Thermal and mechanical nociceptive threshold testing in pregnant sheep

An Exploration of Analgesia Options for Australian Sheep

During their lifetime, sheep undergo many painful husbandry and disease processes. Procedures undertaken on the farm, such as tail docking, castration, and mulesing, all cause considerable pain. In addition, sheep may experience painful diseases and injuries that require treatment by veterinary practitioners, and in biomedical research, sheep may undergo painful experimental procedures or conditions. It is important due to ethics, animal welfare, social licence, and, at times, legal requirements for farmers, veterinary practitioners, and researchers to provide pain relief for animals in their care. While there is a heightened awareness of and a greater interest in animal welfare, there remain few licensed and known analgesia options for sheep within Australia. A literature review was undertaken to identify currently known and potential future options for analgesic agents in sheep in farm and biomedical settings. Non-steroidal anti-inflammatories, opioids, local anaesthetics, α2 adrenoreceptor agonists, and NMDA receptor antagonists are some of the more common classes of analgesic drugs referred to in the literature, but few drugs are registered for use in sheep, with even fewer proven to be effective. Only six analgesic product formulations, namely, lignocaine (e.g., Numocaine®), Tri-Solfen®, ketamine, xylazine, and meloxicam (oral transmucosal and injectable formulations), are currently registered in Australia and known to be efficacious in some types of painful conditions in sheep. The gap in knowledge and availability of analgesia in sheep can pose risks to animal welfare, social licence, and research outcomes. This article presents a summary of analgesic agents that have been used in sheep on farms and in clinical veterinary and biomedical research settings along with details on whether their efficacy was assessed, doses, routes of administration, indication for use, and pain assessment techniques (if any) used. The outcome of this research highlights the challenges, gaps, and opportunities for better analgesia options in sheep.

Analgesic effect of the mint terpenoid L-carvone in sheep

OBJECTIVE

To determine whether L-carvone increases the voltage threshold response to a noxious electrical stimulus in sheep.

STUDY DESIGN

Prospective, blinded, randomized, crossover experimental study.

ANIMALS

A group of six healthy adult sheep.

METHODS

Sheep were instrumented with cranial dorsothoracic subcutaneous copper electrodes. A stimulator delivered a 10 ms square-wave stimulus at 50 pps starting at 0.1 V with a 0.2 V second-1 ramp. The stimulus stopped once two observers who were blinded to treatment noted a behavioral pain response or when a 15 V cut-off was reached. Next, 0.15 mL kg-1 of either a 50% L-carvone solution or a saline-vehicle control was administered intramuscularly, and electrical threshold responses were measured every 5-15 minutes over a 6 hour period using methods identical to the baseline. One week following the first treatment (L-carvone or control), sheep were studied using identical methods with the second treatment (control or L-carvone). Drug and time effects were evaluated using a two-way repeated measures analysis of variance, and pairwise comparisons were evaluated with Holm-Sidák tests with values of p < 0.05 considered significant.

RESULTS

L-carvone significantly increased voltage threshold responses for most time points up to 75 minutes compared with baseline and with saline control. The last time point with a significantly different response between L-carvone and saline treatments was 5 hours after drug administration. The saline-vehicle control decreased voltage threshold responses at several time points after 3 hours.

CONCLUSIONS AND CLINICAL RELEVANCE

Intramuscular L-carvone is analgesic in sheep, although the ethanol-propylene glycol vehicle may cause mild hyperalgesia. This study demonstrates that a food-derived compound can be used to relieve pain in a food-producing animal.

Analgesia for Sheep in Commercial Production: Where to Next?

Simple Summary

Increasing societal and customer pressure to provide animals with ‘a life worth living’ continues to apply pressure on industry to alleviate pain associated with husbandry practices, injury and illness. Although a number of analgesic solutions are now available for sheep, providing some amelioration of the acute pain responses, this review has highlighted a number of potential areas for further research.

