghaus
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Jessica Cathcart
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Shyla Giancola
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Hannah Craig
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Caroline James
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Siddharth Saksena
- Department of Civil and Environmental Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Rachel A. Reed
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
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Reed RA, Krikorian AM, Reynolds RM, Holmes BT, Branning MM, Lemons MB, Barletta M, Quandt JE, Burns CC, Dantino SC, Sakai DM. Post-anesthetic CPS and EQUUS-FAP scores in surgical and non-surgical equine patients: an observational study. FRONTIERS IN PAIN RESEARCH 2023; 4:1217034. [PMID: 37502312 PMCID: PMC10369185 DOI: 10.3389/fpain.2023.1217034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/04/2023] [Indexed: 07/29/2023] Open
Abstract
Background Equine pain scoring may be affected by the residual effect of anesthetic drugs. Objectives To compare pain scores in the hours immediately following anesthetic recovery to baseline pre-anesthetic scores in equine patients undergoing surgical and non-surgical procedures. Study design Clinical observational study. Methods Fifty adult horses undergoing anesthesia for surgical or non-surgical procedures were enrolled. Horses underwent pain scoring using the Composite Pain Score (CPS) and Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP) prior to anesthesia (T0) and following anesthetic recovery to standing, every hour for 5 h (T1-T5). Data were analyzed using a generalized linear mixed effects model. A post-hoc Dunnett's test for multiple comparisons was performed for variables where an effect was detected. Results Mean (95% confidence interval) CPS scores for T0-T5 were 1.6 (1.2-2.0), 6.8 (6.0-7.6), 5.1 (4.3-5.9), 4.3 (3.4-5.2), 3.7 (2.8-4.6), and 2.8 (2.0-3.6) and EQUUS-FAP scores were 0.6 (0.3-0.9), 3.0 (2.5-3.5), 1.9 (1.6-2.2), 1.1 (0.8-1.4), 0.6 (0.4-0.8), and 0.7 (0.4-1.0), respectively. For the CPS, scores greater than 5, and for the EQUUS-FAP scores greater than 3, are consistent with minor pain. There was no effect of type of procedure (surgical vs non-surgical) on CPS or EQUUS-FAP scores. There was an effect of time with CPS scores significantly greater than baseline at T1-T5 and EQUUS-FAP scores significantly greater than baseline at T1 and T2. Main limitations Discomfort caused by hoisting was not quantified and it was difficult to ascertain if this affected the results. Conclusions Post-anesthetic pain scores may be influenced by the residual effect of anesthetic agents for as long as 5 h and 2 h for the CPS and EQUUS-FAP, respectively.
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Affiliation(s)
- Rachel Anne Reed
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Anna M. Krikorian
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Rose M. Reynolds
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Brittany T. Holmes
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Megan M. Branning
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Margaret B. Lemons
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Michele Barletta
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Jane E. Quandt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Charlotte C. Burns
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Stephanie C. Dantino
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Daniel M. Sakai
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
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Bookbinder L, Prisk A. Updates on Diagnosis and Management of Colic in the Field and Criteria for Referral. Vet Clin North Am Equine Pract 2023:S0749-0739(23)00013-5. [PMID: 37121785 DOI: 10.1016/j.cveq.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Gastrointestinal colic is the most common primary care equine emergency and affects nearly one of four horses per year. Colic is a significant welfare concern for equine patients and a financial and emotional burden for owners. The primary care practitioner is instrumental in identifying critical cases quickly and making appropriate management recommendations to improve patient outcomes.
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Affiliation(s)
- Lauren Bookbinder
- Large Animal Clinical Sciences, Michigan State University College of Veterinary Medicine, 736 Wilson Road, East Lansing, MI, USA.
| | - Amanda Prisk
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, USA
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Castro-Cuellar G, Cremer J, Liu CC, Queiroz-Williams P, Hampton C, Leise BS. Buprenorphine has a concentration-dependent cytotoxic effect on equine chondrocytes in vitro. Am J Vet Res 2023; 84:ajvr.22.08.0143. [PMID: 36662607 DOI: 10.2460/ajvr.22.08.0143] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To investigate the cytotoxic effects of 2 different concentrations of buprenorphine and compare them with bupivacaine and morphine on healthy equine chondrocytes in vitro. SAMPLE Primary cultured equine articular chondrocytes from 3 healthy adult horses. PROCEDURES Chondrocytes were exposed for 0 and 2 hours to the following treatments: media (CON; negative control); bupivacaine at 2.2 mg/mL (BUPI; positive control); morphine at 2.85 mg/mL (MOR); buprenorphine at 0.12 mg/mL (HBUPRE); or buprenorphine at 0.05 mg/mL (LBUPRE). Chondrocyte viability was assessed using live/dead staining, water-soluble tetrazolium salt-8 (WST-8) cytotoxic assay, LDH assay, and flow cytometry. All continuous variables were evaluated with a mixed ANOVA with treatment, time, and their interactions as the fixed effects and each horse as the random effect. RESULTS Buprenorphine showed a concentration-dependent chondrotoxic effect. The viability of chondrocytes was significantly decreased with exposure to HBUPRE and BUPI compared to CON, MOR, and LBUPRE. CLINICAL RELEVANCE Negligible chondrotoxic effects were observed in healthy cultured equine chondrocytes exposed to 0.05 mg/mL of buprenorphine, whereas higher concentrations (0.12 mg/mL) showed a marked cytotoxic effect. Based on these results, low concentrations of buprenorphine appear to be safe for intra-articular administration. Further evaluation of this dose in vivo is needed before recommending its clinical use.
