1
|
Upchurch D, Lin KTT, KuKanich B. Two doses of subcutaneous methadone for postoperative analgesia in dogs undergoing tibial plateau levelling osteotomies. J Small Anim Pract 2024; 65:368-375. [PMID: 38594836 DOI: 10.1111/jsap.13728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/28/2024] [Accepted: 03/20/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVES To evaluate analgesia, sedation and adverse effects of two doses of subcutaneous methadone in dogs undergoing tibial plateau levelling osteotomy. MATERIALS AND METHODS Seventeen client-owned dogs undergoing unilateral tibial plateau levelling osteotomy were randomly allocated to receive either 0.25 mg/kg methadone (eight dogs) or 0.5 mg/kg methadone (nine dogs). All dogs were premedicated with methadone and 2 to 6 mcg/kg dexmedetomidine subcutaneously. They were induced and maintained on a standard protocol. All animals received a second dose of methadone subcutaneously 4 hours after premedication and a 4.4 mg/kg dose of carprofen subcutaneously at 8 hours after premedication. During surgery, blood pressure, heart rate and temperature were assessed every 5 minutes. Postoperatively, sedation scores, temperature, heart rate and Glasgow composite modified pain score - short form were assessed for 12 hours postoperatively. RESULTS One of 17 (5.9%) dogs had intraoperative hypotension, nine of 17 dogs had intra-operative bradyarrhythmias and 17 of 17 dogs had intra-operative hypothermia. No dogs required intra-operative rescue. Composite modified pain score - short form scores were below the threshold for intervention in 16 of 17 (94.1%) animals. Only one of 17 (5.9%) dogs required rescue analgesia. Median sedation score was 0 by the T8 time point. Adverse events were rare in both groups with only vocalisation and hypothermia reported commonly postoperatively. CLINICAL SIGNIFICANCE Two doses of methadone at either 0.25 or 0.5 mg/kg administered via subcutaneous injections pre-operatively and 4 hours later, along with 4.4 mg/kg carprofen subcutaneously 8 hours after the first methadone dose appear to provide sufficient pain control for up to 12 hours in dogs undergoing tibial plateau levelling osteotomy.
Collapse
Affiliation(s)
- D Upchurch
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, 66506, USA
| | - K T T Lin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, 48824, USA
| | - B KuKanich
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, 66506, USA
| |
Collapse
|
2
|
Goich M, Bascuñán A, Faúndez P, Siel D. Comparison of analgesic efficacy of tramadol, morphine and methadone in cats undergoing ovariohysterectomy. J Feline Med Surg 2024; 26:1098612X231224662. [PMID: 38545955 PMCID: PMC10983611 DOI: 10.1177/1098612x231224662] [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: 04/19/2024]
Abstract
OBJECTIVES The aim of this study was to compare the analgesic efficacy and the effect on physiological variables and behavior of the use of tramadol, methadone and morphine as preoperative analgesia in healthy cats undergoing elective ovariohysterectomy. METHODS Cats undergoing ovariohysterectomy were randomly assigned to receive one of the following premedication treatments intramuscularly: methadone (0.2 mg/kg; n = 10); morphine (0.2 mg/kg; n = 10); or tramadol (3 mg/kg; n = 10). Induction of anesthesia was done with propofol, and maintenance of anesthesia was done with isoflurane. Intraoperative heart rate, arterial blood pressure, respiratory rate, end-tidal isoflurane concentration and frequency of rescue analgesia (fentanyl 2.5 µg/kg) were compared between groups. Postoperative analgesia was assessed using the UNESP-Botucatu Multidimensional Composite Pain Scale, and perioperative serum glucose, cortisol concentrations and postoperative rescue analgesia were evaluated. RESULTS Intraoperative rescue analgesia was required in 76.5% of cats at some time during surgery, and 27% of cats required postoperative rescue analgesia up to 6 h after extubation. There were no significant differences between groups with respect to intraoperative and postoperative rescue analgesia, pain scale scores and end-tidal isoflurane concentrations. In the immediate postoperative period, after extubation, most of the patients presented with hypothermia; however, 1-6 h postoperatively, hyperthermia was observed in most of the patients, and was most common in the tramadol group. CONCLUSIONS AND CLINICAL RELEVANCE Under the conditions of this study, methadone, morphine and tramadol produced satisfactory postoperative analgesia in most of the cats undergoing ovariohysterectomy, and the effects lasted up to 6 h postoperatively. Intraoperative analgesia was not sufficient in most cases. Significant cardiovascular or respiratory effects contraindicating the use of these drugs were not found. Postanesthetic hyperthermia occurred with all opioids studied and was more frequent in the tramadol group.
Collapse
Affiliation(s)
- Mariela Goich
- Escuela de Medicina Veterinaria, Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile
| | - Alejandra Bascuñán
- Hospital Clínico Veterinario de la Universidad de Chile sede Bilbao, Santiago, Chile
| | - Patricio Faúndez
- Hospital Clínico Veterinario de la Universidad de Chile sede Bilbao, Santiago, Chile
| | - Daniela Siel
- Escuela de Medicina Veterinaria, Facultad de Medicina y Ciencias de la Salud, Universidad Mayor, Santiago, Chile
| |
Collapse
|
3
|
Di Cesare F, Rabbogliatti V, Draghi S, Amari M, Brioschi FA, Villa R, Ravasio G, Cagnardi P. Pharmacokinetics of dexmedetomidine in anaesthetized horses following repeated subcutaneous administration and intravenous constant rate infusion. BMC Vet Res 2023; 19:264. [PMID: 38071301 PMCID: PMC10709979 DOI: 10.1186/s12917-023-03831-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The inclusion of dexmedetomidine (DEX) within a balanced general anaesthesia protocol is effective in improving the clinical outcome and recovery quality of anaesthesia in horses. This study aimed to determine the pharmacokinetic profile of DEX following repeated subcutaneous (SC) administration at 2 µg/kg every 60 min till the end of the procedure in comparison to intravenous constant rate infusion (CRI) at 1 µg/kg/h in anaesthetized horses undergoing diagnostic procedures up to the end of the diagnostic procedure. RESULTS In the CRI and SC groups DEX maximum concentrations (Cmax) were 0.83 ± 0.27 ng/mL and 1.14 ± 0.71 ng/mL, respectively, reached at a time (Tmax) of 57.0 ± 13.4 min and 105.5 ± 29.9 min. Mean residence time to the last measurable concentration (MRTlast) was 11.7 ± 6.2 and 55.8 ± 19.7 min for the CRI group and SC groups, respectively. The apparent elimination half-life was 18.0 ± 10.0 min in the CRI group and 94.8 ± 69.8 min for the SC group, whereas the area under the curve (AUC0-last) resulted 67.7 ± 29.3 and 83.2 ± 60.5 min*ng/mL for CRI and SC group, respectively. Clearance was 16.26 ± 8.07 mL/min/kg for the CRI group. No signs of adverse effects were recorded in both groups. CONCLUSIONS The pharmacokinetic profile of DEX following repeated SC administration in anaesthetized horses was comparable to intravenous CRI administration during the intranaesthetic period and beneficial during the recovery phase from general anaesthesia. The SC route could be considered as an alternative to CRI for improving the recovery quality of equine patients undergoing general anaesthesia.
Collapse
Affiliation(s)
- Federica Di Cesare
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy
| | - Vanessa Rabbogliatti
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy
| | - Susanna Draghi
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy.
| | - Martina Amari
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Roberto Villa
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy
| | - Giuliano Ravasio
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy
| | - Petra Cagnardi
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
4
|
Cubeddu F, Masala G, Sotgiu G, Mollica A, Versace S, Careddu GM. Cardiorespiratory Effects and Desflurane Requirement in Dogs Undergoing Ovariectomy after Administration Maropitant or Methadone. Animals (Basel) 2023; 13:2388. [PMID: 37508165 PMCID: PMC10376119 DOI: 10.3390/ani13142388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/08/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
General anesthesia for ovariectomy in dogs is based on a balanced anesthesia protocol such as using analgesics along with an inhalant agent. While opioids such as fentanyl and methadone are commonly used for their analgesic potency, other drugs can also have analgesic effects. Maropitant, an antiemetic for dogs and cats, has also been shown to exert analgesic effects, especially on visceral pain. The aim of this study was to compare the cardiorespiratory effects and analgesic properties of maropitant and methadone combined with desflurane in dogs undergoing ovariectomy. Two groups of 20 healthy mixed-breeds bitches undergoing elective ovariectomy received intravenous either maropitant at antiemetic dose of 1 mg kg-1 or methadone at the dose of 0.3 mg kg-1. Cardiorespiratory variables were collected before premedication, 10 min after sedation and during surgery. Recovery quality and postoperative pain were evaluated 15, 30, 60, 120, 240 and 360 min postoperatively. Results showed that maropitant produced analgesia and reduced the requirement of desflurane in amounts similar to those determined by methadone (5.39 ± 0.20% and 4.91 ± 0.26%, respectively) without significant difference, while maintaining heart rate, arterial blood pressure, respiratory rate and carbon dioxide end-tidal partial pressure even at a more satisfactory level. Therefore, maropitant may be recommended as an analgesic drug for abdominal surgery not only in healthy dogs but also in those with reduced cardiorespiratory compensatory capacities or at risk of hypotension, especially when combined with a sedative such as dexmedetomidine.
Collapse
Affiliation(s)
- Francesca Cubeddu
- Department of Veterinary Medicine, University of Sassari, Via Vienna 2, 07100 Sassari, Italy
| | - Gerolamo Masala
- Department of Veterinary Medicine, University of Sassari, Via Vienna 2, 07100 Sassari, Italy
| | - Giovanni Sotgiu
- Department of Surgical and Experimental Medical Sciences Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy
| | - Alessandra Mollica
- Department of Veterinary Medicine, University of Sassari, Via Vienna 2, 07100 Sassari, Italy
| | - Sylvia Versace
- Department of Veterinary Medicine, University of Sassari, Via Vienna 2, 07100 Sassari, Italy
| | - Giovanni Mario Careddu
- Department of Veterinary Medicine, University of Sassari, Via Vienna 2, 07100 Sassari, Italy
| |
Collapse
|
5
|
Ryan AC, Murrell JC, Gurney MA. Post-operative nausea and vomiting (PONV) observed in a clinical study designed to assess the analgesic effects of intravenous and subcutaneous methadone in dogs. Vet J 2022; 287:105876. [PMID: 35901924 DOI: 10.1016/j.tvjl.2022.105876] [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: 12/02/2021] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 10/16/2022]
Abstract
Opioids are a key component of multimodal analgesia. Methadone is licensed in Europe for IV, IM and SC use in dogs despite there being no published studies assessing the analgesic efficacy of SC administration. Our intention was to compare the analgesic effect of IV or SC methadone. Fifteen dogs presenting for stifle surgery were administered 0.4mg/kg methadone IV followed by a randomised 0.4mg/kg methadone IV or SC dose 3h later. All dogs received ultrasound-guided sciatic and saphenous nerve blocks with bupivacaine prior to surgery. This protocol resulted in opioid adverse effects (hypersalivation, vomiting and/or regurgitation) in 5/15 dogs (33%). Thus, in consultation with the ethical review committee, an otherwise identical protocol using a revised 0.2mg/kg methadone dose was implemented. In the next three dogs studied, similar opioid adverse effects were found in all three dogs and the study was terminated. This paper highlights the potential for post operative nausea and vomiting (PONV), which may have been induced by methadone when used in combination with efficacious locoregional anaesthesia.
