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Pinheiro AV, Petrucci GN, Dourado A, Silva F, Pires I. Pain Management in Animals with Oncological Disease: Opioids as Influencers of Immune and Tumor Cellular Balance. Cancers (Basel) 2024; 16:3015. [PMID: 39272873 PMCID: PMC11394036 DOI: 10.3390/cancers16173015] [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: 06/12/2024] [Revised: 08/07/2024] [Accepted: 08/28/2024] [Indexed: 09/15/2024] Open
Abstract
Advancements in understanding pain physiopathology have historically challenged animals' absence of pain senses. Studies have demonstrated that animals have comparable neural pain pathways, suggesting that cats and dogs likely experience pain similarly to humans. Understanding brain circuits for effective pain control has been crucial to adjusting pain management to the patient's individual responses and current condition. The refinement of analgesic strategies is necessary to better cater to the patient's demands. Cancer pain management searches to ascertain analgesic protocols that enhance patient well-being by minimizing or abolishing pain and reducing its impact on the immune system and cancer cells. Due to their ability to reduce nerve sensitivity, opioids are the mainstay for managing moderate and severe acute pain; however, despite their association with tumor progression, specific opioid agents have immune-protective properties and are considered safe alternatives to analgesia for cancer patients.
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Affiliation(s)
- Ana Vidal Pinheiro
- Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal
- Animal and Veterinary Department, University Institute of Health Sciences, Advanced Polytechnic and University Cooperative, CRL, 4585-116 Gandra, Portugal
- School of Agrarian Sciences, Polytechnic Institute of Viana do Castelo, Refoidos do Lima, 4990-706 Ponte de Lima, Portugal
| | - Gonçalo N Petrucci
- Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Animal and Veterinary Department, University Institute of Health Sciences, Advanced Polytechnic and University Cooperative, CRL, 4585-116 Gandra, Portugal
- Onevetgroup Hospital Veterinário do Porto (HVP), 4250-475 Porto, Portugal
- Center for Investigation Vasco da Gama (CIVG), Department of Veterinary Sciences, Vasco da Gama University School (EUVG), 3020-210 Coimbra, Portugal
| | - Amândio Dourado
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal
- Onevetgroup Hospital Veterinário do Porto (HVP), 4250-475 Porto, Portugal
| | - Filipe Silva
- Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal
| | - Isabel Pires
- Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal
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Gomez-Martinez MI, Hughes J, Alderson B, Deutsch J. A randomized clinical trial comparing the efficacy of lidocaine administered intravenously, intranasally or as infraorbital nerve block in dogs undergoing rostral rhinosocopy. Vet Anaesth Analg 2024; 51:372-380. [PMID: 38772853 DOI: 10.1016/j.vaa.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/31/2024] [Accepted: 04/09/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVE To compare the efficacy of lidocaine administered intravenously, intranasally or as an infraorbital nerve block in dogs undergoing rostral rhinoscopy. STUDY DESIGN Randomized clinical trial. ANIMALS A total of 43 client-owned dogs. METHODS After premedication with medetomidine 0.01 mg kg-1 and methadone 0.2 mg kg-1 intramuscularly, anaesthesia was induced with propofol and maintained with isoflurane in oxygen. Dogs were randomly allocated to receive 2 mg kg-1 of 2% lidocaine as a bilateral infraorbital nerve block (INB) via the caudal intraoral approach, via bilateral topical intranasal administration (TIA) or as an intravenous bolus (IVB). At 5 minutes following lidocaine administration, responses to rhinoscopy (RR) and biopsies (RB) were evaluated using a simple scoring system (0: no reaction; 1: reaction). Response to the rhinoscopy in the recovery period (RE) was recorded. Recovery quality was scored using a simple descriptive score. Heart rate, respiratory rate and noninvasive arterial blood pressure were recorded. Intravenous (IV) fentanyl 0.001 mg kg-1 was administered if an increase > 20% in any variable occurred. Gross movement was attenuated using propofol 0.5 mg kg-1 IV. Scores were analysed using the Chi-square test with Monte Carlo method. Cardiorespiratory changes among and overtime between groups were compared using one-way anova and one-way anova for repeated measures, respectively, or the correspondent non-parametric tests; p < 0.05. RESULT Of the 43 dogs, 42 completed the study. No statistically significant differences were detected in either physical reactions or changes in cardiorespiratory variables for RR, RB, RE or recovery quality, although RB tended to be higher in group TIA (7/10 versus 1/10 INB and 3/13 IVB).Various cardiorespiratory variables changed overtime within groups. CONCLUSIONS AND CLINICAL RELEVANCE In dogs, all three investigated techniques attenuated responses during rostral rhinoscopy in dogs, although INB and IVB were more efficacious when biopsies were taken.