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Affiliation(s)
- Gabriel Castro-Cuellar
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA
| | - Jeannette Cremer
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA
| | - Chin-Chi Liu
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA
| | - Patricia Queiroz-Williams
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA
| | - Chiara Hampton
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN
| | - Britta Sigrid Leise
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA
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Reed R, Trenholme N, Skrzypczak H, Chang K, Ishikawa Y, Barletta M, Quandt J, Knych H, Sakai D. Comparison of hydromorphone and butorphanol for management of pain in equine patients undergoing elective arthroscopy: a randomized clinical trial. Vet Anaesth Analg 2022; 49:490-498. [PMID: 35752564 DOI: 10.1016/j.vaa.2022.05.006] [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] [Received: 03/30/2022] [Revised: 05/27/2022] [Accepted: 05/27/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare the effects of hydromorphone and butorphanol in horses undergoing arthroscopy and describe the pharmacokinetics of hydromorphone in anesthetized horses. STUDY DESIGN Randomized controlled clinical trial. ANIMALS A total of 40 adult horses admitted for elective arthroscopy. METHODS Horses were randomly assigned to be administered intravenous hydromorphone (0.04 mg kg-1; group TxH; n = 19) or butorphanol (0.02 mg kg-1; group TxB; n = 21) prior to surgery as part of a standardized anesthetic protocol. Pain was scored by two observers unaware of group assignment using the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP) and a composite pain scale (CPS) prior to surgery (baseline), 2 hours (P2) and 4 hours (P4) following recovery from anesthesia. Blood samples were collected at various time points for determination of plasma hydromorphone concentration using liquid chromatography-tandem mass spectrometry. Data were analyzed with a mixed-effect model. RESULTS Median (range) baseline EQUUS-FAP was 1.2 (0.0-4.0) with no effect of group, time points or interaction. Baseline CPS was similar between groups. Group TxH baseline CPS was 2.5 (0.0-10.0), increased at P2 [4.5 (0-10.0); p = 0.046] and returned to baseline values at P4 [3.0 (0.0-11.0)]. Group TxB baseline CPS was 2.0 (0.0-8.0), increased at P2 [3.5 (0.0-11.0); p = 0.009] and P4 [5.0 (0.0-11.0); p < 0.001]. Pharmacokinetic terminal half-life was 774 ± 82.3 minutes, area under the curve was 1362 ± 314 ng minutes mL-1, clearance was 30.7 ± 7.23 mL minute-1 kg-1 and volume of distribution at steady state was 884 ± 740 mL kg-1. CONCLUSIONS Hydromorphone, but not butorphanol, decreased CPS back to baseline at P4 after recovery. CLINICAL RELEVANCE Hydromorphone may provide superior postoperative analgesia compared with butorphanol in horses undergoing arthroscopy.
