Cardiopulmonary effects of sufentanil long acting on sevoflurane anaesthesia in dogs

Randomized clinical trial comparing outcomes after fentanyl or ketamine-dexmedetomidine analgesia in thoracolumbar spinal surgery in dogs

Background

Opioids are widely used for perioperative pain control in dogs undergoing spinal surgery, but alternatives may be required because data suggest that opioids exacerbate inflammation in the injured spinal cord and veterinary access to opioids may become more restricted in the future.

Objectives

To compare recovery of ambulation and other functions between spinal cord‐injured dogs receiving peri‐operative fentanyl and those receiving a ketamine‐dexmedetomidine combination.

Animals

A total of 102 client‐owned dogs undergoing decompressive surgery for thoracolumbar intervertebral disc herniation.

Methods

Randomized clinical trial. Dogs were randomized 1:1 to fentanyl or a ketamine‐dexmedetomidine combination for intra and postoperative analgesia. Primary outcome was time to recovery of ambulation; secondary outcomes were the postoperative Colorado Acute Pain Scale, the short‐form Glasgow Composite Measure Pain Scale, time to recovery of voluntary urination and time to unassisted eating.

Results

No difference was found in time to recovery of ambulation between groups (adjusted sub‐hazard ratio, 0.83; 95% confidence interval [CI], 0.55‐1.24; P = .36) or in pain scores (Colorado: χ² = 14.74; P = .32; Glasgow: χ² = 6.61; P = .76). Differences in time to recovery of eating and urination were small but favored ketamine‐dexmedetomidine (adjusted odds ratios, 3.31; 95% CI, 1.53‐7.16; P = .002 and 2.43; 95% CI, 1.00‐5.96; P = .05, respectively).

Conclusions and Clinical Importance

There was no evidence that, at the doses used, fentanyl impaired ambulatory outcome after surgery for thoracolumbar intervertebral disc herniation in dogs. Pain control appeared similar between groups. Secondary outcomes suggested minor benefits associated with ketamine‐dexmedetomidine. The ketamine‐dexmedetomidine combination appears to be a reasonable alternative to peri‐operative opioids.

Gonadectomy in Raccoons: Anesthetic and Cardiorespiratory Effects of Two Ketamine-Based Pre-Anesthetic Protocols before Sevoflurane-Sufentanil

Nineteen raccoons were enrolled in this study. The aim was to evaluate and compare the quality of anesthesia and the cardiorespiratory effects following treatment with a ketamine-based combination with either dexmedetomidine (KD group) or midazolam (KM group) in raccoons undergoing ovariohysterectomy/orchiectomy. General anesthesia was maintained with sevoflurane in oxygen and sufentanil infusion. The time required to approach the animals was similar among groups resulting in a median of 5 min after IM injection. Animals in group KD were scored with greater myorelaxation (p < 0.01) and easier intubation (p < 0.05). Moreover 70% of them did not require other drugs for tracheal intubation unlike animals in group KM, which required propofol in 100% of cases. After intubation and connection to the breathing circuit, physiological parameters were monitored continuously and recorded every 5 min. Sevoflurane requirements were lower in group KD than KM (p = 0.005). Blood pressure was maintained within physiological ranges in both groups but with higher values in group KM (p < 0.05). Mild respiratory depression occurred during surgery and animals in group KM showed greater respiratory acidosis (p < 0.05). Recovery was smooth and uneventful in all animals. Both anesthetic protocols can be recommended for safe anesthesia in wild raccoons.

Comparison between the intravenous and caudal routes of sufentanil in children undergoing orchidopexy and further evaluation of the association of caudal adrenaline and neostigmine

Background:

The aim of this study was to compare the intravenous (IV) and caudal routes of administration of sufentanil for children undergoing orchidopexy and also to evaluate the effects on addition of caudal adrenaline and neostigmine.

Materials and Methods:

Sixty patients scheduled for orchidopexy were divided into the following groups: 1) Group IVSu received IV 0.5 μg/kg sufentanil and caudal saline; 2) Group CSu received caudal 0.5 μg/kg sufentanil and IV saline; 3) Group CSuAdr received caudal sufentanil plus adrenaline 5 μg/ml (1:200,000) and IV saline; 4) Group CSuNeo received caudal sufentanil plus neostigmine, and IV saline; and 5) Group CSuNeoAdr received caudal sufentanil plus neostigmine plus adrenaline, and IV saline. Heart rate and mean blood pressure >15% was treated with increasing isoflurane concentration. Consumption of isoflurane, side effects, quality of sleep, time to first administration of analgesic, and number of doses of 24-h rescue analgesic were recorded.

Results:

Groups were demographically similar. Isoflurane consumption showed the following association: Group IVSu = Group CSuNeo = Group CSuNeoAdr < Group CSu = Group CSuAdr (P < 0.02). VAS for sedation on reversal of anesthesia showed the following association: Group CSuNeo = Group CSuNeoAdr < Group CSu = Group CSuAdr = Group IVSu (P < 0.005). Time to the first administration of dipyrone showed the following association: Group IVSu = Group CSu = Group CSuAdr (3-4 h) < Group CSuNeo = Group CSuNeoAdr (10-11 h) (P < 0.05). Number of doses of rescue analgesic showed the following association: Group IVSu = Group CSu = Group CSuAdr > Group CSuNeo = Group CSuNeoAdr (P < 0.005). Incidence of adverse effects was similar among groups.

Conclusion:

Caudal sufentanil alone was no better than when administered in the IV route, and would just be justified by the association of neostigmine, but not adrenaline. Neostigmine association resulted in better perioperative analgesia.

A comparison of the effects of hydromorphone HCl and a novel extended release hydromorphone on arterial blood gas values in conscious healthy dogs

The purpose of this study was to evaluate arterial blood gases in dogs that were given hydromorphone or extended release liposome-encapsulated hydromorphone (LEH). Dogs were randomly administered LEH, n=6, (2.0 mg kg(-1)), hydromorphone, n=6, (0.2 mg kg(-1)) or a placebo of blank liposomes, n=3, subcutaneously on separate occasions. Arterial blood samples were drawn at serial time points over a 6-h time period for blood gas analysis. There was no change from baseline values in P(a)CO(2), P(a)O(2), (HCO(3)-), pH, and SBEc in the dogs that received the placebo. Administration of hydromorphone resulted in significant increases in P(a)CO(2) (maximum (mean+SD] 44.4+1.1mm of Hg) and significant decreases in P(a)O(2) (minimum (mean+SD) 82.4+4.7 mm of Hg) and pH (minimum (mean+SD) 7.31+0.01) compared with baseline. Administration of LEH resulted in significant increases in P(a)CO(2) (maximum (mean+SD) 44.6+0.9 mm of Hg) and significant decreases in P(a)O(2) (minimum (mean+SD) 84.8+2.6mm of Hg) and pH (minimum (mean+SD) 7.34+0.02) compared with baseline. There was no significant difference between these two groups at any time point. The changes observed in P(a)CO(2), P(a)O(2), and pH, however, were within clinically acceptable limits for healthy dogs. LEH was determined to cause moderate changes in arterial blood gas values similar to those caused by hydromorphone.