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Affiliation(s)
| | - Jodie Hughes
- North Down Specialist Referrals, Bletchingley, UK
| | - Briony Alderson
- Small Animal Teaching Hospital, University of Liverpool, Neston, UK
| | - Julia Deutsch
- Langford Vets Small Animal Referral Hospital, University of Bristol, Langford, UK
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Lazzarini E, Gioeni D, Del Prete G, Sala G, Baio M, Carotenuto AM. A comparative analysis of opioid-free and opioid-sparing anaesthesia techniques for laparoscopic ovariectomy in healthy dogs. Vet Anaesth Analg 2024; 51:288-297. [PMID: 38553381 DOI: 10.1016/j.vaa.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 02/01/2024] [Accepted: 02/19/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVE To compare the perioperative analgesic effects of an opioid-free (OFA) and an opioid-sparing (OSA) anaesthetic protocol in dogs undergoing laparoscopic ovariectomy. STUDY DESIGN Prospective, randomized, blinded, clinical trial. ANIMALS A group of 28 client-owned dogs. METHODS Dogs were allocated to one of two groups. The OFA group was administered intramuscular (IM) dexmedetomidine 5 μg kg-1 and ketamine 1 mg kg-1, followed by two intraoperative constant rate infusions (CRIs) of dexmedetomidine (3 μg kg-1 hour-1) and lidocaine (1 mg kg-1 loading dose, 2 mg kg-1 hour-1). The OSA group was administered IM dexmedetomidine 5 μg kg-1, ketamine 1 mg kg-1 and methadone 0.2 mg kg-1, followed by two intraoperative saline CRIs. In both groups, anaesthesia was induced with intravenous (IV) propofol 2 mg kg-1 and diazepam 0.2 mg kg-1 and maintained with isoflurane. Rescue dexmedetomidine (0.5 μg kg-1) was administered IV if there was a 20% increase in cardiovascular variables compared with pre-stimulation values. Ketorolac (0.5 mg kg-1) was administered IV when the surgery ended. Postoperative analgesia was evaluated using the Short Form-Glasgow Composite Measure Pain Scale and methadone (0.2 mg kg-1) was administered IM if the pain score was ≥ 6/24. Statistical analysis included mixed analysis of variance, Chi-square test and Mann-Whitney U test. RESULTS There were no significant differences in the intraoperative monitored variables between groups. The OFA group showed a significantly lower intraoperative rescue analgesia requirement (p = 0.016) and lower postoperative pain scores at 3 (p =0.001) and 6 (p < 0.001) hours. No dogs were administered rescue methadone postoperatively. CONCLUSIONS AND CLINICAL RELEVANCE Although both groups achieved acceptable postoperative pain scores with no need for further intervention, the analgesic efficacy of the OFA protocol was significantly superior to that of the OSA protocol presented and was associated with a lower intraoperative rescue analgesia requirement and early postoperative pain scores.