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Affiliation(s)
- Rachel Reed
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
| | - Nicole Trenholme
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Heather Skrzypczak
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Kevin Chang
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Yushun Ishikawa
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Michele Barletta
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Jane Quandt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Heather Knych
- K.L. Maddy Equine Analytical Pharmacology Laboratory, University of California-Davis, Davis, CA, USA
| | - Daniel Sakai
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
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Rønnow Kjærulff LN, Lindegaard C. A narrative review of caudal epidural anaesthesia and analgesia in horses. Part 2: Clinical indications and techniques. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13489] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- L. N. Rønnow Kjærulff
- Department of Veterinary Clinical Sciences Faculty of Health Sciences University of Copenhagen Taastrup Denmark
| | - C. Lindegaard
- Department of Veterinary Clinical Sciences Faculty of Health Sciences University of Copenhagen Taastrup Denmark
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Haunhorst FR, Hopster K, Schmicke M, Bienert-Zeit A, Kästner S. Clinical effect of buprenorphine or butorphanol, in combination with detomidine and diazepam, on sedation and postoperative pain after cheek tooth extraction in horses. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2022; 63:39-46. [PMID: 34975166 PMCID: PMC8682929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The objective of this study was to compare effects of butorphanol (BUT) or buprenorphine (BUP), in combination with detomidine and diazepam, on the sedation quality, surgical conditions, and postoperative pain control after cheek tooth extraction in horses, randomly allocated to 2 treatment groups (BUT: n = 20; BUP: n = 20). A bolus of detomidine (15 μg/kg, IV) was followed by either BUP (7.5 μg/kg, IV) or BUT (0.05 mg/kg, IV). After 20 min, diazepam (0.01 mg/kg, IV) was administered and sedation was maintained with a detomidine IV infusion (20 μg/kg/h), with rate adjusted based on scores to 5 variables. All horses received a nerve block (maxillary or mandibular), and gingival infiltration with mepivacaine. Sedation quality was assessed by the surgeon from 1 (excellent) to 10 (surgery not feasible). A pain scoring system (EQUUS-FAP) was used to assess postoperative pain. Serum cortisol concentrations and locomotor activity (pedometers) were measured. Horses in BUP and BUT required a median detomidine infusion rate of 30.2 μg/kg/h (20 to 74.4 μg/kg/h) and 32.2 μg/kg/h (20 to 48.1 μg/kg/h), respectively (P = 0.22). Horses in the BUP group had better sedation quality (P < 0.05) during surgery and higher step counts (P < 0.001) postoperatively. Buprenorphine combined with detomidine provided a more reliable sedation than butorphanol. However, the EQUUS-FAP pain scale became unreliable because of BUP-induced excitement behavior.
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Affiliation(s)
- Franziska R Haunhorst
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany (Haunhorst, Bienert-Zeit); Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 382 West Street Road, Kennett Square, Philadelphia, Pennsylvania 19348, USA (Hopster); Institute of Agricultural and Nutritional Sciences, Martin-Luther University Halle-Wittenberg, Theodor-Lieser-Str. 11, 06120 Halle, Germany (Schmicke); Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany (Kästner)
| | - Klaus Hopster
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany (Haunhorst, Bienert-Zeit); Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 382 West Street Road, Kennett Square, Philadelphia, Pennsylvania 19348, USA (Hopster); Institute of Agricultural and Nutritional Sciences, Martin-Luther University Halle-Wittenberg, Theodor-Lieser-Str. 11, 06120 Halle, Germany (Schmicke); Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany (Kästner)
| | - Marion Schmicke
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany (Haunhorst, Bienert-Zeit); Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 382 West Street Road, Kennett Square, Philadelphia, Pennsylvania 19348, USA (Hopster); Institute of Agricultural and Nutritional Sciences, Martin-Luther University Halle-Wittenberg, Theodor-Lieser-Str. 11, 06120 Halle, Germany (Schmicke); Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany (Kästner)
| | - Astrid Bienert-Zeit
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany (Haunhorst, Bienert-Zeit); Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 382 West Street Road, Kennett Square, Philadelphia, Pennsylvania 19348, USA (Hopster); Institute of Agricultural and Nutritional Sciences, Martin-Luther University Halle-Wittenberg, Theodor-Lieser-Str. 11, 06120 Halle, Germany (Schmicke); Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany (Kästner)
| | - Sabine Kästner
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany (Haunhorst, Bienert-Zeit); Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 382 West Street Road, Kennett Square, Philadelphia, Pennsylvania 19348, USA (Hopster); Institute of Agricultural and Nutritional Sciences, Martin-Luther University Halle-Wittenberg, Theodor-Lieser-Str. 11, 06120 Halle, Germany (Schmicke); Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany (Kästner)
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Loomes K, Louro LF. Recovery of horses from general anaesthesia: A systematic review (2000-2020) of the influence of anaesthetic protocol on recovery quality. Equine Vet J 2021; 54:219-261. [PMID: 34668220 DOI: 10.1111/evj.13524] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 09/30/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND The recovery phase after equine general anaesthesia (GA) is a time of considerable risk and therefore has been the subject of extensive research over the last 20 years. Various pharmacological interventions have been developed and studied with the objective of improving recovery quality and reducing anaesthetic-related mortality and morbidity. Nevertheless, some controversy remains regarding the influence of anaesthetic protocol choice on recovery quality from GA and its implications for recovery-related mortality and morbidity. A systematic review of the literature investigating the influence of anaesthetic protocol choice on recovery quality is currently lacking. OBJECTIVES To perform a detailed evaluation of the equine veterinary literature investigating the effect of anaesthetic protocol choice on equine recovery quality utilising the GRADE framework. STUDY DESIGN A systematic evaluation of the equine veterinary literature was performed using the GRADE framework. METHODS A literature search was performed and studies were assessed for eligibility by both authors utilising PRISMA guidelines. Studies meeting inclusion criteria were evaluated by both authors, categorically summarised and the quality of evidence for each sub-topic was assessed using the GRADE framework. RESULTS A total of 124 studies were identified which directly assessed the impact of anaesthetic protocol choice on recovery quality after GA in horses. Evaluation of the available evidence indicated that certain partial intravenous anaesthesia (PIVA) agents, cessation of intravenous lidocaine 30 minutes prior to recovery and provision of adequate analgesia improves recovery quality. MAIN LIMITATIONS The validity of the results of some studies may have been compromised by missing data and small sample sizes. CONCLUSIONS There is evidence to indicate that certain PIVA agents, cessation of intravenous lidocaine 30 minutes prior to recovery and provision of adequate analgesia improves recovery quality.