Collapse
Affiliation(s)
- A C Ryan
- Anderson Moores Veterinary Specialists, Bunstead Barns, Poles Lane, Hursley, Hampshire, SO21 2LL, UK.
| | - J C Murrell
- Highcroft Veterinary Referrals, 615 Wells Road, Bristol, BS14 9BE, UK
| | - M A Gurney
- Anderson Moores Veterinary Specialists, Bunstead Barns, Poles Lane, Hursley, Hampshire, SO21 2LL, UK
| |
Collapse
|
6
|
Rabbogliatti V, Amari M, Brioschi FA, Di Cesare F, Zani DD, De Zani D, Di Giancamillo M, Cagnardi P, Ravasio G. Use of dexmedetomidine repeated subcutaneous administration for balanced anaesthesia in horses. BMC Vet Res 2022; 18:269. [PMID: 35818051 PMCID: PMC9275161 DOI: 10.1186/s12917-022-03350-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 06/10/2022] [Indexed: 11/30/2022] Open
Abstract
Background A balanced anaesthetic protocol is a common concept in modern veterinary anaesthesia and aims to maintain good intraoperative cardiopulmonary function. In horses, alpha-2-agonists produce sedation and analgesia and have been shown to reduce inhalational anaesthetic requirements when administered intravenously. Furthermore, these drugs can improve recovery quality. Preliminary investigations of subcutaneous dexmedetomidine administration in humans demonstrated a reduced haemodynamic impact if compared with the intravenous route suggesting that dexmedetomidine is adequately absorbed with both administration routes. The aim of the study was to compare two different dexmedetomidine (DEX) administration routes: intravenous constant rate infusion (CRI) versus repeated subcutaneous (SC) injections on cardiopulmonary function and recovery in anaesthetized horses. Results No significant differences between groups in heart rate and systolic arterial pressure were detected. A significantly higher mean and diastolic arterial pressure were detected in the SC group at T25 (p = 0.04; p = 0.02), T75 (p = 0.02; p = 0.009), and T85 (p = 0.001; p = 0.005). In SC group there was a significantly lower dobutamine infusion rate (p = 0.03) and a significantly higher urinary output (p = 0.02). Moreover, recovery quality was higher (p = 0.01). Conclusions Cardiopulmonary effects in both groups were comparable and within clinical ranges with less dobutamine requirement in the subcutaneous group. Recovery was of better quality with fewer attempts in horses receiving subcutaneous dexmedetomidine. The present study suggests that intravenous constant rate infusion and subcutaneous repeated administration of dexmedetomidine at indicated dosage can be useful in balanced anaesthesia without any systemic or local adverse effects; moreover, in healthy horses undergoing general anaesthesia, repeated subcutaneous dexmedetomidine administration may be a suitable alternative if constant rate infusion is not feasible.
Collapse
Affiliation(s)
- Vanessa Rabbogliatti
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Martina Amari
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | | | - Federica Di Cesare
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Davide Danilo Zani
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Donatella De Zani
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Mauro Di Giancamillo
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Petra Cagnardi
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Giuliano Ravasio
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy.
| |
Collapse
|
7
|
Gomez A, Al-Tannak N, Auckburally A, Watson D, Flaherty D. Stability of dilutions of methadone alone, and in combination with lidocaine and ketamine. J Small Anim Pract 2022; 63:526-531. [PMID: 35246850 DOI: 10.1111/jsap.13490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 12/22/2021] [Accepted: 01/18/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess stability and degradation over time, of methadone alone, and mixed with lidocaine and ketamine, using various diluents and storage conditions. MATERIALS AND METHODS Solutions of methadone diluted in 0.9% NaCl, and methadone-lidocaine-ketamine diluted in 0.9% NaCl or Hartmann's solution, and stored at room temperature with exposure to light, or refrigerated at 4°C and protected from light, were maintained over 10 days. Chemical stability was determined using liquid chromatography immediately after preparation and following 4, 24, 48, 96 and 240 hours of storage. Physical stability of the solutions was evaluated by visual examination and absorbance of ultraviolet/visible light. A linear model assessed the impact of different diluent solutions and storage conditions on drug degradation over time. RESULTS There was no evidence of physicochemical incompatibility for any solution. Methadone concentration, when diluted alone or in methadone-lidocaine-ketamine with Hartmann's solution at 4°C, did not decline over time. Ketamine and lidocaine decreased to a similar extent over time, regardless of the diluent used or storage method, while methadone in methadone-lidocaine-ketamine diluted with 0.9% NaCl or with Hartmann's solution at room temperature exposed to light, also declined over time; however, all three methadone-lidocaine-ketamine components retained acceptable stability (<10% degradation) for at least 48 hours following preparation, irrespective of diluent or storage conditions. CLINICAL SIGNIFICANCE Regardless of the diluent or storage method, methadone-lidocaine-ketamine solutions degrade over time, but this only becomes clinically significant after 48 hours. Solutions of 1 mg/ml methadone in 0.9% NaCl are stable for at least 10 days under storage conditions likely to be encountered in general practice.
Collapse
Affiliation(s)
- A Gomez
- Southern Counties Veterinary Specialists, Ringwood, Hampshire, BH24 3JW, UK
| | - N Al-Tannak
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, G4 0RE, UK.,Department of Pharmaceutical Chemistry, Kuwait University, 12037, Kuwait
| | - A Auckburally
- Southern Counties Veterinary Specialists, Ringwood, Hampshire, BH24 3JW, UK
| | - D Watson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, G4 0RE, UK
| | - D Flaherty
- Southern Counties Veterinary Specialists, Ringwood, Hampshire, BH24 3JW, UK
| |
Collapse
|
8
|
Libera N, McFadzean W. An opioid‐free anaesthesia (OFA) technique for dorsal laminectomy in a dog subsequent to severe bradycardia and hypothermia after previous subcutaneous methadone administration. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.287] [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]
Affiliation(s)
- Natalia Libera
- Small Animal Teaching Hospital, University of Liverpool Neston UK
- Cave Veterinary Specialists, George's Farm West Buckland UK
| | | |
Collapse
|
9
|
Sambugaro B, De Gennaro C, Vettorato E. Anaesthetic management and complications during cutting balloon and high‐pressure balloon dilation in a dog with a double‐chambered right ventricle. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
10
|
Papageorgiou V, Ververidis C, Anagnostou T, Savvas I, Kazakos G. Use of propofol to induce food consumption by anorectic dogs following ovariohysterectomy. J Am Vet Med Assoc 2021; 259:56-61. [PMID: 34125612 DOI: 10.2460/javma.259.1.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether IV propofol administration at a dose of 2 mg/kg (0.9 mg/lb) could induce food consumption by anorectic female dogs following elective ovariohysterectomy. ANIMALS 51 healthy female dogs that failed to eat voluntarily when food was offered 6 hours after ovariohysterectomy. PROCEDURES In a randomized, blinded, controlled clinical trial, dogs received propofol (2 mg/kg; n = 31) or an equivalent volume of saline (0.9% NaCl) solution (20) IV 6 hours after ovariohysterectomy. Afterward, food was offered to the dogs and food consumption was reassessed. Pain, sedation, and stress were scored before and immediately after treatment. RESULTS 27 of the 31 (87%) dogs in the propofol group consumed food immediately after administration of the assigned treatment, whereas only 1 of 20 (5%) dogs in the placebo group did. No difference in pain, sedation, or stress scores was identified between the 2 groups. Sedation scores for dogs in the propofol group increased immediately after propofol administration. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that food consumption following elective surgical procedures can be effectively induced in anorectic female dogs by IV administration of propofol at a dose of 2 mg/kg.
Collapse
|
11
|
Ultrasound-Guided Funicular Block: Ropivacaine Injection into the Tissue around the Spermatic Cord to Improve Analgesia during Orchiectomy in Dogs. Animals (Basel) 2021; 11:ani11051275. [PMID: 33925210 PMCID: PMC8146739 DOI: 10.3390/ani11051275] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Orchiectomy is a common surgical procedure performed on small animals and postoperative analgesia is very important because pain causes various negative effects that prevent patient recovery. Our study aimed to compare the intraoperative ultrasound-guided funicular block with ropivacaine and general anaesthesia using hypnotic and/or analgesic drugs and the postoperative hemodynamic stability and pain scores. This study demonstrated that the use of ultrasound-guided funicular, using ropivacaine, guarantees long-lasting and high-quality analgesic coverage and minimises the post-surgical pain inevitably associated with orchiectomy. This study stemmed from a general trend towards increasing attention on postoperative pain after orchiectomy in dog. Since veterinarians are becoming more focused on relieving surgical pain, anaesthetists are expected to use better protocols that can minimise pain. In fact, acute postsurgical pain is of great interest due to potential risk of becoming chronic if not treated properly. The routine use of the intraoperative ultrasound-guided funicular block with ropivacaine block is considered a useful alternative for pain management for orchiectomy in dogs, which can be performed under sedation or superficial general anaesthesia. In addition, the intraoperative ultrasound-guided funicular block with ropivacaine block ensures satisfactory analgesic coverage that lasts for at least 6 h postoperatively. Abstract Orchiectomy is a common surgical procedure performed on small animals, and it requires postoperative pain management despite its relative simplicity. This study aimed to evaluate the hemodynamic stability, intraoperative administration of additional hypnotic and/or analgesic drugs, and postoperative pain scores following the combination of ultrasound-guided injection of ropivacaine hydrochloride into the spermatic cord and infiltration by the same anaesthetic of the incisional prescrotal line (ROP) or general anaesthesia. Dogs in the ROP group showed greater intraoperative hemodynamic stability and lower pain scores than the control group. The locoregional approach used in this study proved effective in minimising the responses to the surgical stimulus and ensured adequate analgesia intra- and postoperatively. This method, called ultrasound-guided funicular block, allows orchiectomy to be performed under deep sedation without general anaesthesia.