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Affiliation(s)
| | | | | | - Giulia Sala
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Matteo Baio
- Ospedale Veterinario San Francesco, Milano, Italy
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Stabile M, Lacitignola L, Acquafredda C, Scardia A, Crovace A, Staffieri F. Evaluation of a constant rate intravenous infusion of dexmedetomidine on the duration of a femoral and sciatic nerve block using lidocaine in dogs. Front Vet Sci 2023; 9:1061605. [PMID: 36713886 PMCID: PMC9880291 DOI: 10.3389/fvets.2022.1061605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/19/2022] [Indexed: 01/14/2023] Open
Abstract
Objectives This study investigated the effects of 1 μg/kg/h intravenous constant rate infusion (CRI) of dexmedetomidine on the sensory and motor blockade for femoral and sciatic nerve blocks in dogs undergoing stifle surgery. Materials and methods Client-owned dogs referred for stifle surgery were enrolled in this prospective, randomized, blinded study. Dogs were pre-medicated with acepromazine (0.005-0.01 mg/kg intramuscularly, IM); anesthesia was induced with propofol intravenously and maintained with isoflurane in a mixture of air and oxygen. Electrolocation-guided sciatic and femoral nerve blocks with lidocaine 2% (0.15 mL/kg) were performed using the parasacral and lateral pre-iliac approaches, respectively. After performing local block, a systemic infusion of saline solution (group C) or dexmedetomidine (group D) was started at a CRI at 1 ml/kg/h and continued until the end of surgery. Dexmedetomidine was infused at a dose of 1 μg/kg/h. Respiratory and hemodynamic variables were recorded during surgery. Sensory and motor blockade was evaluated by response to pinching the skin innervated by the sciatic/femoral nerves, with forceps and by observing the dogs' ability to walk and testing proprioception at 30, 60, 120, 180, and 240 min after extubation. Analgesia was monitored with SF-GCPS. Methadone IM was administered as rescue analgesia. Intraoperative data were analyzed by analysis of variance, while postoperative data were analyzed by the independent two-tailed t-test and a Kaplan-Meier test (p < 0.05). Results Twenty dogs were included in this study (10/group). A significant difference in the recovery of sensory nerve function was observed between the groups. The mean durations of the sensory blockade for femoral and sciatic nerves, respectively, was longer (p < 0.001) for group D [168 (146-191, 95% CI), 161 (143-179, 95% CI) min] than in group C [120 (96.1-144, 95% CI), 116 (90.9-142, 95% CI]. No differences in the recovery of patellar and tibial reflexes, proprioceptive function, and ability to walk were found among groups. The overall postoperative rescue analgesia requirement was significantly different (p = 0.019) between groups, with an incidence of 5/10 (50%) dogs in group D and 10/10 (100%) dogs in group C. Conclusion Dexmedetomidine administered as a CRI (1 μg/kg/h) combined with local lidocaine increases the duration of the sensory component of the sciatic and femoral nerve blocks and reduces the requirement for additional analgesia during the immediate postoperative hours.
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Cattai A, Merlanti R, Bizzotto R, Lucatello L, Capolongo F, Franci P. Development and optimization of a fentanyl pharmacokinetic model for target-controlled infusion in anaesthetized dogs. Vet Anaesth Analg 2023; 50:31-40. [PMID: 35550343 DOI: 10.1016/j.vaa.2021.08.049] [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: 07/26/2020] [Revised: 07/01/2021] [Accepted: 08/07/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate pharmacokinetics (PK) of fentanyl administered by target-controlled infusion (TCI), and to develop a PK model optimized by covariates for TCI in anaesthetized dogs. STUDY DESIGN Prospective clinical study. ANIMALS A group of 20 client-owned dogs with spinal pain undergoing anaesthesia for magnetic resonance imaging. METHODS Fentanyl was administered as an infusion to 20 anaesthetized dogs using a TCI system incorporating a previously described fentanyl two-compartment PK. Arterial blood samples were collected at specific time points during the infusion and over 60 minutes post-infusion for measurement of fentanyl plasma concentrations. The predictive performance of the Sano PK model was assessed by comparing predicted and measured plasma concentrations. A population PK analysis was then performed using a nonlinear mixed-effect modelling approach, allowing inter- and intra-individual variability estimation. Finally, a quantitative stepwise evaluation of the influence of various covariates such as weight, body condition score, size, size-related age, sex and type of premedication on the PK model was considered. RESULTS Overall predictive performance of the Sano PK set of variables was not clinically acceptable in anaesthetized dogs. Fentanyl PK was best described by a three-compartment model. Weight and sex were found to affect the volume of distribution of the central compartment. Addition of these two covariate/variable associations resulted in a reduction of the objective function value (OFV) from -340.18 to -448.34, and of the median population weighted residual and the median population absolute weighted residual from 16.1% and 38.6% to 3.9% and 20.3%, respectively. Fentanyl infusions at measured concentrations up to 5.4 ng mL-1 in sevoflurane-anaesthetized dogs resulted in stable anaesthesia and smooth recoveries without complications. CONCLUSIONS AND CLINICAL RELEVANCE A population three-compartment PK model for fentanyl TCI in anaesthetized dogs was developed. Weight and sex have been detected and incorporated as significant covariates.