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Loomes K, Jopling P. Anaesthetic management of 10 horses undergoing cervical intervertebral body fusion ‘wobbler surgery’. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Methadone or Butorphanol as Pre-Anaesthetic Agents Combined with Romifidine in Horses Undergoing Elective Surgery: Qualitative Assessment of Sedation and Induction. Animals (Basel) 2021; 11:ani11092572. [PMID: 34573538 PMCID: PMC8467133 DOI: 10.3390/ani11092572] [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] [Received: 07/18/2021] [Revised: 08/11/2021] [Accepted: 08/30/2021] [Indexed: 12/20/2022] Open
Abstract
Simple Summary When considering sedation or general anaesthesia in horses, a multimodal strategy is commonly preferred over a single drug. This includes the association of alpha-2 adrenoceptor agonists, phenothiazines or opioids, to improve the overall sedative and analgesic effects accordingly. However, the use of opioids alone is limited in horses due to the risk of sympathetic stimulation, central nervous system stimulation, excitement and head jerking. In some countries, butorphanol is currently the only licensed and most used opioid in equine medicine. We aimed to evaluate the pre-anaesthetic association of romifidine with either butorphanol or methadone. The two combinations were administered before induction of general anaesthesia, which included diazepam and ketamine. Evaluations involved the degree of sedation and ataxia, effects on physiological parameters, such as heart and respiratory rates, rectal temperature, quality of induction, ease of intubation and the need for top-up agents before transition to the operating theatre and the institution of a maintenance regimen. Abstract While butorphanol is the most commonly used opioid in horses, methadone is not licensed in most countries. Our aim was to compare the effects of both drugs, combined with romifidine, regarding the quality of sedation and induction in horses undergoing elective surgery. Results indicate the suitability of both methadone and butorphanol in this patient population. Animals were scored 10 min after intravenous injection of sedatives. Despite lower overall sedation (OS) score in horses receiving methadone (p = 0.002), the quality and time of induction and intubation remained unchanged. None of the horses had the lowest OS score (no sedation), nor the highest score for ataxia (horse falling). Methadone induced a tendency for minor noise reaction yet minor head lowering scores, the latter being probably the most influencing parameter when scoring OS. Measured physiological parameters decreased in both groups, with greater bradycardia recorded after methadone (p = 0.017), including a higher incidence of atrioventricular blocks that resolved during general anaesthesia. The quality of induction was good–excellent in most of the animals. While comparisons between the degree of antinociception were beyond the scope of this study, analgesic potency might influence the choice when considering opioids as pre-anaesthetic drugs in combination with romifidine before surgery in equines.
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Mackenzie C. Clinical insights: Equine analgesia. Equine Vet J 2021; 53:407-409. [PMID: 33834534 DOI: 10.1111/evj.13421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/10/2021] [Indexed: 11/30/2022]
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Flynn H, Cenani A, Brosnan RJ, DiMaio Knych HK, de Araujo Aguiar AJ. Pharmacokinetics and pharmacodynamics of a high concentration of buprenorphine (Simbadol) in conscious horses after subcutaneous administration. Vet Anaesth Analg 2021; 48:585-595. [PMID: 33934992 DOI: 10.1016/j.vaa.2021.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/27/2021] [Accepted: 02/17/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine the pharmacokinetics and pharmacodynamics of high-concentration formulation of buprenorphine (1.8 mg mL-1; Simbadol) following subcutaneous (SC) administration in horses. STUDY DESIGN Prospective, randomized, crossover trial. ANIMALS A group of six healthy adult horses weighing 521-602 kg. METHODS On three occasions, Simbadol (0.005 mg kg-1; treatment S5), (0.0025 mg kg-1; treatment S2.5) or saline (treatment SAL) were administered SC at least 7 days apart in random order. Electrical nociceptive threshold (ENT) measured on the neck region, physiologic variables, locomotor activity, degree of restlessness and presence of excitatory signs were measured at baseline and for up to 48 hours after injection. Blood was collected for pharmacokinetic analysis at the same time intervals and plasma buprenorphine concentration (Cp) measured using liquid chromatography-tandem mass spectrometry. RESULTS Buprenorphine was quantifiable in all horses from 15 minutes after administration up to 8-12 hours. ENT was significantly increased in treatment S2.5 compared with treatment SAL at 0.75-6 hours after treatment. Increase in locomotor activity and compulsive behavior were recorded in all horses after Simbadol, and degree of restlessness was significantly higher in treatment S5 than SAL for a sustained time. Gastrointestinal motility significantly decreased in all horses after Simbadol and returned to baseline by 16 hours after treatment. CONCLUSIONS AND CLINICAL RELEVANCE In horses, SC Simbadol was rapidly absorbed and Cp decreased rapidly. Side effects commonly seen in horses after opioids were observed in both Simbadol treatments, but degree of opioid-induced excitement lasted significantly longer in treatment S5. Simbadol (0.0025 mg kg-1) SC has the potential to be used clinically to treat pain in horses. However, at this dose, duration of antinociceptive effects was not longer than that reported for conventional buprenorphine, and side effects, including reduction in gastrointestinal motility and increased locomotor activity, were documented.