Abstract

Increasing societal and customer pressure to provide animals with ‘a life worth living’ continues to apply pressure on livestock production industries to alleviate pain associated with husbandry practices, injury and illness. Over the past 15–20 years, there has been considerable research effort to understand and develop mitigation strategies for painful husbandry procedures in sheep, leading to the successful launch of analgesic approaches specific to sheep in a number of countries. However, even with multi-modal approaches to analgesia, using both local anaesthetic and non-steroidal anti-inflammatory drugs (NSAID), pain is not obliterated, and the challenge of pain mitigation and phasing out of painful husbandry practices remains. It is timely to review and reflect on progress to date in order to strategically focus on the most important challenges, and the avenues which offer the greatest potential to be incorporated into industry practice in a process of continuous improvement. A structured, systematic literature search was carried out, incorporating peer-reviewed scientific literature in the period 2000–2019. An enormous volume of research is underway, testament to the fact that we have not solved the pain and analgesia challenge for any species, including our own. This review has highlighted a number of potential areas for further research.

Analgesic Comparison of Flunixin Meglumine or Meloxicam for Soft-Tissue Surgery in Sheep: A Pilot Study

Simple Summary

Pain management is lacking in U.S. commercial sheep production systems. This is, in part, due to the limited amount of scientific data evaluating sheep pain responses after analgesia treatment. Non-steroidal anti-inflammatory drugs (NSAIDs), such as meloxicam (MEL) and flunixin meglumine (FLU), are the most common drug class provided to livestock species to manage pain. Pain assessment tools, such as facial grimace scales, which use changes in facial expression to monitor pain, are also needed to improve pain management and sheep welfare. In this study, sheep undergoing a laparotomy (a surgical procedure where an incision is made into the abdominal cavity) were treated with either MEL or FLU to manage pain. A third group of ewes did not undergo surgery and served as study controls (CON). Behavior and physiologic outcome measures were collected pre-procedure and up to 48 h post-procedure. The results suggest that MEL and FLU were equally effective at providing post-operative analgesia; however, even with NSAID administration, acute pain and inflammation were still present in surgical sheep compared to non-surgical controls. The facial grimace scale results were not consistent with the other outcome measures taken in this study and it should not be used as a stand-alone pain assessment tool.

Abstract

The amount of scientific data evaluating sheep pain responses after analgesia treatment is limited. The aims of this study were to compare the efficacy of flunixin meglumine (FLU) and meloxicam (MEL) at relieving post-surgical pain in sheep and to evaluate the utility of the Sheep Grimace Scale (SGS). Thirty ewes were assigned to one of three treatment groups: oral MEL or intravenous FLU to manage pain associated with a laparotomy procedure, or a non-surgical control (CON) group. Behavior and physiologic outcome measures were collected pre-procedure and up to 48 h post-procedure. There were no significant differences in behavior, gait, degree of inflammation or pain around the surgical site when MEL and FLU sheep were compared, suggesting that both drugs provided similar levels of analgesia. Significant differences in behavior, gait, abdominal inflammation and pain were found when surgical sheep were compared to non-surgical controls. More work is needed to characterize the amount of pain relief provided by MEL and FLU. The SGS had moderate reliability between scorers; however, the results were inconsistent with the other study outcome measures. The SGS may have some utility as a pain assessment tool but should be used in conjunction with other pain measures.

Remote Controlled Nociceptive Threshold Testing Systems in Large Animals

Simple Summary

Measurement of the nociceptive threshold (NT) is widely used in the study of pain and its alleviation. This records the intensity of a stimulus that causes pain to the test subject. The end point of the test that indicates when the subject experiences pain, the NT, is a behavioural escape response. Detection of a reliable and repeatable response depends on the animal behaving normally throughout testing. Restraint and an unfamiliar environment may prevent the animal from displaying normal behaviour and impede acquisition of robust NTs. Remotely controlled testing enables NT data to be collected from unrestrained animals behaving normally. Development of a remote controlled system for measurement of thermal and mechanical NTs in a range of large animal species is described. Normal “baseline” thermal and mechanical NTs from untreated animals are reported. This information can be used to improve both the welfare of the animals under investigation and the quality of the data collected. Remote controlled systems are now in use worldwide in both the study of pain physiology and in developing new pharmaceutical and non-drug-based methods of pain relief.