Collapse
|
12
|
Arenillas M, Canfrán S, Aguado D, Gómez de Segura IA. Sedative and analgesic effects of two subanaesthetic doses of ketamine in combination with methadone and a low dose of dexmedetomidine in healthy dogs. Vet Anaesth Analg 2021; 48:545-553. [PMID: 34083140 DOI: 10.1016/j.vaa.2020.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 10/06/2020] [Accepted: 11/16/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the sedative, analgesic and recovery characteristics of two subanaesthetic ketamine doses in combination with dexmedetomidine and methadone for intramuscular sedation in healthy Beagles. STUDY DESIGN Randomized, blinded, crossover, experimental study. ANIMALS Six healthy adult Beagles. METHODS Dogs were randomly given three treatments: dexmedetomidine (3 μg kg-1) and methadone (0.3 mg kg-1) combined with ketamine at 1 and 2 mg kg-1 (K1 and K2, respectively) or saline (K0), intramuscularly. Sedation score, response to tail clamping and rectal temperature were recorded at baseline, 5, 15, 25, 35, and 45 minutes posttreatment. Pulse rate (PR), respiratory rate, oxygen haemoglobin saturation and noninvasive blood pressure were also recorded at baseline and every 5 minutes until 45 minutes posttreatment. Onset and duration of recumbency, response to venous catheterization and recovery quality were also assessed. Sedation and physiological variables were compared between treatments and within treatments compared to baseline (analysis of variance). Nonparametric data were analysed with the Friedman and Cochran's Q tests; p < 0.050. RESULTS Increased sedation was found at 15 (K0 and K1), 25 (all treatments) and 35 (K1) minutes compared with baseline. Sedation score, onset (3-12 minutes) and duration of recumbency (29-51 minutes) were similar between treatments. Recovery quality was considered acceptable in all cases. Response to tail clamping was inconsistent within treatments with no differences between them. None of the dogs responded to venous catheterization. There were no differences between treatments in physiological variables, except for PR which was higher in K2 than in K0. Oxygen supplementation was required in five and three dogs administered saline and ketamine, respectively. CONCLUSIONS AND CLINICAL RELEVANCE The addition of 1 or 2 mg kg-1 of ketamine to methadone and dexmedetomidine combination did not enhance sedation or antinociception in healthy dogs. Recovery quality was unaffected.
Collapse
Affiliation(s)
- Mario Arenillas
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain.
| | - Susana Canfrán
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Delia Aguado
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Ignacio A Gómez de Segura
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|
13
|
Escobar A, Barletta M, Pypendop BH, Sakai DM, Gordon J, Quandt JE. Pharmacokinetics and pharmacodynamics of methadone administered intravenously and intramuscularly to isoflurane-anesthetized chickens. Am J Vet Res 2021; 82:181-188. [PMID: 33629899 DOI: 10.2460/ajvr.82.3.181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the pharmacokinetics and pharmacodynamics of methadone after IV or IM administration to isoflurane-anesthetized chickens. ANIMALS 6 healthy adult Hy-Line hens. PROCEDURES In a randomized crossover-design study, methadone (6 mg/kg) was administered IV and IM to isoflurane-anesthetized chickens with a 1-week washout period between experiments. Blood samples were collected immediately before and at predetermined time points up to 480 minutes after methadone administration. Plasma concentrations were determined by liquid chromatography-mass spectrometry, and appropriate compartmental models were fit to the plasma concentration-versus-time data. Cardiorespiratory variables were compared between treatments and over time with mixed-effect repeated-measures analysis. RESULTS A 3-compartment model best described the changes in plasma methadone concentration after IV or IM administration. Estimated typical values for volumes of distribution were 692 mL/kg for the central compartment and 2,439 and 2,293 mL/kg for the first and second peripheral compartments, respectively, with metabolic clearance of 23.3 mL/kg/min and first and second distributional clearances of 556.4 and 51.8 mL/kg/min, respectively. Typical bioavailability after IM administration was 79%. Elimination half-life was 177 minutes, and maximum plasma concentration after IM administration was 950 ng/mL. Heart rate was mildly decreased at most time points beginning 5 minutes after IV or IM drug administration. CONCLUSIONS AND CLINICAL RELEVANCE Disposition of methadone in isoflurane-anesthetized chickens was characterized by a large volume of distribution and moderate clearance, with high bioavailability after IM administration. Additional studies are warranted to assess pharmacokinetics and pharmacodynamics of methadone in awake chickens.
Collapse
|
14
|
Amon T, Kästner SBR, Kietzmann M, Tünsmeyer J. Plasma levels of a methadone constant rate infusion and their corresponding effects on thermal and mechanical nociceptive thresholds in dogs. BMC Vet Res 2021; 17:35. [PMID: 33461553 PMCID: PMC7814539 DOI: 10.1186/s12917-020-02735-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/20/2020] [Indexed: 11/22/2022] Open
Abstract
Background The present study aimed to collect pharmacokinetic data of a methadone continuous rate infusion (CRI) and to investigate its effect on mechanical and thermal nociceptive thresholds. Seven, 47 to 54 months old beagle dogs, weighing 9.8 to 21.2 kg, were used in this experimental, randomized, blinded, placebo-controlled crossover study. Each dog was treated twice with either a methadone bolus of 0.2 mg kg− 1 followed by a 0.1 mg kg− 1 h− 1 methadone CRI (group M) or an equivalent volume of isotonic saline solution (group P) for 72 h. Mechanical and thermal thresholds, as well as vital parameters and sedation were measured during CRI and for further 24 h. Blood samples for methadone plasma concentrations were collected during this 96 h period. Results Percentage thermal excursion (%TE) increased significantly from baseline (BL) until 3 h after discontinuation of CRI in M. Within P and between treatment groups differences were not significant. Mechanical threshold (MT) increased in M until 2 h after CRI discontinuation. Bradycardia and hypothermia occurred in M during drug administration and dogs were mildly sedated for the first 47 h. Decreased food intake and regurgitation were observed in M in five and four dogs, respectively. For methadone a volume of distribution of 10.26 l kg− 1 and a terminal half-life of 2.4 h were detected and a clearance of 51.44 ml kg− 1 min− 1 was calculated. Effective methadone plasma concentrations for thermal and mechanical antinociception were above 17 ng ml− 1. Conclusion A methadone CRI of 0.1 mg kg− 1 h− 1 for 3 days after a loading dose results in steady anti-nociceptive effects in an acute pain model in healthy dogs. Main side effects were related to gastrointestinal tract, hypothermia, bradycardia and sedation.
Collapse
Affiliation(s)
- T Amon
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany.
| | - S B R Kästner
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany
| | - M Kietzmann
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Foundation, Bünteweg 17, 30559, Hannover, Germany
| | - J Tünsmeyer
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany
| |
Collapse
|
15
|
KuKanich B, KuKanich K, Rankin DC, Upchurch DA, Comroe A, Crauer B, Berke K, Klocke EE, Gonzalez SE, Mason D, Jensen G, Orchard R, Fitzgerald AH, Cho P, Komp M. Perioperative analgesia associated with oral administration of a novel methadone-fluconazole-naltrexone formulation in dogs undergoing routine ovariohysterectomy. Am J Vet Res 2020; 81:699-707. [PMID: 33112167 DOI: 10.2460/ajvr.81.9.699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine perioperative analgesia associated with oral administration of a novel methadone-fluconazole-naltrexone formulation in dogs undergoing routine ovariohysterectomy. ANIMALS 43 healthy female dogs. PROCEDURES Dogs were randomly assigned to receive the methadone-fluconazole-naltrexone formulation at 1 of 2 dosages (0.5 mg/kg, 2.5 mg/kg, and 0.125 mg/kg, respectively, or 1.0 mg/kg, 5.0 mg/kg, and 0.25 mg/kg, respectively, PO, q 12 h, starting the evening before surgery; n = 15 each) or methadone alone (0.5 mg/kg, SC, q 4 h starting the morning of surgery; 13). Dogs were sedated with acepromazine, and anesthesia was induced with propofol and maintained with isoflurane. A standard ovariohysterectomy was performed by experienced surgeons. Sedation and pain severity (determined with the Glasgow Composite Pain Scale-short form [GCPS-SF]) were scored for 48 hours after surgery. Rescue analgesia was to be provided if the GCPS-SF score was > 6. Dogs also received carprofen starting the day after surgery. RESULTS None of the dogs required rescue analgesia. The highest recorded GCPS-SF score was 4. A significant difference in GCPS-SF score among groups was identified at 6:30 am the day after surgery, but not at any other time. The most common adverse effect was perioperative vomiting, which occurred in 11 of the 43 dogs. CONCLUSIONS AND CLINICAL RELEVANCE Oral administration of a methadone-fluconazole-naltrexone formulation at either of 2 dosages every 12 hours (3 total doses) was as effective as SC administration of methadone alone every 4 hours (4 total doses) in dogs undergoing routine ovariohysterectomy. Incorporation of naltrexone in the novel formulation may provide a deterrent to human opioid abuse or misuse.
Collapse
|
16
|
Salla KM, Lepajoe J, Candido MV, Spillmann T, Casoni D. Comparison of the effects of methadone and butorphanol combined with acepromazine for canine gastroduodenoscopy. Vet Anaesth Analg 2020; 47:748-756. [PMID: 33041210 DOI: 10.1016/j.vaa.2020.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 02/28/2020] [Accepted: 03/06/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To evaluate the feasibility of gastroduodenoscopy in dogs premedicated with acepromazine in combination with butorphanol or methadone. STUDY DESIGN Prospective, randomized, double-blinded clinical trial. ANIMALS A group of 40 client-owned dogs. METHODS Dogs were randomly allocated to one of two groups and give intramuscular acepromazine 0.02 mg kg-1 combined with either butorphanol 0.3 mg kg-1 (group ACEBUT) or methadone 0.2 mg kg-1 (group ACEMET). General anaesthesia was induced with propofol and ketamine and maintained with sevoflurane (2.3%) in oxygen. Cardiopulmonary variables were recorded at 5 minute intervals during anaesthesia. Feasibility of the entire gastroduodenoscopy was evaluated with a visual analogue scale (VAS) from 0 (best) to 100 (worst) (primary outcome of the study). Lower oesophageal sphincter dilatation and duodenal intubation were scored. Pylorus diameter was measured with standard endoscopic inflatable balloons. Overall cardiovascular stability was assessed during anaesthesia, using a VAS (0-100), as was the presence of fluid in the oesophagus, regurgitation, need for mechanical ventilation, and intraoperative and postoperative rescue analgesia (secondary outcomes of the study). Differences between treatments were analysed with Mann-Whitney U, Student t test, Fisher exact test or mixed model analysis of variance as appropriate. Subsequently, feasibility VAS of the gastroduodenoscopy was assessed for noninferiority between groups. The noninferiority margin was set as -10. RESULTS All gastroduodenoscopies were successfully completed in both groups using an endoscope tip diameter of 12.8 mm in all but one dog. Feasibility of gastroduodenoscopy was evaluated as 2.9 ± 5.6 in group ACEBUT and 5.1 ± 5.8 in group ACEMET. No significant differences between groups were detected in any measured or assessed variables, and noninferiority was confirmed. CONCLUSION AND CLINICAL RELEVANCE In our study population, the effects of methadone and butorphanol when combined with acepromazine were comparable.