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Affiliation(s)
- Harriet Flynn
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Alessia Cenani
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA.
| | - Robert J Brosnan
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Heather K DiMaio Knych
- KL Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Antonio J de Araujo Aguiar
- Department of Veterinary Surgery and Anesthesiology, Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista - UNESP, Botucatu, SP, Brazil
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Lord S, Girling SJ, Eivers C, Pizzi R, Panti A. Presumptive buprenorphine associated intraoperative apnoea and prolonged recovery in a giant panda (
Ailuropoda melanoleuca
) during castration for testicular neoplasia. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-001063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Samuel Lord
- Clinical StudiesThe University of Edinburgh Royal Dick School of Veterinary StudiesEaster BushUK
| | | | - Caroline Eivers
- Diagnostic ImagingUniversity of Glasgow College of Medical Veterinary and Life SciencesGlasgowUK
| | - Romain Pizzi
- Wildlife Surgery InternationalRoslinMidlothianUK
| | - Ambra Panti
- AnaesthesiaUniversity of Edinburgh Royal Dick School of Veterinary StudiesEdinburghMidlothianUK
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Bowen IM, Redpath A, Dugdale A, Burford JH, Lloyd D, Watson T, Hallowell GD. BEVA primary care clinical guidelines: Analgesia. Equine Vet J 2020; 52:13-27. [PMID: 31657050 DOI: 10.1111/evj.13198] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 10/18/2019] [Indexed: 02/07/2023]
Abstract
Primary care guidelines provide a reference point to guide clinicians based on a systematic review of the literature, contextualised by expert clinical opinion. These guidelines develop a modification of the GRADE framework for assessment of research evidence (vetGRADE) and applied this to a range of clinical scenarios regarding use of analgesic agents. Key guidelines produced by the panel included recommendations that horses undergoing routine castration should receive intratesticular local anaesthesia irrespective of methods adopted and that horses should receive NSAIDs prior to surgery (overall certainty levels high). Butorphanol and buprenorphine should not be considered appropriate as sole analgesic for such procedures (high certainty). The panel recommend the continuation of analgesia for 3 days following castration (moderate certainty) and conclude that phenylbutazone provided superior analgesia to meloxicam and firocoxib for hoof pain/laminitis (moderate certainty), but that enhanced efficacy has not been demonstrated for joint pain. In horses with colic, flunixin and firocoxib are considered to provide more effective analgesia than meloxicam or phenylbutazone (moderate certainty). Given the risk of adverse events of all classes of analgesic, these agents should be used only under the control of a veterinary surgeon who has fully evaluated a horse and developed a therapeutic, analgesic plan that includes ongoing monitoring for such adverse events such as the development of right dorsal colitis with all classes of NSAID and spontaneous locomotor activity and potentially ileus with opiates. Finally, the panel call for the development of a single properly validated composite pain score for horses to allow accurate comparisons between medications in a robust manner.