Abstract

Nociceptive threshold (NT) testing is widely used for the study of pain and its alleviation. The end point is a normal behavioural response, which may be affected by restraint or unfamiliar surroundings, leading to erroneous data. Remotely controlled thermal and mechanical NT testing systems were developed to allow free movement during testing and were evaluated in cats, dogs, sheep, horses and camels. Thermal threshold (TT) testing incorporated a heater and temperature sensor held against the animal’s shaved skin. Mechanical threshold (MT) testing incorporated a pneumatic actuator attached to a limb containing a 1–2 mm radiused pin pushed against the skin. Both stimuli were driven from battery powered control units attached on the animal’s back, controlled remotely via infra-red radiation from a handheld component. Threshold reading was held automatically and displayed digitally on the unit. The system was failsafe with a safety cut-out at a preset temperature or force as appropriate. The animals accepted the equipment and behaved normally in their home environment, enabling recording of reproducible TT (38.5–49.8 °C) and MT (2.7–10.1 N); precise values depended on the species, the individual and the stimulus characteristics. Remote controlled NT threshold testing appears to be a viable refinement for pain research.

Repeatability and Feasibility of Pressure Algometry for Quantifying Mechanical Nociceptive Threshold in the Thoracic Region of Calves

Pressure algometry can be used to quantify mechanical nociceptive threshold (MNT) in humans and animals. If reliable this may be a useful tool to examine calves for increased mechanical sensitivity, which may be induced by disease or pain. This study measures the repeatability and feasibility of pressure algometry using a handheld digital pressure algometer (PRODPlus, Top Cat metrology) using three serial measurements applied to six sites on the thoraces of 35 healthy calves by two different operators. The range of MNTs recorded in healthy calves was 1.2-25 Newtons (median = 10.1 IQR = 7.1-14.0). A multivariable mixed effects model identified that the MNT's recorded were influenced by Operator, Site, and Calf. Intra and inter-operator reliability were measured by intra-class correlation coefficients (ICCs). Based on average ICCs, intra-operator reliability at two sites was good; one site overlying the ventral aspect of the 6th intercostal space [ICC = 0.79 95% CI (0.63-0.89)] and the other overlying the dorsal aspect of the 9th intercostal space [ICC = 0.75 95% CI (0.56-0.87)]. Average ICCs for three other measurement sites were moderate or poor, and one site proved unfeasible. For inter-operator agreement average ICCs showed that agreement was also good at the same 6 and 9th intercostal space, [ICCs = 0.77 95% CI (0.35-0.90) and 0.77 95% CI (0.54-0.88), respectively], agreement was moderate for the remainder of the sites. This study identifies two sites that are potentially useful for monitoring of thoracic sensitivity as an indicator of pain in calves by means of pressure algometry using the average of three measurements. It also identifies sources of variability to be considered when applying the tool for clinical or research purposes.

Comparison of analgesic efficacy and fetal effects between transdermal administration of fentanyl and intramuscular administration of buprenorphine in pregnant sheep

OBJECTIVE

To compare analgesic efficacy and fetal effects between transdermal administration of fentanyl and IM administration of buprenorphine in pregnant sheep.

ANIMALS

12 healthy pregnant ewes.

PROCEDURES

Before study initiation, each ewe was confirmed pregnant with a single fetus between 113 and 117 days of gestation. Ewes were randomly assigned to receive buprenorphine (0.01 mg/kg, IM, q 8 h for 48 hours beginning 1 hour before anesthesia induction; n = 6) or fentanyl (a combination of transdermal fentanyl patches sufficient to deliver a dose of 2 μg of fentanyl/kg/h applied between the dorsal borders of the scapulae 24 hours before anesthesia induction; 6). Ewes were anesthetized and underwent a surgical procedure to instrument the fetus with an arterial catheter and place a catheter in utero for collection of amniotic fluid samples. Physiologic variables and behavioral changes indicative of pain were assessed, and amniotic fluid and blood samples from ewes and fetuses were collected for determination of drug concentrations at predetermined times.