Collapse
Affiliation(s)
- Kati Maria Salla
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Finland.
| | - Jaan Lepajoe
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Finland
| | - Marcus Vinicius Candido
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Finland
| | - Thomas Spillmann
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Finland
| | - Daniela Casoni
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Finland
| |
Collapse
|
17
|
Spertus CB, Espinheira Gomes F, Martin-Flores M, Parry SA, Ledbetter EC. Analgesic effect of topical and subconjunctival morphine in dogs after phacoemulsification: A pilot study. Vet Ophthalmol 2020; 23:674-681. [PMID: 32369267 DOI: 10.1111/vop.12770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/07/2020] [Accepted: 04/07/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the efficacy of a single treatment of topical and subconjunctival 0.1% preservative-free morphine sulfate (PFMS) in providing analgesia following phacoemulsification in dogs. ANIMALS STUDIED Ten diabetic and ten non-diabetic client-owned dogs treated with bilateral phacoemulsification. PROCEDURES A prospective, randomized, masked, negative-controlled clinical trial was performed. All dogs received topical (0.2 mL) and subconjunctival (0.1 mL) 0.1% PFMS in one eye following phacoemulsification. The other eye received an equal volume and mode of administration of balanced salt solution (BSS). Ophthalmic examination, blinking rates, tearing, conjunctival hyperemia, aqueous flare, and central corneal esthesiometry (CCE) were evaluated in all eyes 1 day prior to surgery and at 4, 24, and 48 hours after surgery. Complete physical examination, ocular ultrasound, electroretinogram, hemogram, and serum biochemistry panel were performed in all dogs prior to phacoemulsification. All dogs received the standard of care treatment before and after surgery, including uniform anesthetic protocol. RESULTS Baseline ophthalmic exams were unremarkable, except for the presence of cataracts, in all dogs. The mean CCE (±SD) at 4 hours post-operatively was 1.76 ± 1.27 g/mm2 and 1.85 ± 1.5 g/mm2 for the negative control and PFMS groups, respectively. There were no statistical differences in blepharospasm, conjunctival hyperemia, tearing, aqueous flare, blinking rates, CCE, or intraocular pressure (IOP) between the treatment groups for any of the time points for the non-diabetic and diabetic dogs, or for all dogs combined (P > .05). CONCLUSIONS Topical and subconjunctival 0.1% PFMS did not affect the evaluated parameters after phacoemulsification in the study dogs at the timepoints assessed.
Collapse
Affiliation(s)
- Chloe B Spertus
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Filipe Espinheira Gomes
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Manuel Martin-Flores
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Stephen A Parry
- Statistical Consulting Unit, College of Human Ecology, Cornell University, Ithaca, NY, USA
| | - Eric C Ledbetter
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| |
Collapse
|
18
|
Cueni C, Nytko KJ, Thumser-Henner P, Weyland MS, Rohrer Bley C. Methadone does not potentiate the effect of doxorubicin in canine tumour cell lines. Vet Med Sci 2020; 6:283-289. [PMID: 32306524 PMCID: PMC7397897 DOI: 10.1002/vms3.266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/03/2020] [Accepted: 03/23/2020] [Indexed: 12/17/2022] Open
Abstract
Opioid receptor activation was shown to enhance the efficacy of anti‐neoplastic drugs in several human cancer cell lines. In these cell lines, doxorubicin increased the number of opioid receptors and methadone concurrently enhanced cellular doxorubicin uptake. Triggered through lay press and media, animal owners started to challenge veterinary oncologists with questions about methadone use in anti‐cancer therapy. Especially in veterinary medicine, where side effects of chemotherapy are tolerated to a lesser extent and hence smaller doses are given, agents potentiating chemotherapeutic agents would be an optimal approach to treatment. Canine transitional cell carcinoma cells (TCC, K9TCC), canine osteosarcoma cells (OSA, Abrams) and canine hemangiosarcoma cells (HSA, DAL‐4) were incubated with different combinations of methadone, buprenorphine and doxorubicin, in order to test inhibition of cell proliferation. Opioid receptor density was assessed with fluorescence‐activated cell sorting in drug native and doxorubicin pretreated cells. In TCC and OSA cell lines opioid receptor density increased after doxorubicin pretreatment. In combination treatment, however, we did not find significant potentiation of doxorubicin's inhibitory effect on proliferation in these cell lines. Neither was there a significant increase of the effect of doxorubicin when the opioids were added 24 hr before doxorubicin. Hence, we could not confirm the hypothesis that opioids increase the anti‐proliferative effect of the anti‐neoplastic drug doxorubicin in any of these canine tumour cell lines. The lack of effect on a cellular level does not warrant a clinical approach to use opioids together with doxorubicin in dogs with cancer.
Collapse
Affiliation(s)
- Claudia Cueni
- Division of Radiation Oncology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.,Center for Clinical Studies at the Vetsuisse Faculty of the University of Zurich, Zurich,, Switzerland
| | - Katarzyna J Nytko
- Division of Radiation Oncology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.,Center for Clinical Studies at the Vetsuisse Faculty of the University of Zurich, Zurich,, Switzerland
| | - Pauline Thumser-Henner
- Division of Radiation Oncology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.,Center for Clinical Studies at the Vetsuisse Faculty of the University of Zurich, Zurich,, Switzerland
| | - Mathias S Weyland
- Division of Radiation Oncology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.,ZHAW School of Engineering, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Carla Rohrer Bley
- Division of Radiation Oncology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| |
Collapse
|
19
|
Sedative effects of two doses of alfaxalone in combination with methadone and a low dose of dexmedetomidine in healthy Beagles. Vet Anaesth Analg 2020; 47:463-471. [PMID: 32507717 DOI: 10.1016/j.vaa.2019.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 11/11/2019] [Accepted: 12/02/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To evaluate the sedative effects of two doses of alfaxalone when added to a combination of dexmedetomidine and methadone injected intramuscularly (IM) in healthy Beagles. STUDY DESIGN Randomized, blinded, crossover, experimental study. ANIMALS A group of six adult Beagles. METHODS Dogs were sedated on three different occasions with IM dexmedetomidine (3 μg kg-1) and methadone (0.3 mg kg-1) combined with two doses of alfaxalone (0.5 and 1 mg kg-1; A0.5 and A1, respectively) or saline (A0). Quality of sedation, response to tail clamping and rectal temperature were recorded at baseline, 5, 15, 25, 35 and 45 minutes. Pulse and respiratory rates, oxygen saturation of haemoglobin (SpO2) and noninvasive blood pressure (NIBP) were recorded every 5 minutes. Onset of sedation and duration of recumbency, response to venous catheterization and recovery quality were assessed. Physiological variables (analysis of variance) were analysed between treatments and within treatments compared with baseline (Student t test). Nonparametric data were analysed using Friedman and Cochran's Q tests. Significance was p < 0.05. RESULTS Sedation scores were significantly higher when alfaxalone was co-administered (area under the curve; p = 0.024, A0.5; p = 0.019, A1), with no differences between doses. Onset of sedation was similar, but duration of recumbency was longer in A0.5 than in A0 [median (minimum-maximum), 43 (35-54) versus 30 (20-47) minutes, p = 0.018], but not in A1. Response to venous catheterization and tail clamping, and quality of recovery (acceptable) presented no differences between treatments. A decrease in all physiological variables (compared with baseline) was observed, except for NIBP, with no differences between treatments. All dogs required oxygen supplementation due to reduced SpO2. CONCLUSIONS AND CLINICAL RELEVANCE Adding alfaxalone to methadone and dexmedetomidine enhanced sedation and duration of recumbency. Although cardiopulmonary depression was limited, oxygen supplementation is advisable.
Collapse
|
20
|
The effect of neuraxial morphine on postoperative pain in dogs after extrahepatic portosystemic shunt attenuation. Vet Anaesth Analg 2019; 47:111-118. [PMID: 31718938 DOI: 10.1016/j.vaa.2019.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/19/2019] [Accepted: 06/25/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the analgesic effect of epidural morphine after surgical extrahepatic portosystemic shunt (EHPSS) attenuation. STUDY DESIGN Randomized clinical trial. ANIMALS A total of 20 dogs with a congenital EHPSS. METHODS Dogs were randomly allocated to be given either a single epidural dose of 0.2 mg kg-1 preservative-free morphine (group M) or not (group C) before surgery. All dogs were administered 0.3 mg kg-1 methadone intravenously (IV) as preanaesthetic medication. Pain scores were determined every 2 hours for the first 24 hours postoperatively using the short-form Glasgow Composite Measure Pain Scale (GCMPS-SF). Dogs with a GCMPS-SF pain score >4/20 or >5/24 received 0.1 mg kg-1 methadone IV as rescue analgesia and were reassessed 30 minutes later. If more than three doses of methadone were administered in a 2 hour period, alternative pain relief was provided and a treatment failure recorded. The GCMPS-SF pain scores and number of rescue analgesia injections were analysed over 24 hours. The last observation carried forward method was applied in case of treatment failure. Food consumption and time to first urination were recorded. Data were analysed using a Mann-Whitney U test and presented as median (minimum-maximum range), with significance set at p < 0.05. RESULTS Group M showed lower GCMPS-SF pain scores [15 (11-41) versus 31 (11-86); p = 0.023] and lower postoperative methadone requirements [0 (0-0.2) versus 0.25 (0-0.5) mg kg-1; p = 0.029] than group C. There were three treatment failures in group C only. Food consumption and time to first urination did not differ between groups. CONCLUSIONS AND CLINICAL RELEVANCE Epidural morphine reduced the requirement for postoperative analgesia in this study population.