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Affiliation(s)
| | - Roberta Merlanti
- Department of Comparative Biomedicine and Food Science, Università degli Studi di Padova, Padua, Italy
| | | | - Lorena Lucatello
- Department of Comparative Biomedicine and Food Science, Università degli Studi di Padova, Padua, Italy
| | - Francesca Capolongo
- Department of Comparative Biomedicine and Food Science, Università degli Studi di Padova, Padua, Italy
| | - Paolo Franci
- Department of Veterinary Science, Università degli Studi di Torino, Turin, Italy
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Di Bella C, Pennasilico L, Botto R, Salvaggio A, Galosi M, Staffieri F, Piccionello AP. Efficacy of dexmedetomidine as adjuvant to bupivacaine in femoral-sciatic nerve blocks in dogs undergoing tibial plateau levelling osteotomy (TPLO). Res Vet Sci 2023; 154:124-131. [PMID: 36584520 DOI: 10.1016/j.rvsc.2022.12.015] [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: 09/11/2022] [Revised: 12/18/2022] [Accepted: 12/24/2022] [Indexed: 12/28/2022]
Abstract
The aim of this randomized, prospective clinical study was to evaluate the efficacy of dexmedetomidine combined with bupivacaine on sciatic and femoral nerve blocks in dogs. Thirty dogs were selected for elective unilateral tibial plateau levelling osteotomy, and each subject was assigned randomly to receive perineural bupivacaine 0.5% (0.1 mL/kg) and intramuscular dexmedetomidine (0.5 μg/kg) in the BDs group, perineural bupivacaine 0.5% (0.1 mL/kg) plus dexmedetomidine (0.5 μg/kg) in the BDloc group, and perineural bupivacaine 0.5% (0.1 mL/kg) plus intramuscular administration of saline solution the in Bupi group. Nerve blocks were guided by electrolocation. The main intraoperative parameters were registered 10 min before the start of surgery (BASE) and during the skin incision (SKIN), the osteotomy (BONE) and the suture (SUTURE). At 2, 4, 6, 8, 10, 15, 20 and 24 h after blocks, the Glasgow Composite Pain scale (GPCs) was used to identify the degree of pain during the postoperative period. Patients with scores ≥5/20 received rescue analgesia and were excluded. Furthermore, heart rate, mean arterial pressure, footstep capacity, reaction to wound touch and femoral and sciatic skin sensitivity were registered. Parametric data were compared at each time point of the study with the one-way ANOVA for repeated measures and Fisher's test for yes/no variables analysis (p < 0.05). No subject required intraoperative rescue analgesia. In BDloc group, the GCPs score was <5/20 for all dogs at all times of the study, and 70% of dogs did not need systemic analgesia. In the Bupi and BDs groups, 100% of subjects achieved a score ≥ 5/20 between 8 and 10 h after the blocks, and 100% of subjects showed femoral and sciatic skin sensitivity and required rescue analgesia within 10 h. Our results showed that the addition of dexmedetomidine as an adjuvant to bupivacaine in SF blocks may prolong the sensory block and ensure sufficient analgesia for up to 24 h in dogs undergoing TPLO surgery.