RESULTS

Both protocols provided acceptable postoperative analgesia with no adverse effects observed in the ewes or fetuses. Compared with the buprenorphine protocol, the fentanyl protocol induced more profound analgesia, decreased the requirement for isoflurane during surgery, and was associated with a shorter anesthesia recovery time. Fetal indices did not differ significantly between the 2 analgesic protocols.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that both protocols provided acceptable analgesia. However, the fentanyl protocol was superior in regard to the extent of analgesia induced, inhalant-sparing effects, and anesthesia recovery time.

Determination of the minimum alveolar concentration of sevoflurane that blunts adrenergic responses and the effect of a constant rate infusion of ketamine in sheep

Minimizing sympathetic stimulation under anesthesia prevents activation of the neuroendocrine stress response. The minimum alveolar concentration blunting adrenergic responses in 50% of the population when exposed to a noxious stimulus is defined as MAC-BAR. The purpose of this study was to determine the MAC-BAR of sevoflurane (MAC-BAR_sevo) in sheep and the MAC-BAR sparing effects of ketamine. Thirteen healthy Dorset-cross adult ewes, 4 ± 1 year old and weighing 74 ± 9 kg, were enrolled in a randomized blinded crossover study design. Ewes were anesthetized twice for MAC-BAR_sevo determination. After face mask induction with sevoflurane, sheep received intravenous ketamine at 1.5 mg/kg and a constant rate infusion of 1.5 mg/kg/h or an equivalent volume of saline (placebo). After 8 day washout, the other treatment was administered. A bracketing technique was used for MAC-BAR_sevo determination and values were collected in duplicate. The mechanical stimulus (sponge forceps) was applied at the coronary band for 1 min and blood was collected for ketamine plasma concentrations. The MAC-BAR_sevo values of each treatment were compared using a paired t-test. Mean MAC-BAR_sevo of the ketamine and placebo were 2.73 ± 0.23% and 2.77 ± 0.31%, respectively and no significant difference was found (p = .638). Average ketamine plasma concentrations was 1.54 ± 0.18 μg/mL maintained through the study. Ketamine at 1.5 mg/kg, followed by 1.5 mg/kg/h, did not decrease the MAC-BAR_sevo in sheep. Further studies to determine the effect of higher doses of ketamine on inhalational anesthetic agents and their potential adverse effects are warranted.

Use and Efficacy of Analgesic Agents in Sheep (Ovis aries) Used in Biomedical Research

Sheep (Ovis aries) are widely used as large animal models in biomedical research. However, current literature on the use of analgesics in sheep generally focuses on an industry or farm level of use. This structured review evaluates use and efficacy of analgesics administered to sheep in a biomedical research setting. Electronic databases were searched with terms related to analgesia in research sheep. After application of exclusion criteria, 29 peer-reviewed publications were evaluated from 1995 to 2018. Drugs used for analgesia in sheep include opioids, α₂ agonists, NSAID, local anesthetics, NMDA receptor antagonists, and calcium channel blockers. Opioid agonists have previously been considered short acting and of questionable efficacy in sheep, but newer modalities may provide effective analgesia. NSAID may exhibit an analgesic effect only when inflammatory pain is present and may not be beneficial for use in acute pain models. α₂ agonists provide effective yet short-lived analgesia; however, side effects are of concern. Local anesthetics were previously widely used as stand-alone agents, as alternatives to the use of general anesthetics in sheep. These agents have since fallen out of favor as sole agents. Despite this, they provide a valuable analgesic effect when used as adjuncts to general anesthetic regimes. The NMDA antagonist ketamine provided good analgesia and is likely underutilized as an analgesic agent in sheep. Future controlled studies should further evaluate the analgesic properties of ketamine in sheep.