Collapse
|
21
|
Di Cesare F, Gioeni D, Ravasio G, Pellegrini A, Lucatello L, Bisutti V, Villa R, Cagnardi P. Clinical pharmacokinetics of a dexmedetomidine-methadone combination in dogs undergoing routine anaesthesia after buccal or intramuscular administration. J Vet Pharmacol Ther 2019; 42:392-400. [PMID: 31197847 DOI: 10.1111/jvp.12771] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 03/11/2019] [Accepted: 04/03/2019] [Indexed: 01/09/2023]
Abstract
This study aimed to define the pharmacokinetic profiles of dexmedetomidine and methadone administered simultaneously in dogs by either an oral transmucosal route or intramuscular route and to determine the bioavailability of the oral transmucosal administration relative to the intramuscular one of both drugs, so as the applicability of this administration route in dogs. Twelve client-owned dogs, scheduled for diagnostic procedures, were treated with a combination of dexmedetomidine hydrochloride (10 μg/kg) and methadone hydrochloride (0.4 mg/kg) through an oral transmucosal route or intramuscularly. Oral transmucosal administration caused ptyalism in most subjects, and intramuscular administration caused transient peripheral vasoconstriction. The results showed reduced and delayed absorption of both dexmedetomidine and methadone when administered through an oral transmucosal route, with median (range) Cmax values of 0.82 (0.42-1.49) ng/ml and 13.22 (2.80-52.30) ng/ml, respectively. The relative bioavailability was low: 16.34% (dexmedetomidine) and 15.5% (methadone). Intramuscular administration resulted in a more efficient absorption profile, with AUC and Cmax values for both drugs approximately 10 times higher. Dexmedetomidine and methadone administered simultaneously by an oral transmucosal route using injectable formulations were not well absorbed through the oral mucosa. Nevertheless, additional studies on these drugs combination using alternative administration routes are recommended.
Collapse
Affiliation(s)
- Federica Di Cesare
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare, Università degli Studi di Milano, Milan, Italy
| | - Daniela Gioeni
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Giuliano Ravasio
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | | | - Lorena Lucatello
- Dipartimento di Biomedicina Comparata ed Alimentazione, Università degli Studi di Padova, Legnaro (PD), Italy
| | - Vittoria Bisutti
- Dipartimento di Biomedicina Comparata ed Alimentazione, Università degli Studi di Padova, Legnaro (PD), Italy
| | - Roberto Villa
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare, Università degli Studi di Milano, Milan, Italy
| | - Petra Cagnardi
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
22
|
Romagnoli N, Barbarossa A, Cunto M, Ballotta G, Zambelli D, Armorini S, Zaghini A, Lambertini C. Evaluation of methadone concentrations in bitches and in umbilical cords after epidural or systemic administration for caesarean section: A randomized trial. Vet Anaesth Analg 2018; 46:375-383. [PMID: 30981587 DOI: 10.1016/j.vaa.2018.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 09/13/2018] [Accepted: 10/26/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To measure plasma methadone concentrations in bitches and the umbilical cords of their puppies after systemic or epidural administration. STUDY DESIGN Prospective, randomized, clinical study. ANIMALS A total of 27 healthy pregnant female dogs undergoing caesarean section, 4.3 ± 2.3 years of age and weighing 19.9 ± 13.2 kg. METHODS The dogs were randomly divided into three groups: 1) intramuscular methadone (0.3 mg kg-1) (group MET; n = 9); 2) epidural methadone (0.1 mg kg-1) (group METEPI; n = 9); and 3) epidural lidocaine (4.4 mg kg-1) [group CON (control group); n = 9]. Ten minutes before induction, methadone was administered intramuscularly to the group MET dogs. Anaesthesia was induced with propofol and maintained with isoflurane. Cardiovascular and respiratory parameters were monitored throughout the anaesthesia. After induction, epidural anaesthesia was administered to dogs in groups METEPI and CON. Before any treatment (T0) and, as soon as the last foetus was removed from the uterus (T1), venous blood samples were collected from each dog into heparinized tubes; the umbilical cords were collected and stored at -80 °C until pharmacological analysis was carried out. The samples were analysed using ultra performance liquid chromatography. RESULTS The cardiorespiratory parameters of the bitches and of the puppies at birth, and the Apgar scores did not differ significantly between groups. At T1 both the median maternal methadone plasma concentration and the median methadone umbilical cord concentration were higher in group MET compared to group METEPI (p = 0.0018 and p = 0.004, respectively). The maternal plasma concentration was higher than the concentration in the umbilical cords (p = 0.05) in group METEPI but not in group MET (p = 0.25). CONCLUSIONS AND CLINICAL RELEVANCE Epidural methadone (0.1 mg kg-1) administered to bitches undergoing caesarean section is associated with lower umbilical cord methadone concentrations as compared with intramuscularly administered methadone at higher dosages (0.3 mg kg-1).
Collapse
Affiliation(s)
- Noemi Romagnoli
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Andrea Barbarossa
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Marco Cunto
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy.
| | - Giulia Ballotta
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Daniele Zambelli
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Sara Armorini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Anna Zaghini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Carlotta Lambertini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| |
Collapse
|
23
|
State of the art analgesia- recent developments in pharmacological approaches to acute pain management in dogs and cats. Part 1. Vet J 2018; 238:76-82. [DOI: 10.1016/j.tvjl.2018.06.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 05/16/2018] [Accepted: 06/04/2018] [Indexed: 01/11/2023]
|
24
|
Ripplinger A, Aiello G, Chaves RO, Andrades AO, Beckmann DV, Polidoro D, Soares AV, Mazzanti A. Efeitos adversos da morfina, metadona e tramadol no pós-operatório de cães submetidos à cirurgia da coluna vertebral: 180 casos (2011-2016). PESQUISA VETERINÁRIA BRASILEIRA 2018. [DOI: 10.1590/1678-5150-pvb-5307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO: A dor pós-operatória em cães que são submetidos a cirurgias da coluna vertebral é considerada severa e seu manejo inadequado pode influenciar no tempo de recuperação do paciente, na qualidade de vida e no resultado cirúrgico. Dentre os analgésicos indicados para uso no pós-operatório dessas cirurgias tem-se os opioides, que podem apresentar inúmeros efeitos adversos que requerem atenção. Devido à escassez de estudos clínicos acerca desse assunto em se tratando do pós-operatório de cães, objetivou-se com o presente estudo retrospectivo apresentar os efeitos adversos da morfina, metadona e tramadol utilizados no pós-operatório de cirurgias da coluna vertebral. Foram revisadas e avaliadas as fichas de 180 cães e anotadas as alterações observadas no pós-operatório e decorrentes do uso de opioides. Os principais efeitos adversos observados foram anorexia, hiporexia, vômito, salivação, vocalização, bradicardia, hipotermia, ofegação e sedação. Também foi observada persistência da dor em alguns cães mesmo com o uso de analgésicos. Houve diferença na ocorrência de anorexia nos cães tratados com morfina e nos tratados com metadona em relação aos tratados com tramadol. Ocorreu diferença também entre a observação de dor dos grupos morfina e tramadol. A associação de dipirona com morfina e com metadona não revelou diferença com relação à ocorrência de efeitos adversos, bem como a variação de doses. Conclui-se que a morfina, a metadona e o tramadol apresentam efeitos adversos quando empregados para tratamento da dor pós-operatória em cães submetidos à cirurgia da coluna vertebral; a anorexia, a hiporexia e o vômito foram os efeitos adversos frequentes com o uso de morfina e de metadona e, mesmo que o tramadol apresente menor ocorrência desses efeitos, seu uso, na dose estudada, pode não ser vantajoso quando se leva em consideração o grau de dor para cirurgias da coluna vertebral.
Collapse
|
25
|
Elwell-Cuddy T, Li M, KuKanich B, Lin Z. The construction and application of a population physiologically based pharmacokinetic model for methadone in Beagles and Greyhounds. J Vet Pharmacol Ther 2018; 41:670-683. [DOI: 10.1111/jvp.12676] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 03/30/2018] [Accepted: 05/18/2018] [Indexed: 01/18/2023]
Affiliation(s)
- Trevor Elwell-Cuddy
- Institute of Computational Comparative Medicine (ICCM); Department of Anatomy and Physiology; College of Veterinary Medicine; Kansas State University; Manhattan Kansas
| | - Miao Li
- Institute of Computational Comparative Medicine (ICCM); Department of Anatomy and Physiology; College of Veterinary Medicine; Kansas State University; Manhattan Kansas
| | - Butch KuKanich
- Institute of Computational Comparative Medicine (ICCM); Department of Anatomy and Physiology; College of Veterinary Medicine; Kansas State University; Manhattan Kansas
| | - Zhoumeng Lin
- Institute of Computational Comparative Medicine (ICCM); Department of Anatomy and Physiology; College of Veterinary Medicine; Kansas State University; Manhattan Kansas
| |
Collapse
|
26
|
Shah MD, Yates D, Hunt J, Murrell JC. A comparison between methadone and buprenorphine for perioperative analgesia in dogs undergoing ovariohysterectomy. J Small Anim Pract 2018; 59:539-546. [PMID: 29781530 DOI: 10.1111/jsap.12859] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 02/21/2018] [Accepted: 02/22/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate whether preoperative methadone provides superior perioperative analgesia compared to buprenorphine in dogs undergoing ovariohysterectomy. METHODS Eighty female dogs were recruited to an assessor-blinded, randomised, clinical trial. Dogs received a premedication dose of 0·05 mg/kg acepromazine or 10 μg/kg medetomidine combined with either 0·3 mg/kg methadone or 20 μg/kg buprenorphine intramuscularly. Anaesthesia was induced with propofol and maintained with isoflurane. Pain was assessed using two scoring schemes (a dynamic interactive visual analogue scale and the short form of the Glasgow Composite Pain Scale) before premedication, 30 minutes later and every hour for 8 hours after premedication. If indicated, rescue analgesia was provided with methadone. Meloxicam was administered after the final assessment. The area under the curve for change in pain scores over time and the requirement for rescue analgesia were compared between groups. RESULTS Groups premedicated with buprenorphine had significantly higher pain scores than those premedicated with methadone. There was no interaction between opioid and sedative for any outcome measure. Rescue analgesia was required by significantly more dogs premedicated with buprenorphine (45%) than that of methadone (20%). CLINICAL SIGNIFICANCE At the doses investigated, methadone produced superior postoperative analgesia compared to buprenorphine in dogs undergoing ovariohysterectomy.