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Affiliation(s)
- Caterina Di Bella
- School of Bioscience and Veterinary Medicine, University of Camerino, Camerino, Italy.
| | - Luca Pennasilico
- School of Bioscience and Veterinary Medicine, University of Camerino, Camerino, Italy.
| | - Riccardo Botto
- School of Bioscience and Veterinary Medicine, University of Camerino, Camerino, Italy.
| | - Alberto Salvaggio
- School of Bioscience and Veterinary Medicine, University of Camerino, Camerino, Italy
| | - Margherita Galosi
- School of Bioscience and Veterinary Medicine, University of Camerino, Camerino, Italy.
| | - Francesco Staffieri
- Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantations, University of Bari, Bari, Italy.
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Monteiro BP, Lascelles BDX, Murrell J, Robertson S, Steagall PVM, Wright B. 2022
WSAVA
guidelines for the recognition, assessment and treatment of pain. J Small Anim Pract 2022. [DOI: 10.1111/jsap.13566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- B. P. Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. D. X. Lascelles
- Comparative Pain Research Laboratory and Surgery Section North Carolina State University 4700 Hillsborough Street Raleigh NC USA
| | - J. Murrell
- Highcroft Veterinary Referrals 615 Wells Rd, Whitchurch Bristol BS149BE UK
| | - S. Robertson
- Senior Medical Director Lap of Love Veterinary Hospice 17804 N US Highway 41 Lutz FL 33549 USA
| | - P. V. M. Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine Université de Montréal 3200 rue Sicotte, Saint‐Hyacinthe Quebec Canada
| | - B. Wright
- Mistral Vet 4450 Thompson Pkwy Fort Collins CO 80534 USA
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Lovell S, Simon B, Boudreau EC, Mankin J, Jeffery N. Randomized clinical trial comparing outcomes after fentanyl or ketamine-dexmedetomidine analgesia in thoracolumbar spinal surgery in dogs. J Vet Intern Med 2022; 36:1742-1751. [PMID: 35962706 PMCID: PMC9511085 DOI: 10.1111/jvim.16514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022] Open
Abstract
Background Opioids are widely used for perioperative pain control in dogs undergoing spinal surgery, but alternatives may be required because data suggest that opioids exacerbate inflammation in the injured spinal cord and veterinary access to opioids may become more restricted in the future. Objectives To compare recovery of ambulation and other functions between spinal cord‐injured dogs receiving peri‐operative fentanyl and those receiving a ketamine‐dexmedetomidine combination. Animals A total of 102 client‐owned dogs undergoing decompressive surgery for thoracolumbar intervertebral disc herniation. Methods Randomized clinical trial. Dogs were randomized 1:1 to fentanyl or a ketamine‐dexmedetomidine combination for intra and postoperative analgesia. Primary outcome was time to recovery of ambulation; secondary outcomes were the postoperative Colorado Acute Pain Scale, the short‐form Glasgow Composite Measure Pain Scale, time to recovery of voluntary urination and time to unassisted eating. Results No difference was found in time to recovery of ambulation between groups (adjusted sub‐hazard ratio, 0.83; 95% confidence interval [CI], 0.55‐1.24; P = .36) or in pain scores (Colorado: χ2 = 14.74; P = .32; Glasgow: χ2 = 6.61; P = .76). Differences in time to recovery of eating and urination were small but favored ketamine‐dexmedetomidine (adjusted odds ratios, 3.31; 95% CI, 1.53‐7.16; P = .002 and 2.43; 95% CI, 1.00‐5.96; P = .05, respectively). Conclusions and Clinical Importance There was no evidence that, at the doses used, fentanyl impaired ambulatory outcome after surgery for thoracolumbar intervertebral disc herniation in dogs. Pain control appeared similar between groups. Secondary outcomes suggested minor benefits associated with ketamine‐dexmedetomidine. The ketamine‐dexmedetomidine combination appears to be a reasonable alternative to peri‐operative opioids.