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Affiliation(s)
- I M Bowen
- Oakham Veterinary Hospital/University of Nottingham, Sutton Bonington, Loughborough, UK
| | - A Redpath
- Oakham Veterinary Hospital/University of Nottingham, Sutton Bonington, Loughborough, UK
| | - A Dugdale
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, Loughborough, UK
| | - J H Burford
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, Loughborough, UK
| | - D Lloyd
- ChesterGates Veterinary Specialists, Chester, UK
| | - T Watson
- Waterlane Equine Vets, Stroud, UK
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Gozalo-Marcilla M, Luna SP, Gasthuys F, Pollaris E, Vlaminck L, Martens A, Haspeslagh M, Schauvliege S. Clinical applicability of detomidine and methadone constant rate infusions for surgery in standing horses. Vet Anaesth Analg 2019; 46:325-334. [PMID: 30935776 DOI: 10.1016/j.vaa.2019.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 12/12/2018] [Accepted: 01/19/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To determine the required rate of a detomidine infusion (loading dose 5 μg kg-1; initial rate 12.5 μg kg-1 hour-1) added to a constant infusion of methadone (0.2 mg kg-1; 0.05 mg kg-1 hour-1) for sedation in standing horses and ponies undergoing elective surgeries with appropriate local anaesthetic techniques. STUDY DESIGN Prospective, clinical study. ANIMALS Adult, healthy, client-owned, non-food-producing horses or ponies sedated for elective standing surgeries longer than 45 minutes. METHODS At baseline (in the stables before administration of sedative agents), at 10 minutes after sedation and every 5 minutes thereafter, ataxia, sedation and surgical condition were evaluated; each scored 0-3. These scores were used to adjust the detomidine administration rate using the Ghent Sedation Algorithm. A 10 cm visual analogue scale (VAS) was used by the main surgeon at the end of the procedure to evaluate the surgical conditions. Heart rate, systolic arterial pressure and respiratory frequency were also recorded at each time point. For statistical analysis, anova for normal, Kruskal-Wallis H-test for non-normal variables, and Mann-Whitney U test for VAS were used. RESULTS From the 42 horses/ponies included in this study, 28 underwent dental procedures and 14 other types of procedures. Overall, dental procedures required higher mean detomidine rates compared with other types of surgeries (16.9 ± 4.5 versus 9.0 ± 1.9 μg kg-1 hour-1) (p < 0.001). Dental procedures were assigned similar VAS scores, median (range), of 7.8 (5.8-10) with other procedures, 8.7 (2.8-10). Cardiovascular changes were not clinically significant. No signs or behavioural changes of abdominal pain were observed postoperatively. CONCLUSIONS AND CLINICAL RELEVANCE Satisfactory surgical conditions were achieved using a combination of detomidine and methadone infusions with locoregional anaesthesia, with no adverse effects. Dental procedures required higher detomidine dose rates compared with other surgeries.
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Affiliation(s)
- Miguel Gozalo-Marcilla
- The Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Edinburgh, UK.
| | - Stelio Pl Luna
- School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Frank Gasthuys
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Elke Pollaris
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Lieven Vlaminck
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Ann Martens
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | | | - Stijn Schauvliege
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Gozalo-Marcilla M, de Oliveira AR, Fonseca MW, Possebon FS, Pelligand L, Taylor PM, Luna SPL. Sedative and antinociceptive effects of different detomidine constant rate infusions, with or without methadone in standing horses. Equine Vet J 2018; 51:530-536. [PMID: 30485499 DOI: 10.1111/evj.13054] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 11/19/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Standing surgery avoids the risks of general anaesthesia in horses. OBJECTIVES To assess sedation, antinociception and gastrointestinal motility in standing horses after a detomidine loading dose and 2-h constant rate intravenous (i.v.) infusion, with or without methadone. STUDY DESIGN Blinded, randomised, crossover with seven healthy adult cross-bred horses, three geldings and four females (404 ± 22 kg). METHODS Five i.v. treatments were administered to all horses with 1-week washout period: saline (SAL), detomidine low (2.5 μg/kg bwt + 6.25 μg/kg bwt/h) (DL) and high doses (5 μg/kg bwt + 12.5 μg/kg bwt/h) (DH) alone or combined with methadone (0.2 mg/kg bwt + 0.05 mg/kg bwt/h), (DLM) and (DHM), respectively. Height of head above the ground (HHAG), electrical (ET), thermal (TT) and mechanical (MT) nociceptive thresholds and gastrointestinal motility were evaluated at predetermined times between 5 and 240 min. A mixed effect model and Kruskal-Wallis test were used to analyse normally and non-normally distributed data, respectively. RESULTS Sedation (<50% basal HHAG) was achieved for the duration of the infusion, and for an additional 15 min in DH and DHM groups. Nociceptive thresholds were higher than baseline, to the greatest degree and the longest duration, with DHM (ET and TT for 135 min and MT for 150 min). After DH, TT was significantly higher than baseline from 30 to 120 min and MT from 15 to 135 min. After DLM, ET was increased at 90 min, TT at 30 min and MT for 120 min. Gastrointestinal motility was reduced for up to 135 min after DL, 150 min after DLM and 210 min after DH and DHM. MAIN LIMITATIONS Nociceptive thresholds are not equivalent to surgical stimuli. CONCLUSION Methadone with the highest detomidine dose (DHM) may provide sufficient sedation and analgesia for standing surgical procedures and warrants further investigation.