Collapse
Affiliation(s)
- M D Shah
- University of Bristol, Langford, Somerset, BS40 5DU, UK
| | - D Yates
- Greater Manchester Animal Hospital, Manchester, UK
| | - J Hunt
- Cave Veterinary Specialists, West Buckland, Wellington, TA219LE, UK
| | - J C Murrell
- Cave Veterinary Specialists, West Buckland, Wellington, TA219LE, UK
| |
Collapse
|
27
|
Trimble T, Bhalla RJ, Leece EA. Comparison of sedation in dogs: methadone or butorphanol in combination with dexmedetomidine intravenously. Vet Anaesth Analg 2018; 45:597-603. [PMID: 30077553 DOI: 10.1016/j.vaa.2018.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 03/05/2018] [Accepted: 03/26/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Opioids can be combined with alpha-2-adrenoreceptor agonists to sedate dogs for radiography. The study investigated the sedative effects of methadone or butorphanol in combination with dexmedetomidine in dogs undergoing stifle radiography. STUDY DESIGN Prospective, blinded, randomized, clinical trial. ANIMALS A total of 52 healthy dogs requiring sedation for stifle radiography were enrolled. METHODS Dogs were assessed for body condition [body condition score (BCS)], temperament and pain using the short-form composite measure pain scale (CMPS-SF). Dogs were randomized to be administered methadone 0.2 mg kg-1 (group M) or butorphanol 0.2 mg kg-1 (group B) in combination with dexmedetomidine 2 μg kg-1 intravenously (IV). Sedation was assessed using a numerical descriptive score, from 0 (no sedation) to 11 (greatest sedation), before administration and at 5, 10, 15 and 20 minutes by one blinded assessor. Onset signs of sedation, pulse rate and respiratory rates were recorded. Positioning for radiography was attempted at 5 minutes. If positioning was not possible at 10 minutes, dexmedetomidine 2 μg kg-1 was administered IV, with the dog recorded as failed sedation and withdrawn from further analysis. Following normality testing, data were assessed using Student t test, Mann-Whitney test, two-way analysis of variance and Fisher's exact test for failed sedations. Results are reported as mean ± standard deviation. Statistical significance was set at p < 0.05. RESULTS Groups were similar for sex, age, weight, BCS, temperament and CMPS-SF. The onset of sedation was faster in group B than in group M (p = 0.048). Sedation scores were higher in group B at 10 minutes compared to group M (p = 0.003). Failed sedation occurred in 12 dogs in group M and two in group B (p = 0.002). Pulse rates were lower in group B at 5 and 10 minutes (p = 0.002). CONCLUSION AND CLINICAL RELEVANCE IV butorphanol provides more effective sedation at 10 minutes than methadone, in combination with dexmedetomidine.
Collapse
Affiliation(s)
- Toby Trimble
- Dick White Referrals, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK.
| | - Rebecca J Bhalla
- Dick White Referrals, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK
| | - Elizabeth A Leece
- Northwest Veterinary Specialists, Sutton Weaver, Cheshire, WA7 3FW, UK
| |
Collapse
|
28
|
Kongara K. Pharmacogenetics of opioid analgesics in dogs. J Vet Pharmacol Ther 2017; 41:195-204. [DOI: 10.1111/jvp.12452] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 07/28/2017] [Indexed: 02/03/2023]
Affiliation(s)
- K. Kongara
- Animal Welfare Science and Bioethics Centre; Institute of Veterinary, Animal and Biomedical Sciences, Massey University; Palmerston North New Zealand
| |
Collapse
|
29
|
Amengual M, Leigh H, Rioja E. Postoperative respiratory effects of intravenous fentanyl compared to intravenous methadone in dogs following spinal surgery. Vet Anaesth Analg 2017; 44:1042-1048. [DOI: 10.1016/j.vaa.2016.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/28/2016] [Accepted: 11/01/2016] [Indexed: 11/25/2022]
|
30
|
Höglund OV, Lövebrant J, Olsson U, Höglund K. Blood pressure and heart rate during ovariohysterectomy in pyometra and control dogs: a preliminary investigation. Acta Vet Scand 2016; 58:80. [PMID: 27855712 PMCID: PMC5112883 DOI: 10.1186/s13028-016-0263-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 11/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Surgery causes a stress response, a physiologic response to trauma. The intraoperative surgical stress response in dogs diagnosed with pyometra has not previously been described. The aim of this study was to investigate the intraoperative surgical stress response, assessed by blood pressure and heart rate measurements, in dogs diagnosed with pyometra and healthy controls. All dogs were premedicated with acepromazine and methadone, anaesthesia was induced with propofol and maintained with isoflurane, where after the dogs were subjected to ovariohysterectomy. RESULTS Eight dogs diagnosed with pyometra and eight healthy controls were used. Systolic blood pressure and heart rate were measured to assess the surgical stress response. Additionally propofol dosage at induction of anaesthesia and the end-tidal isoflurane concentration were investigated. The surgery was split into four phases. Phase 0 was the period 10 min before the skin incision, phase 1 was skin incision and opening of abdomen, phase 2 was manipulation of uterine horns, lifting of the ovary with stretching of the mesovarium, ligation and transection of mesovarium and phase 3 was ligation and transection of cervix, removal of organs and closing of the abdomen. Dosage of propofol at induction of anaesthesia was 3.6 ± 1 mg/kg in dogs with pyometra and 4.1 ± 1 in healthy controls (P = 0.37). In both groups, systolic blood pressure increased between phase 1 and 2, from 87 ± 15 to 114 ± 19 mmHg in dogs with pyometra, and from 88 ± 18 to 106 ± 20 mmHg in healthy controls, (both P < 0.0001). Systolic blood pressure did not differ significantly between groups in any of the phases. Heart rate and end-tidal concentration of isoflurane did not differ significantly between phases or between groups. CONCLUSIONS The increased blood pressure at removal of ovaries during ovariohysterectomy suggests a pronounced noxious stimulus at this part of the procedure. In principle, the study parameters and response to surgery did not differ significantly between dogs with pyometra and healthy controls.
Collapse
|
31
|
DeRossi R, Jardim PHA, Hermeto LC, Pagliosa RC. Comparison of analgesic and systemic effects of bupivacaine, methadone, or bupivacaine/methadone administered epidurally in conscious sheep. Aust Vet J 2016; 93:164-9. [PMID: 25939263 DOI: 10.1111/avj.12313] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 08/05/2014] [Accepted: 08/28/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the combination of bupivacaine and methadone administered epidurally in sheep. METHODS Six healthy female mixed-breed sheep weighing 35-46 kg and aged 12-18 months were included. Each sheep was assigned to receive three treatments: 0.5 mg/kg 0.25% bupivacaine (BP), 0.3 mg/kg 1% methadone (MT) or 0.25 mg/kg bupivacaine and 0.15 mg/kg methadone (BPMT). All drugs were injected into the lumbosacral space through an epidural catheter. Each animal received each treatment at random. Heart rate, arterial blood pressure (systolic, diastolic and mean), respiratory rate, rectal temperature, analgesia, sedation and motor block were determined before treatment and at predetermined intervals. RESULTS The duration of analgesia was 240, 220, and 180 min for BP, MT and BPMT, respectively (P < 0.05). Motor block for all agents was mild to moderate. None or the treatments significantly altered the heart rate, blood pressure or respiratory rate. CONCLUSION Our findings suggest that lumbosacral epidural administration of bupivacaine, methadone or a combination of the two drugs can provide perioperative analgesia in sheep as part of their management for surgical procedures in the flank and hindlimbs.
Collapse
Affiliation(s)
- R DeRossi
- Department of Veterinary Medicine-Surgery and Anesthesiology, Faculty of Veterinary Medicine and Animal Science, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | | | | | | |
Collapse
|
32
|
Navarrete-Calvo R, Gutiérrez-Bautista ÁJ, Granados MM, Domínguez JM, Fernández-Sarmiento JA, Quirós-Carmona S, Morgaz J. Comparison of the isoflurane concentration of using dexketoprofen or methadone at premedication during orthopedic surgery in dogs. Res Vet Sci 2016; 105:36-40. [DOI: 10.1016/j.rvsc.2016.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 12/09/2015] [Accepted: 01/12/2016] [Indexed: 10/22/2022]
|
33
|
Methadone Increases and Prolongs Detomidine-Induced Arterial Hypertension in Horses, but These Effects Are Not Mediated by Increased Plasma Concentrations of Arginine Vasopressin or Serum Concentrations of Catecholamines. J Equine Vet Sci 2016. [DOI: 10.1016/j.jevs.2015.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
34
|
KuKanich B, KuKanich K. Chloramphenicol significantly affects the pharmacokinetics of oral methadone in Greyhound dogs. Vet Anaesth Analg 2015; 42:597-607. [DOI: 10.1111/vaa.12257] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 12/13/2014] [Indexed: 11/29/2022]
|
35
|
Alinejad S, Kazemi T, Zamani N, Hoffman RS, Mehrpour O. A systematic review of the cardiotoxicity of methadone. EXCLI JOURNAL 2015; 14:577-600. [PMID: 26869865 PMCID: PMC4747000 DOI: 10.17179/excli2015-553] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 01/14/2015] [Indexed: 01/07/2023]
Abstract
UNLABELLED Methadone is one of the most popular synthetic opioids in the world with some favorable properties making it useful both in the treatment of moderate to severe pain and for opioid addiction. Increased use of methadone has resulted in an increased prevalence of its toxicity, one aspect of which is cardiotoxicity. In this paper, we review the effects of methadone on the heart as well as cardiac concerns in some special situations such as pregnancy and childhood. METHODS We searched for the terms methadone, toxicity, poisoning, cardiotoxicity, heart, dysrhythmia, arrhythmia, QT interval prolongation, torsade de pointes, and Electrocardiogram (ECG) in bibliographical databases including TUMS digital library, PubMed, Scopus, and Google Scholar. This review includes relevant articles published between 2000 and 2013. The main cardiac effects of methadone include prolongation of QT interval and torsade de pointes. Other effects include changes in QT dispersion, pathological U waves, Taku-Tsubo syndrome (stress cardiomyopathy), Brugada-like syndrome, and coronary artery diseases. The aim of this paper is to inform physicians and health care staff about these adverse effects. Effectiveness of methadone in the treatment of pain and addiction should be weighed against these adverse effects and physicians should consider the ways to lessen such undesirable effects. This article presents some recommendations to prevent heart toxicity in methadone users.