Mechanical nociceptive thresholds in endurance horses

BACKGROUND

Alteration of limb sensitivity is forbidden in equine sports but difficult to enforce. We aimed to develop an objective field method to assess mechanical nociceptive threshold (MNT) in endurance horses.

METHODS

A remotely controlled pneumatic actuator (1 mm tip) was used to measure forelimb pastern MNT in 108 endurance horses.

RESULTS

Median (IQR) MNT at rest was 1.9 N (0.9-3.5). Icing had no significant effect on limb sensitivity. MNT measured at weekly intervals increased from week 1 (1.2 N (0.6-1.8)) to week 3 (1.9 N (1.2-2.8)) (P<0.05). In 17 horses without impaired sensitivity, MNT increased from 1.2 N (0.6-2.3) before to 2.4 N (1.2-5.2) after racing (P=0.0017). In desensitised horses, MNT after racing was higher (8 limbs-23.1 N (21.4 to >25)) than in horses without impaired sensitivity (42 limbs-2.2 N (1.2-4.3)) (P<0.0001). Desensitisation with mepivacaine increased MNT to above the safety cut-off (25 N) at 10 minutes; sensitivity return to baseline varied between individuals but was restored by 330 minutes. None of the horses became averse to the technique.

CONCLUSION

MNT was practical, non-traumatic, repeatable and well tolerated under field conditions in endurance horses. The technique differentiated postracing MNT in horses with normal sensitivity from those with impaired sensitivity.

Development of a model for investigation of perennial ryegrass toxicosis in sheep

AIMS To develop a clinical model of perennial ryegrass toxicosis (PRGT) based on feeding a known dose of lolitrem B and ergotamine, and to produce a consistent clinical presentation for assessment of disease pathophysiology, neurological changes and neurohistopathology. METHODS Male lambs, aged between 10-12 months, were randomly assigned to either Treatment (n=9) or Control (n=9) groups. Lambs in the Treatment group received feed containing a novel endophyte-infested perennial ryegrass seed, commencing on Day 0 of the Feeding phase with a low induction dose, then increasing after 3 days to provide 0.16 mg/kg live bodywight (LBW)/day of lolitrem B and 0.054 mg/kg LBW/day ergotamine. Lambs were examined daily and when defined signs of PRGT were observed they were transferred to the Testing phase. Neurological examinations, assessment of gait, surface electromyography (EMG) and mechanosensory nociceptive threshold testing were carried out and blood samples collected during both phases of the trial, with a full necropsy, histopathological examination and measurement of faecal cortisol metabolites (FCM) performed on Day 2 of the Testing phase. RESULTS Typical clinical signs of PRGT, including ataxia of vestibulocerebellar origin leading to stumbling, were observed in all Treatment lambs. The median interval from the start of the Feeding phase to entry into the Testing phase was 21 (min 18, max 34) days. Histopathological characterisation of neurological lesions included the presence of Purkinje cell vacuolation, pyknotic granular layer neurons and proximal axonal Purkinje cell spheroids. Lesions were most apparent within the vestibulocerebellum. Mean root-mean-square voltages from triceps EMG increased in Treatment lambs between Feeding phase Day 0 and Testing phase Day 2 (p<0.001). Daily water intake during the Testing phase for the Treatment group was less than in Control group lambs (p=0.002), and concentrations of FCM at necropsy were higher in Treatment compared to Control lambs (p=0.02). CONCLUSIONS AND CLINICAL RELEVANCE Lolitrem B and ergotamine dosing in feed on a live weight basis combined with neurological/gait assessment provides an effective model for investigation of PRGT and potential therapeutics. Assessment of gait changes using defined criteria and RMS voltages from EMG appear to be useful tools for the assessment of the severity of neurological changes.