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Affiliation(s)
- Stephanie Lovell
- Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Bradley Simon
- Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Elizabeth C Boudreau
- Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Joseph Mankin
- Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Nicholas Jeffery
- Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
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Gültiken N, Gürler H, Yarım GF, Binli F, Tuncay M, Büyükbudak F, Gökçeoğlu A, Anadol E. Antioxidant and analgesic potential of butorphanol in dogs undergoing ovariohysterectomy. Theriogenology 2022; 190:1-7. [PMID: 35849850 DOI: 10.1016/j.theriogenology.2022.07.002] [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: 04/14/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 10/17/2022]
Abstract
The aim of this study was to evaluate the postoperative analgesic and antioxidant effects of butorphanol given in the preoperative or early postoperative period. Twenty-seven healthy female dogs undergoing ovariohysterectomy were randomly divided into three groups as before surgery group (BSG, n = 7) received butorphanol 30 min before preanesthetic administration, after surgery group (ASG, n = 10) received butorphanol during the last skin suture and the control group (CG, n = 10) received no butorphanol. Pain was assessed with short form of the Glasgow composite pain scale (CMPS-SF). Serum concentration of malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase activities (GPx) were quantified by spectrophotometric methods to assess oxidative stress status. The pain score increased rapidly at 1 h after surgery and then decreased gradually towards to 24 h in all groups. There was no statistical difference among the groups in terms of CMPS-SF scores (P > 0.05). Serum concentration of MDA was lower in ASG than in BSG and CG from 1 h to 24 h after surgery. Serum activity of GPx was higher in ASG than in BSG and CG from 2 h to 24 h (P < 0.05). Serum activity of SOD was higher in ASG than in BSG and CG from 1 h to 24 h after surgery (P < 0.05). Serum SOD activity at different time points in ASG did not differ compared to preoperative level though it decreased significantly from 1 h onwards both in CT and BSG. The results indicate that single butorphanol administration either before or after the operation might not provide sufficient analgesia, however, it seems that it has antioxidant potential and may protect tissues by reducing oxidative stress when administered early postoperative period following ovariohysterectomy.
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Affiliation(s)
- Nilgün Gültiken
- Department of Obstetrics and Gynecology, Faculty of Veterinary Medicine, Ondokuz Mayis University, 55200, Samsun, Turkey.
| | - Hande Gürler
- Department of Obstetrics and Gynecology, Faculty of Veterinary Medicine, Ondokuz Mayis University, 55200, Samsun, Turkey
| | - Gül Fatma Yarım
- Department of Biochemistry, Faculty of Veterinary Medicine, Ondokuz Mayis University, 55200, Samsun, Turkey
| | - Firdevs Binli
- Department of Obstetrics and Gynecology, Faculty of Veterinary Medicine, Ondokuz Mayis University, 55200, Samsun, Turkey
| | - Müge Tuncay
- Department of Obstetrics and Gynecology, Faculty of Veterinary Medicine, Ondokuz Mayis University, 55200, Samsun, Turkey
| | - Fatih Büyükbudak
- Department of Obstetrics and Gynecology, Faculty of Veterinary Medicine, Ondokuz Mayis University, 55200, Samsun, Turkey
| | - Ayris Gökçeoğlu
- Department of Biochemistry, Faculty of Veterinary Medicine, Ondokuz Mayis University, 55200, Samsun, Turkey
| | - Elvan Anadol
- Laboratory Animal Breeding and Experimental Researches Centre, Gazi University, 06510, Ankara, Turkey
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de Moura RS, Bittar IP, Gomes JH, de Oliveira YVR, de Sousa Filho GD, de Faria Soares GCF, Lima EM, Franco LG. Plasma concentration, cardiorespiratory and analgesic effects of ketamine-fentanyl infusion in dogs submitted to mastectomy. BMC Vet Res 2022; 18:225. [PMID: 35701767 PMCID: PMC9199142 DOI: 10.1186/s12917-022-03244-1] [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: 07/08/2021] [Accepted: 02/28/2022] [Indexed: 01/12/2023] Open
Abstract