Collapse
Affiliation(s)
- Samira Alinejad
- Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences,Birjand, Iran
| | - Toba Kazemi
- Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences,Birjand, Iran
| | - Nasim Zamani
- Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Robert S. Hoffman
- Division of Medical Toxicology, Ronald O. Pereleman Department of Emergency Medicine, New York University School of Medicine, New York, NY, USA
| | - Omid Mehrpour
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences (BUMS), Pasdaran Avenue, Birjand, 9713643138 Iran
| |
Collapse
|
36
|
Höglund OV, Hagman R, Olsson K, Olsson U, Lagerstedt AS. Intraoperative Changes in Blood Pressure, Heart Rate, Plasma Vasopressin, and Urinary Noradrenalin During Elective Ovariohysterectomy in Dogs: Repeatability at Removal of the 1st and 2nd Ovary. Vet Surg 2014; 43:852-9. [DOI: 10.1111/j.1532-950x.2014.12264.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 08/19/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Odd V. Höglund
- Department of Clinical Sciences; Swedish University of Agricultural Sciences; Uppsala Sweden
| | - Ragnvi Hagman
- Department of Clinical Sciences; Swedish University of Agricultural Sciences; Uppsala Sweden
| | - Kerstin Olsson
- Department of Anatomy, Physiology and Biochemistry; Swedish University of Agricultural Sciences; Uppsala Sweden
| | - Ulf Olsson
- Department of Economics; Applied Statistics and Mathematics, Swedish University of Agricultural Sciences; Uppsala Sweden
| | - Anne-Sofie Lagerstedt
- Department of Clinical Sciences; Swedish University of Agricultural Sciences; Uppsala Sweden
| |
Collapse
|
37
|
Scala C, Marsot A, Limoges MJ, Locatelli Y, Simon N, Alvarez JC. Population pharmacokinetics of methadone hydrochloride after a single intramuscular administration in adult Japanese sika deer (Cervus nippon nippon). Vet Anaesth Analg 2014; 42:165-72. [PMID: 24962270 DOI: 10.1111/vaa.12186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 12/07/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the population pharmacokinetics of methadone in deer. STUDY DESIGN Prospective non-randomized experimental trial. ANIMALS Twelve healthy adult sika deer (nine males and three females). METHODS Deer received intramuscular administration of racemic methadone hydrochloride at 0.5 mg kg(-1) or 1 mg kg(-1) . Plasma methadone and its metabolite 2-Ethylidene-1,5-Dimethyl-3,3-Diphenyl-Pyrolidine (EDDP) concentrations were determined by validated liquid chromatography coupled to tandem mass spectrometry methods, at times 0, 30 minutes, 1, 2, 3, 4, 5, 6, 8, 12 and 24 hours. Population pharmacokinetics analysis was undertaken using a non-linear mixed effects modelling (NONMEM). RESULTS A two-compartment linear disposition model best described observed time-concentration profiles of methadone and EDDP. Population parameter estimates of methadone were elimination clearance (17.3 L hour(-1) ), metabolic clearance (34.6 L hour(-1) ), volume of distribution of compartment 1 (216.0 L) and volume of distribution of compartment 2 (384.0 L). Population parameter estimates of EDDP were elimination clearance (121.0 L hour(-1) ), volume of distribution of compartment 3 (1.08 L) and volume of distribution of compartment 4 (499.5 L). The total clearance and total volume of distribution of methadone and EDDP were 51.9 L hour(-1) , 121.0 L hour (-1) , 600.0 L and 500.6 L, respectively. The methadone terminal elimination half-life was 8.19 hours. No adverse effects were observed after methadone administration. CONCLUSIONS AND CLINICAL RELEVANCE Following intramuscular injection, methadone was characterized by a large total volume of distribution, high systemic clearance and intermediate terminal half-life in sika deer.
Collapse
Affiliation(s)
- Christopher Scala
- Réserve de la Haute-Touche, Muséum National d'Histoire Naturelle, Obterre, France
| | | | | | | | | | | |
Collapse
|
38
|
Portela DA, Romano M, Briganti A. Retrospective clinical evaluation of ultrasound guided transverse abdominis plane block in dogs undergoing mastectomy. Vet Anaesth Analg 2014; 41:319-24. [PMID: 24754569 DOI: 10.1111/vaa.12122] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 05/28/2013] [Indexed: 11/28/2022]
Abstract
HISTORY Eleven female dogs of different breeds undergoing unilateral radical (n = 7) or regional abdominal mastectomy (n = 4) received an ultrasound guided transverse abdominis plane block (TAP-block). PHYSICAL EXAMINATION Subjects showed single or multiple mammary tumours. Serum biochemistry, CBC and electrocardiogram were unremarkable. Eight animals were classified as ASA physical status II and 3 as ASA III. MANAGEMENT Dogs were premedicated with methadone [0.1 or 0.2 mg kg(-1) intravenously (IV) or intramuscularly respectively] or fentanyl (2.5 μg kg(-1) IV). Anaesthesia was induced with propofol and maintained with isoflurane or sevoflurane. Unilateral ultrasound guided TAP blocks were performed in the caudal and cranial abdomen with bupivacaine 0.25% (0.3 to 0.35 mL kg(-1) ). Intercostal nerve blocks (T4 to T11 ) with bupivacaine 0.25% (0.013 to 0.04 mL kg(-1) ) completed the blocked area in dogs undergoing radical mastectomy. FOLLOW UP The median (range) of end-expired isoflurane and sevoflurane necessary to maintain anaesthesia was 1.15 (1.07-1.22) and 2.07 (2.05-2.2) vol% respectively. A single administration of fentanyl (2.5 μg kg(-1) , IV) was administered to control nociception (defined as an increased heart rate or mean arterial blood pressure above 20% of the pre-incisional value) in four of 11 dogs. All dogs received carprofen (2 mg kg(-1) subcutaneously) at the end of surgery. Post-operative pain, assessed for 120 minutes using the short form of Glasgow Composite Pain Scale (0-24), was always lower than 3. No rescue analgesia (allowed by the protocol) was required in this time. CONCLUSION Transverse abdominis plane block combined with intercostal nerve blocks may be useful to produce intraoperative anti-nociception and short term post-operative analgesia in dogs undergoing unilateral mastectomy.
Collapse
Affiliation(s)
- Diego A Portela
- Department of Veterinary Sciences, Veterinary Teaching Hospital "Mario Modenato", University of Pisa, San Piero a Grado, Italy
| | | | | |
Collapse
|
39
|
Hunt JR, Slingsby LS, Murrell JC. The effects of an intravenous bolus of dexmedetomidine following extubation in a mixed population of dogs undergoing general anaesthesia and surgery. Vet J 2014; 200:133-9. [PMID: 24582423 DOI: 10.1016/j.tvjl.2014.01.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 01/23/2014] [Accepted: 01/24/2014] [Indexed: 11/25/2022]
Abstract
An observer blinded, placebo controlled study evaluated the effects of 62.5 μg/m(2) dexmedetomidine administered IV on recovery from isoflurane anaesthesia in dogs. Forty-four healthy dogs, weighing 1.8-19.95 kg, presented for surgery that was expected to cause mild to moderate pain were studied. All were premedicated with 125 μg/m(2) dexmedetomidine and 20 μg/kg buprenorphine IM. Anaesthesia was induced with propofol and maintained with isoflurane. Non-steroidal anti-inflammatory drugs and local anaesthetics were administered as appropriate. Immediately prior to extubation dogs were treated with dexmedetomidine 62.5 μg/m(2) (group D) or an equivalent volume of heparinised saline (S). Assessments of heart rate, respiratory rate, pain (short form Glasgow composite pain scale [SF-GCPS], dynamic interactive visual analogue scale [DIVAS]), sedation (simple descriptive scale [SDS], DIVAS) and mechanical nociceptive threshold (MNT) were performed immediately before premedication, 20 min later, at the time of test drug administration (T0) and at 15-30 min intervals for four hours (T240 min). Recovery quality was scored 0 - 3 (SDS). Data were analysed with Student's t and Mann-Whitney U tests, two-way ANOVA and Fisher's exact test. Significantly fewer poor quality recoveries were observed in group D (D 2 [1-3]; S 2 [0-3]; P=0.02), however, sedation was increased in group D compared to group S from T15 to T150 min (P=0.0001). Pain scores were lower in group D compared to group S from T15 to T120 min (P=0.001), but the requirement for additional analgesia in the first 4h following extubation was not different between groups. Dexmedetomidine may decrease the incidence of poor quality anaesthetic recoveries in dogs.
Collapse
Affiliation(s)
- James R Hunt
- University of Bristol, Department of Clinical Veterinary Sciences, Langford House BS40 5DU, UK.
| | - Louisa S Slingsby
- University of Bristol, Department of Clinical Veterinary Sciences, Langford House BS40 5DU, UK
| | - Joanna C Murrell
- University of Bristol, Department of Clinical Veterinary Sciences, Langford House BS40 5DU, UK
| |
Collapse
|
40
|
Menegheti TM, Wagatsuma JT, Pacheco AD, Perez B, Pacheco CM, Abimussi CJX, dos Santos PPS, de Souza Oliva VNL. Electrocardiographic evaluation of the degree of sedation and the isolated use of methadone in healthy dogs. Vet Anaesth Analg 2014; 41:97-104. [DOI: 10.1111/vaa.12086] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 09/30/2012] [Indexed: 11/30/2022]
|
41
|
Methadone in healthy goats – Pharmacokinetics, behaviour and blood pressure. Res Vet Sci 2013; 95:231-7. [DOI: 10.1016/j.rvsc.2013.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 01/29/2013] [Accepted: 02/22/2013] [Indexed: 11/24/2022]
|
42
|
Intramuscular administration of sodium benzylpenicillin in horses as an alternative to procaine benzylpenicillin. Res Vet Sci 2013; 95:212-8. [PMID: 23419937 DOI: 10.1016/j.rvsc.2013.01.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 11/02/2012] [Accepted: 01/20/2013] [Indexed: 11/21/2022]
Abstract
The aim was to supply information about the possibility of replacing the procaine salt with the sodium salt for benzylpenicillin IM treatment in horse in order to diminish the risk for procaine adverse effects. In a crossover study eight horses were given 15 mg/kg sodium benzylpenicillin (Na-pc) twice daily or procaine benzylpenicillin (control) once daily IM for four days. The half-life of Na-pc was 1.9h, peak concentration was 14,600 ng/mL reached after about 23 min. Trough plasma concentration was 281 ng/mL and protein binding 62.8%. The fT>MIC for Staphylococcus aureus was 63% and 100% for Streptococcus equi subsp. equi and Streptococcus zooepidemicus, indicating an adequate antimicrobial therapy. However, Na-pc cannot be recommended from a welfare point of view since the horses showed more pain related behaviour and more pain and swelling compared to the control treatment.
Collapse
|
43
|
Hoffmann MV, Kästner SBR, Kietzmann M, Kramer S. Contact heat thermal threshold testing in beagle dogs: baseline reproducibility and the effect of acepromazine, levomethadone and fenpipramide. BMC Vet Res 2012; 8:206. [PMID: 23110740 PMCID: PMC3541171 DOI: 10.1186/1746-6148-8-206] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 09/23/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In this methodology article a thermal threshold testing device designed to test nociception in cats was assessed in six dogs. The purpose of this study was to investigate baseline reproducibility of thermal thresholds obtained by the contact heat testing device, to assess the influence of acepromazine and levomethadone and fenpipramide in dogs. The relationship between change in nociceptive thermal threshold and the opioid's plasma concentration was determined. Six adult beagle dogs received levomethadone (0.2 mg/kg), acepromazine (0.02 mg/kg) or saline placebo by intramuscular injection (IM) in a randomized cross-over design. Three baseline nociceptive thermal threshold readings were taken at 15 minutes intervals prior to treatment. Further readings were made at 15, 30, 45, 60, 90, 120, 150, 180, 210, 240, 270, 300, 330, 360, 420 and 480 minutes after injection. A sedation score was assigned at every reading. Four saline placebo treatments were performed to assess baseline reproducibility. Levomethadone serum concentrations were measured prior and 0.5, 1, 2, 4, 8, 12 and 24 hours after drug dosing in a separate occasion. RESULTS Acepromazine did not seem to increase the thermal threshold at any time. After levomethadone there was a significant rise of the thermal threshold between 15 to 120 minutes at serum concentrations between 22.6-46.3 ng/mL. Baseline reproducibility was stable in adult beagle dogs. CONCLUSION The thermal threshold testing system is a suitable device for nociceptive threshold testing in dogs.