Sedation of sheep following the administration of acepromazine with buprenorphine or morphine is similar

The aim of this study was to compare sedation of sheep with acepromazine and buprenorphine or morphine. Twenty merino sheep received acepromazine (0.03mg/kg) with buprenorphine (0.02mg/kg, AB, n=10) or morphine (0.3mg/kg, AM, n=10) by intramuscular injection. Sedation was scored (SS) on a scale from 0 (no sedation) to 10 (heavy sedation). Response to restraint was scored (RS) on a scale from 0 (agitated) to 4 (relaxed). Three independent blinded observers and a single blinded observer determined the SS and RS, respectively. The SSs were summed (maximum 30). Data were compared using a t-test. Data is mean±SD (95% confidence interval). Each group comprised 2 wethers and 8 ewes. There was no difference between the AB and AM groups: weight 44±3.1kg and 44.7±3kg (p=0.58); SS 4.6±3.2 (2.4-6.9) and 6.6±3.5 (4.1-9.1) (p=0.21); and RS 1.6±1.3 (0.5-2.7) and 2±1.5 (0.7-3.3) (p=0.6). No adverse effects of the drugs were observed. Sedation with AB or AM at these doses is similar in sheep without observed adverse effects.

The uptake of transdermal fentanyl in a pregnant sheep model

OBJECTIVE

To evaluate the maternal and foetal uptake of transdermal fentanyl patch applied to the groin of pregnant sheep following surgery.

STUDY DESIGN

Prospective series.

ANIMALS

A group of 16 singleton pregnant sheep underwent anaesthesia for laparotomy, hysterotomy and instrumentation of the foetus. Of these ewes 10 (101 ± 12 days of gestation) were used to evaluate the maternal uptake of transdermal fentanyl, and the efficacy of the drug in the postoperative period (n = 10). To determine the extent of transplacental transfer of fentanyl, six ewes from the group of 10, and six other ewes (92 ± 1 days' gestation) were studied.

METHODS

A 75 μg hour^-1 fentanyl patch was placed onto the woolless skin of the medial thigh close to the groin at the end of surgery. Maternal blood samples were collected from the cephalic or jugular vein, and pain and sedation scores were determined, prior to application of the patch (time 0) and at 3, 6, 12, 24, 36 and 48 hours after. A commercial Fentanyl ELISA kit was used to determine the concentration of fentanyl. Paired maternal and foetal blood samples were collected 48 hours after surgery. Animals were euthanized at the end of the study. Data were tested for normality and compared with Student t test or one-way anova and are expressed as mean ± standard deviation or median (range).

RESULTS

Recovery from anaesthesia and surgery was uneventful in all ewes. The dose of fentanyl was 1.4 ± 0.2 μg kg^-1 hour^-1. The maximum maternal plasma concentration of fentanyl was 0.547 ng mL^-1 (range, 0.349-0.738 ng mL^-1) at 12 hours. After 48 hours, the concentration of fentanyl was 0.381 ng mL^-1 (range, 0.211-0.487 ng mL^-1; maternal) and 0.295 ng mL^-1 (range, 0.185-0.377 ng mL^-1; foetal; p = 0.175). The placental transfer rate of fentanyl was 77%.

CONCLUSIONS AND CLINICAL RELEVANCE

The uptake of fentanyl varied between animals. The placental transfer rate of fentanyl was 77%.