Background The analgesic and cardiorespiratory effects of ketamine, fentanyl, or ketamine-fentanyl constant rate infusion (CRI) in dogs undergoing mastectomy were evaluated. Seventeen female dogs received CRI of ketamine (GK [n = 6]: bolus 0.5 mg/kg; CRI 20 µg/kg/min in intra- and postoperative periods], fentanyl (GF [n = 5]: bolus 20 µg/kg; intraoperative CRI 5 20 µg/kg/hour and postoperative CRI 2 20 µg/kg/hour), or combination of ketamine-fentanyl (GKF [n = 6]: aforementioned doses) for 8 h. Cardiorespiratory, blood gas analyses, plasma drug concentrations, sedation score (SS), Pain Scores were evaluated. Results The heart rate decreased in the GF and GKF (p < 0.04); the mean arterial pressure was lower in the GKF than in the GK at 35 min (p < 0.001). Maximum plasma concentrations were observed 5 min after bolus in the GK (2847.06 ± 2903.03 ng/mL) and GKF (2811.20 ± 1931.76 ng/mL). Plasma concentration in intraoperative period of ketamine was of > 100 ng/mL in 5/5 and 2/5 animals in the GKF and GK, respectively; and > 1.1 ng/mL of fentanyl in 4/5 and 3/5 in GKF and GF, respectively. Conclusion Ketamine with/without fentanyl provided analgesia without significant cardiorespiratory and guaranteed the minimal plasma levels with analgesic potential during the 8 h.
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Affiliation(s)
- Rauane Sousa de Moura
- Department of Veterinary Medicine, Federal University of Goiás, 74.690-900, Goiânia, GO, Brazil
| | - Isabela Plazza Bittar
- Department of Veterinary Medicine, Federal University of Goiás, 74.690-900, Goiânia, GO, Brazil
| | - Janainne Hilbig Gomes
- Department of Veterinary Medicine, Federal University of Goiás, 74.690-900, Goiânia, GO, Brazil
| | | | | | | | - Eliana Martins Lima
- Development and Technological Innovation in Drugs - FarmaTec, Research Center, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | - Leandro Guimarães Franco
- Department of Veterinary Medicine, Federal University of Goiás, 74.690-900, Goiânia, GO, Brazil.
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Corrêa JMX, Niella RV, Oliveira JNSD, Silva Junior AC, Marques CSDC, Pinto TM, Silva EBD, Beier SL, Silva FL, Lavor MSLD. Antinociceptive and analgesic effect of continuous intravenous infusion of maropitant, lidocaine and ketamine alone or in combination in cats undergoing ovariohysterectomy. Acta Vet Scand 2021; 63:49. [PMID: 34838084 PMCID: PMC8626950 DOI: 10.1186/s13028-021-00615-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 11/17/2021] [Indexed: 11/23/2022] Open
Abstract
Background Multimodal analgesia consists of the combination of analgesic drugs at low doses to act in different places along the path of pain. Studies with continuous infusion of analgesic drugs in cats are not common. This study aimed to evaluate the analgesic effect of maropitant, lidocaine and ketamine alone or in combination (intravenous bolus + subsequent continuous intravenous infusion) in the management of acute postoperative pain in cats undergoing ovariohysterectomy. Seventy healthy cats undergoing an ovariohysterectomy received a standard anesthetic protocol consisting of acepromazine and morphine, propofol (anesthesia induction), and isoflurane (anesthesia maintenance). The animals were stratified into seven groups (n = 10 in each group): control (CG), maropitant (MG), lidocaine (LG), ketamine (KG), maropitant + lidocaine (LMG), maropitant + ketamine (KMG), and maropitant + lidocaine + ketamine (LKMG). All drugs were injected first as an intravenous bolus and then by continuous intravenous infusion. During surgery, esophageal temperature, respiratory rate, heart rate, oxygen saturation, expired isoflurane concentration, and partial pressure of carbon dioxide at the end of expiration were evaluated at 7 time points. Postoperative pain was evaluated for 6 h after extubation using the visual analogue scale and the UNESP-Botucatu multidimensional composite pain scale for assessing postoperative pain in cats. Results Adverse effects related to maropitant, lidocaine and ketamine infusion were not observed. Pain scores were lower in the MG, KG and LG groups when compared to the CG group using both scales. Although pain scores were also lower in all combination groups than CG, more animals in these groups required rescue analgesia compared to MG. This indicates that the postoperative analgesic effect of all drugs, either alone or in combination, confers analgesia, although the combinations did not promote greater analgesia. Conclusions Continuous intravenous infusion of maropitant, lidocaine, and ketamine alone induces postoperative analgesic effect in cats undergoing ovariohysterectomy, but combinations of these drugs did not increase the analgesic effect. No adverse effect was observed with any drug or their combination.