Collapse
Affiliation(s)
- Marina Verena Hoffmann
- Department of Small Animal Medicine and Surgery (Hoffmann, Kästner and Kramer), Bünteweg 9, D-30559, Hannover, Germany
| | | | | | | |
Collapse
|
44
|
Tünsmeyer J, Vaske B, Bösing B, Kästner SBR. Cardiovascular effects of a proprietary l-methadone/fenpipramide combination (Polamivet) alone and in addition to acepromazine in healthy Beagle dogs. Vet Anaesth Analg 2012; 39:451-63. [PMID: 22788416 DOI: 10.1111/j.1467-2995.2012.00757.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the cardiovascular effects of a proprietary l-methadone/fenpipramide combination (Polamivet) alone and in addition to acepromazine in dogs. STUDY DESIGN Prospective, randomized, experimental crossover study. ANIMALS Five adult healthy Beagle dogs (one male and four females, weighing 12.8-16.4 kg). METHODS Dogs were instrumented for haemodynamic measurements whilst anaesthetized with isoflurane. Three hours after recovery dogs received 0.025 mg kg(-1) acepromazine (AP) or saline (SP) IM followed by 0.5 mg kg(-1) L-methadone/ 0.025 mg kg(-1) fenpipramide IV after 30 minutes. Cardiac output using thermodilution, heart rate, mean arterial pressure (MAP), central venous pressure (CVP), mean pulmonary artery pressure (MPAP), pulmonary artery occlusion pressure (PAOP), haemoglobin concentration, arterial and mixed-venous blood gas analysis were measured and sedation evaluated at baseline (BL), 30 minutes after acepromazine or saline IM (A/S), 5 minutes after L-methadone/fenpipramide IV application (35), every 15 minutes for 1 hour (50, 65, 80, 95 minutes) and every hour until baseline cardiac output was regained. Standard cardiovascular parameters were calculated. Data were analyzed by repeated measures anova and paired t-tests with p < 0.05 considered significant. RESULTS Baseline measurements did not differ. Cardiac index decreased after acepromazine administration in treatment AP (p = 0.027), but was not significantly influenced after l-methadone/fenpipramide injection in either treatment. In both treatments heart rate did not change significantly over time. Stroke volume index increased after A/S in both treatments (p = 0.049). Systemic vascular resistance index, MAP, CVP, MPAP, and pulmonary vascular resistance index did not change significantly after either treatment and did not differ between treatments. Dogs were deeply sedated in both treatments with a longer duration in treatment AP. CONCLUSIONS AND CLINICAL RELEVANCE In healthy dogs the dose of l-methadone/fenpipramide used in this study alone and in combination with acepromazine induced deep sedation without significant cardiovascular changes.
Collapse
Affiliation(s)
- Julia Tünsmeyer
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany.
| | | | | | | |
Collapse
|
45
|
Gurney MA. Pharmacological options for intra-operative and early postoperative analgesia: an update. J Small Anim Pract 2012; 53:377-86. [DOI: 10.1111/j.1748-5827.2012.01243.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M. A. Gurney
- Department of Anaesthesia; Northwest Surgeons; Cheshire; WA7 3FW
| |
Collapse
|
46
|
Garofalo NA, Teixeira Neto FJ, Pereira CDN, Pignaton W, Vicente F, Alvaides RK. Cardiorespiratory and neuroendocrine changes induced by methadone in conscious and in isoflurane anaesthetised dogs. Vet J 2012; 194:398-404. [PMID: 22750283 DOI: 10.1016/j.tvjl.2012.03.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 03/07/2012] [Accepted: 03/21/2012] [Indexed: 11/19/2022]
Abstract
The aim of this study was to compare the cardiorespiratory and neurohormonal effects of methadone in conscious and in isoflurane anaesthetised dogs. Six mature dogs (28.0 ± 3.8 kg bodyweight) received intravenous (IV) methadone (1mg/kg) three times, once when conscious and twice during isoflurane anaesthesia (with a wash-out period of 1 week). The vasopressin antagonist relcovaptan (0.1mg/kg IV) was administered before the methadone either during the first or second (selected randomly) isoflurane anaesthesia to evaluate the contribution of vasopressin to methadone-associated vasoconstriction. Cardiorespiratory data, plasma catecholamines and serum vasopressin were recorded before (baseline) and for 90 min after methadone. Methadone induced dysphoria in all conscious dogs and significantly (P<0.05) increased mean arterial pressure (MAP), catecholamines, and vasopressin concentrations. During anaesthesia, in addition to significantly greater decreases in heart rate (HR) and cardiac index (CI) than during the conscious state, methadone induced apnoea and mechanical ventilation was necessary in all dogs. In anaesthetised animals, methadone administration significantly increased vasopressin concentrations and systemic vascular resistance index (SVRI), while MAP did not differ from baseline. Relcovaptan administration did not modify the increase in SVRI associated with methadone injection during anaesthesia. Increases in plasma catecholamines may account for the slight decreases in HR and CI seen after methadone administration in conscious dogs. In contrast, isoflurane enhanced the intensity of the cardiorespiratory changes induced by methadone. Vasoconstrictive responses associated with methadone did not appear to be induced by vasopressin.
Collapse
Affiliation(s)
- Natache A Garofalo
- Departamento de Anestesiologia, Faculdade de Medicina, Universidade Estadual Paulista (Unesp), Botucatu, São Paulo, CEP 18618-970, Brazil
| | | | | | | | | | | |
Collapse
|
47
|
Campagnol D, Teixeira-Neto FJ, Peccinini RG, Oliveira FA, Alvaides RK, Medeiros LQ. Comparison of the effects of epidural or intravenous methadone on the minimum alveolar concentration of isoflurane in dogs. Vet J 2012; 192:311-5. [DOI: 10.1016/j.tvjl.2011.08.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 08/10/2011] [Accepted: 08/16/2011] [Indexed: 10/17/2022]
|
48
|
Drynan EA, Gray P, Raisis AL. Incidence of seizures associated with the use of acepromazine in dogs undergoing myelography. J Vet Emerg Crit Care (San Antonio) 2012; 22:262-6. [PMID: 22487256 DOI: 10.1111/j.1476-4431.2012.00721.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 02/02/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the frequency of seizures associated with acepromazine administration when used as a premedicant with methadone for dogs undergoing myelography. DESIGN Retrospective clinical case study. SETTING University veterinary teaching hospital. ANIMALS Sixty-six dogs (mixed and pure breeds), aged between 4 months and 15 years, weighing between 3.5-61 kg. All animals were classified as ASA score I or II. INTERVENTIONS Forty-three animals were premedicated with methadone (0.1-0.5 mg/kg) and acepromazine (0.01-0.05 mg/kg) intramuscularly. Twenty-three animals were premedicated with methadone alone (0.1-0.5 mg/kg) intramuscularly. Anesthesia was induced with propofol intravenously and maintained with isoflurane delivered in 100% oxygen. All animals received a balanced isotonic crystalloid solution intravenously at a rate of 10 mL/kg/h. Blood pressure, end-tidal CO(2) , oxygen saturation, respiratory rate, and heart rate were monitored throughout anesthesia. Animals requiring surgery immediately following myelography were excluded from the study. MEASUREMENTS AND MAIN RESULTS The frequency of seizures was 14% (CI: 3.6-24.3%) and 13.0% (CI: 0.7-27%) in dogs that received methadone/acepromazine and methadone alone, respectively. There was no significant difference in the frequency of seizures between dogs receiving methadone/acepromazine or methadone alone (P = 1). Analysis of the association of site of injection of the contrast and the frequency of seizures in dogs receiving methadone/acepromazine showed no significant difference in the frequency of seizures following cervical injection (25%; CI: 0.5-24.5%) or lumbar injection (9.7%; CI: -0.7-20.1%). CONCLUSIONS The administration of acepromazine combined with methadone as a premedicant used with propofol and isoflurane anesthesia did not significantly increase the frequency of seizures following myelography compared to dogs who received methadone alone.
Collapse
Affiliation(s)
- Eleanor A Drynan
- Department of Anaesthesia, Murdoch University Veterinary Hospital, Murdoch, Australia.
| | | | | |
Collapse
|
49
|
Chen W, Hu S. Suitable carriers for encapsulation and distribution of endostar: comparison of endostar-loaded particulate carriers. Int J Nanomedicine 2011; 6:1535-41. [PMID: 21845043 PMCID: PMC3152471 DOI: 10.2147/ijn.s21881] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background Particulate carriers are necessary to control the release of endostar and prolong its circulation in vivo. The purpose of this study was to identify a suitable carrier for the capsulation and delivery of endostar. Methods We prepared a series of poly (DL-lactide-co-glycolide) (PLGA) and poly (ethylene glycol) (PEG)-modified PLGA (PEG-PLGA) particulate carriers, and then characterized them according to their ability to prolong the circulation of endostar, their physicochemical properties, endostar-loading content, and in vitro and in vivo particulate carrier release profiles. Results All the particulate carriers had spherical core shell structures. The PEG-PLGA material and nanosize range appeared to enable the carriers to encapsulate more endostar, release endostar faster in vitro, and accumulate more endostar in vivo. The drug loading capacity of PEG-PLGA and PLGA nanoparticles was 8.03% ± 3.41% and 3.27% ± 5.26%, respectively, and for PEG-PLGA and PLGA microspheres was 15.32% ± 5.61% and 9.21% ± 4.73%. The cumulative amount of endostar released from the carriers in phosphate-buffered saline over 21 days was 23.79%, 20.45%, 15.13%, and 10.41%, respectively. Moreover, the terminal elimination half-life of endostar in the rabbit was 26.91 ± 7.93 hours and 9.32 ± 5.53 hours in the PEG-PLGA group and the PLGA nanoparticle group. Peak endostar concentration was reached at day 7 in the group treated with subcutaneous injection of PEG-PLGA microspheres and at day 14 in the group receiving subcutaneous injection of PLGA microspheres. Endostar was detectable in vivo in both groups after injection of the particulate carriers. Conclusion PEG-PLGA nanoparticles might be better than other nanoparticulate carriers for encapsulation and distribution of endostar.
Collapse
Affiliation(s)
- Weijie Chen
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong Province, People's Republic of China
| | | |
Collapse
|
50
|
|