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Affiliation(s)
- M Gozalo-Marcilla
- São Paulo State University (UNESP), School of Veterinary Medicine and Animal Science, Botucatu, São Paulo, Brazil.,The Royal (Dick) School of Veterinary Studies and the Roslin Institute, The University of Edinburgh, Midlothian, UK
| | - A R de Oliveira
- São Paulo State University (UNESP), School of Veterinary Medicine and Animal Science, Botucatu, São Paulo, Brazil
| | - M W Fonseca
- São Paulo State University (UNESP), School of Veterinary Medicine and Animal Science, Botucatu, São Paulo, Brazil
| | - F S Possebon
- São Paulo State University (UNESP), School of Veterinary Medicine and Animal Science, Botucatu, São Paulo, Brazil
| | - L Pelligand
- Royal Veterinary College, North Mymms, Hatfield, Hertfordshire, UK
| | | | - S P L Luna
- São Paulo State University (UNESP), School of Veterinary Medicine and Animal Science, Botucatu, São Paulo, Brazil
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Grubb TL, Kurkowski D, Sellon DC, Seino KK, Coffey T, Davis JL. Pharmacokinetics and physiologic/behavioral effects of buprenorphine administered sublingually and intravenously to neonatal foals. J Vet Pharmacol Ther 2018; 42:26-36. [PMID: 30242851 DOI: 10.1111/jvp.12715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 07/16/2018] [Accepted: 08/20/2018] [Indexed: 12/29/2022]
Abstract
Buprenorphine is absorbed following sublingual administration, which would be a low-stress delivery route in foals. However, the pharmacokinetics/pharmacodynamics are not described in foals. Six healthy foals <21 days of age participated in a blinded, randomized, 3-period, 5-sequence, 3-treatment crossover prospective study. Foals received 0.01-0.02 mg/kg buprenorphine administered SL or IV with an equivalent volume of saline administered by the opposite route. Blood was collected from the cephalic vein for pharmacokinetic analysis. Physiologic parameters (HR, RR, body temperature, GI sounds), locomotion (pedometer), and behavioral data (activity level, nursing time, response to humans) were recorded. Plasma concentration of buprenorphine exceeded a presumed analgesic level (0.6 ng/ml) in five foals in the IV group and one in the SL group but only for a very brief time. Pharmacokinetic analysis following IV administration demonstrated a short elimination half-life (t1/2β 1.95 ± 0.7 hr), large volume of distribution (6.46 ± 1.54 L/kg), and a high total clearance (55.83 ± 23.75 ml/kg/min), which differs from adult horses. Following SL administration, maximum concentrations reached were 0.61 ± 0.11 ng/ml and bioavailability was 25.1% ± 10.9%. In both groups, there were minor statistical differences in HR, RR, body temperature, locomotion, and time spent nursing. However, these differences were clinically insignificant in this single dose study, and excitement, sedation, or colic did not occur.
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Affiliation(s)
- Tamara L Grubb
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington
| | - Danielle Kurkowski
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington
| | - Deborah C Sellon
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington
| | - Kathy K Seino
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington
| | - Todd Coffey
- Center for Interdisciplinary Statistical Education and Research, Washington State University, Pullman, Washington
| | - Jennifer L Davis
- Department of Biomedical Sciences and Pathobiology, VA-MD College of Veterinary Medicine, VA Tech, Blacksburg, Virginia
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Feng L, Wang H, Lin M. Effect of painless STA on tooth extraction of elderly patients with periodontal diseases. Exp Ther Med 2018. [PMID: 29541167 PMCID: PMC5838287 DOI: 10.3892/etm.2018.5776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This study compared the effects of tooth extractions under novel painless single tooth anesthesia (STA) and conventional anesthesia on elderly patients with periodontal diseases, and the impact of painless STA on clinical indicators of the patients. Elderly patients (n=116) with periodontal diseases who were treated in Jinan Central Hospital were selected to undergo extraction operation on loose teeth; all the patients were randomly divided into two groups. The tooth extraction operations were performed after painless STA and cartridge anesthesia; the effects of the tooth extraction operations and the operation time were recorded; Visual Analogue Scale (VAS), Kuttner facial expression scale, Frankl treatment compliance scale and Houpt behavior rating scale were utilized to assess and record the clinical indicators of the patients during the operations; the impacts of the two anesthesia techniques on the effect of the tooth extraction of patients with periodontal diseases were comprehensively analyzed. Compared with conventional cartridge anesthesia, painless STA could effectively shorten the operation time (P<0.01); the Frankl treatment compliance score and Houpt behavior rating score of patients receiving painless STA were remarkably higher than those of patients receiving conventional cartridge anesthesia (P<0.01); during the operation, painless STA could effectively reduce the blood pressure and slow the heart rate by comparing with cartridge anesthesia (P<0.01, P<0.05); the scores of STA and Kuttner facial expressions in patients receiving painless STA were significantly lower than those in patients receiving conventional cartridge anesthesia (P<0.01); after the operation, the incidence of adverse reactions, such as pain and swelling, in patients receiving painless STA was obviously decreased compared with that in patients receiving conventional cartridge anesthesia (P<0.01). The novel painless STA can notably shorten the time of tooth extraction of elderly patients with periodontal diseases, reduce postoperative pain and swelling, increase the compliance of the operation, alleviate the impact of tooth extraction operation on the clinical indicators of the patients and relieve the pain of patients caused by the operation.