Mechanical nociceptive threshold testing in Bos indicus bull calves

The aim of this prospective, controlled, randomised trial was to develop a technique for mechanical nociceptive threshold testing (NTT) to assess pain in Bos indicus bull calves undergoing surgical castration. Analgesia was provided by 0.5 mg/kg subcutaneous (SC) meloxicam (M) and/or 2 mg/kg of intra-testicular and SC (at the surgery sites) lidocaine (L). Forty-eight Brahman bull calves at 6–8 months of age were divided into six study groups, each with eight animals: no surgery control; surgical castration (C) without analgesia; C and Mpre-op; C and Mpost-op; C, L and Mpost-op; C and L. Mechanical NTT was performed the day before surgery (Day –1) and on Days 1, 2, 6, 10 and 13 after surgery. A handheld manual pneumatic device with a 1-mm (diameter) blunt pin was used to deliver a mechanical stimulus to a maximum of 27 Newtons either side of the most dorsal aspect of the sacrum. The most frequent responses to the mechanical stimulus were lifting or kicking of the leg on the same side as the stimulus (31%) and stepping away from the stimulus (24.9%). Data were analysed with a mixed effect linear model with the nociceptive threshold (NT) as the response variable and day and analgesic treatment as predictors (P < 0.05 was considered significant). For all groups, there was a trend towards decreasing NT over the study period but there were no significant differences between groups. Step down model selection with day, batch and treatment terms revealed a significant effect of day (P < 0.001) and batch (P = 0.007). Mechanical NTT for assessment of pain in Bos indicus bull calves requires further refinement to determine if this is a useful method of pain assessment.

Pharmacokinetics and antinociceptive effects of tramadol and its metabolite O-desmethyltramadol following intravenous administration in sheep

Although sheep are widely used as an experimental model for various surgical procedures there is a paucity of data on the pharmacokinetics and efficacy of analgesic drugs in this species. The aims of this study were to investigate the pharmacokinetics of intravenously (IV) administered tramadol and its active metabolite O-desmethyltramadol (M1) and to assess the mechanical antinociceptive effects in sheep. In a prospective, randomized, blinded study, six healthy adult sheep were given 4 and 6 mg/kg tramadol and saline IV in a cross-over design with a 2-week wash-out period. At predetermined time points blood samples were collected and physiological parameters and mechanical nociceptive threshold (MNT) values were recorded. The analytical determination of tramadol and M1 was performed using high performance liquid chromatography. Pharmacokinetic parameters fitted a two- and a non-compartmental model for tramadol and M1, respectively. Normally distributed data were analysed by a repeated mixed linear model. Plasma concentration vs. time profiles of tramadol and M1 were similar after the two doses. Tramadol and M1 plasma levels decreased rapidly in the systemic circulation, with both undetectable after 6 h following drug administration. Physiological parameters did not differ between groups; MNT values were not statistically significant between groups at any time point. It was concluded that although tramadol and M1 concentrations in plasma were above the human minimum analgesic concentration after both treatments, no mechanical antinociceptive effects of tramadol were reported. Further studies are warranted to assess the analgesic efficacy of tramadol in sheep.

Refinement of a thermal threshold probe to prevent burns

Thermal threshold testing is commonly used for pain research. The stimulus may cause burning and merits prevention. Thermal probe modifications hypothesized to reduce burning were evaluated for practicality and effect. Studies were conducted on two humans and eight cats. Unmodified probe 0 was tested on two humans and promising modifications were also evaluated on cats. Probe 1 incorporated rapid cooling after threshold was reached: probe 1a used a Peltier system and probe 1b used water cooling. Probe 2 released skin contact immediately after threshold. Probe 3 (developed in the light of evidence of 'hot spots' in probe 0) incorporated reduced thermal mass and even heating across the skin contact area. Human skin was heated to 48℃ (6℃ above threshold) and the resulting burn was evaluated using area of injury and a simple descriptive scale (SDS). Probe 1a cooled the skin but required further heat dissipation, excessive power, was not 'fail-safe' and was inappropriate for animal mounting. Probe 1b caused less damage than no cooling (27 ± 13 and 38 ± 11 mm(2) respectively, P = 0.0266; median SDS 1.5 and 4 respectively, P = 0.0317) but was cumbersome. Probe 2 was unwieldy and was not evaluated further. Probe 3 produced even heating without blistering in humans. With probe 3 in cats, after opioid treatment, thermal threshold reached cut-out (55℃) on 24 occasions, exceeded 50℃ in a further 32 tests and exceeded 48℃ in the remainder. No skin damage was evident immediately after testing and mild hyperaemia in three cats at 2-3 days resolved rapidly. Probe 3 appeared to be suitable for thermal threshold testing.