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Affiliation(s)
- Li Feng
- Customer Service Management Office, Shandong University Affiliated to Jinan Central Hospital, Jinan, Shandong 250013, P.R. China
| | - Haiming Wang
- Department of Stomatology, Jinan Hospital, Jinan, Shandong 250013, P.R. China
| | - Ming Lin
- Department of Stomatology, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong 250013, P.R. China
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Affiliation(s)
| | - E. J. Love
- School of Veterinary Sciences University of Bristol Bristol UK
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Gitari A, Nguhiu J, Varma V, Mogoa E. Occurrence, treatment protocols, and outcomes of colic in horses within Nairobi County, Kenya. Vet World 2017; 10:1255-1263. [PMID: 29184373 PMCID: PMC5682272 DOI: 10.14202/vetworld.2017.1255-1263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 09/15/2017] [Indexed: 11/16/2022] Open
Abstract
Aim: The aim of this study was to determine the treatments and their outcomes in horses with colic in Nairobi County, Kenya. Materials and Methods: This is a retrospective study to determine the occurrence, treatments, pain management, and outcomes of colic in horses in Nairobi County. Association between pain management protocols and the outcomes of colic with regard to recovery or death was also determined. Data collected from four equine practitioners were organized manually and given numerical codes as appropriate to facilitate entry into the computer. The coded data were entered into Microsoft Excel 2010 and exported to StatPlus pro 5.9.8 statistical package for analysis. Simple association tests were done between various factors and occurrence of colic. Results: The incidence of colic for the 11 years was 3.1%, which constituted 68.0% spasmodic colic, 27.8% impaction colic, and 4.2% displacement colic. Flunixin meglumine as a nonsteroidal anti-inflammatory drug (NSAID) was used as the only pain management treatment in 85.3% of the cases, flunixin meglumine and butorphanol as NSAID-OPIOD combination in 6.4% of the cases, while buscopan as an antispasmodic was recorded in 5.9% of the cases mainly in spasmodic colic. Univariate analysis revealed simple association between various factors and the type of colic a horse was having. There was an association between the type of colic and the decision-making on the pain management protocol to use, whether single analgesic protocol (χ2=22.5, p<0.001) or use of analgesic combinations (χ2=18.3, p<0.001). The type of colic strongly influenced the decision for performing nasogastric intubation (χ2=265, p<0.001), but performing nasogastric intubation was weakly (χ2=4.9, p=0.03) associated with horse recovery from colic. Type of colic also strongly influenced the need for the use of metabolic stimulants, particularly vitamin B-complex (χ2=99.3, p<0.001). Recovery or death of the horse from colic was strongly associated with the type of colic (χ2=250, p<0.001). The possibility of recurrence of colic was weakly (χ2=4.6, p=0.04) determined by the type of colic, a horse had. Multivariate logistic regression revealed that the main cause of death was intestinal displacement and the majority of the horses with intestinal displacement died (β-estimate 2.7, odds ratio=0.07, p=0.007) compared to horses that had impaction colic. Conclusion: The incidence of colic is 3.1%, and the most common type of colic is spasmodic followed by impaction. The most common pain management protocol for colic is NSAIDs, mainly flunixin meglumine, followed by flunixin-butorphanol combination. Surgery for horses with colic in Nairobi County is not commonly done due to impeding poor prognoses. The horse owners tend to prefer euthanasia for such cases.
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Affiliation(s)
- Anderson Gitari
- Department of Clinical Studies, Faculty of Veterinary Medicine, College of Agriculture and Veterinary Sciences, University of Nairobi, Nairobi, Kenya
| | - James Nguhiu
- Department of Clinical Studies, Faculty of Veterinary Medicine, College of Agriculture and Veterinary Sciences, University of Nairobi, Nairobi, Kenya
| | - Vijay Varma
- Department of Clinical Studies, Faculty of Veterinary Medicine, College of Agriculture and Veterinary Sciences, University of Nairobi, Nairobi, Kenya
| | - Eddy Mogoa
- Department of Clinical Studies, Faculty of Veterinary Medicine, College of Agriculture and Veterinary Sciences, University of Nairobi, Nairobi, Kenya
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Wright S. Highlights of recent clinically relevant papers. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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