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Efficacy and Safety of Dexmedetomidine Premedication in Balanced Anesthesia: A Systematic Review and Meta-Analysis in Dogs. Animals (Basel) 2021; 11:ani11113254. [PMID: 34827988 PMCID: PMC8614454 DOI: 10.3390/ani11113254] [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: 10/25/2021] [Revised: 11/11/2021] [Accepted: 11/11/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Dexmedetomidine, on account of its potent sedative and analgesic properties, is commonly used in balanced anesthesia of small animal anesthesia; however, concerns regarding its cardiovascular effects prevent its full adoption into veterinary clinical practice. We conducted this meta-analysis to determine the effects of dexmedetomidine on sedation, analgesia, cardiovascular and adverse reactions in dogs compared to other premedications. The outcomes included sedation score, pain score, heart rate, systolic arterial blood pressure, mean arterial blood pressure and the incidence of adverse effects. Thirteen studies were included in this meta-analysis. The results showed that dexmedetomidine provides a satisfactory sedative and analgesic effect in balanced anesthesia of dogs. After dexmedetomidine premedication, dogs experienced lower heart rate and higher blood pressure within an acceptable range. The combinations in balanced anesthesia and routes of delivering drugs would affect heart rate, systolic arterial blood pressure, and mean arterial blood pressure of dogs. Before using dexmedetomidine, an animal’s cardiovascular status should be fully considered. Abstract Dexmedetomidine is commonly used in small animal anesthesia for its potent sedative and analgesic properties; however, concerns regarding its cardiovascular effects prevent its full adoption into veterinary clinical practice. This meta-analysis was to determine the effects of dexmedetomidine on sedation, analgesia, cardiovascular and adverse reactions in dogs compared to other premedications. Following the study protocol based on the Cochrane Review Methods, thirteen studies were included in this meta-analysis ultimately, involving a total of 576 dogs. Dexmedetomidine administration probably improved in sedation and analgesia in comparison to acepromazine, ketamine and lidocaine (MD: 1.96, 95% CI: [−0.08, 4.00], p = 0.06; MD: −0.95, 95% CI: [−1.52, −0.37] p = 0.001; respectively). Hemodynamic outcomes showed that dogs probably experienced lower heart rate and higher systolic arterial blood pressure and mean arterial blood pressure with dexmedetomidine at 30 min after premedication (MD: −13.25, 95% CI: [−19.67, −6.81], p < 0.0001; MD: 7.78, 95% CI: [1.83, 13.74], p = 0.01; MD: 8.32, 95% CI: [3.95, 12.70], p = 0.0002; respectively). The incidence of adverse effects was comparable between dexmedetomidine and other premedications (RR = 0.86, 95% CI [0.58, 1.29], p = 0.47). In summary, dexmedetomidine provides satisfactory sedative and analgesic effects, and its safety is proved despite its significant hemodynamic effects as part of balanced anesthesia of dogs.
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Vullo C, Tambella AM, Falcone A, Marino G, Catone G. Constant Rate Infusion of Lidocaine, Tumescent Anesthesia and Their Combination in Dogs Undergoing Unilateral Mastectomy. Animals (Basel) 2021; 11:ani11051280. [PMID: 33946987 PMCID: PMC8146467 DOI: 10.3390/ani11051280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 11/16/2022] Open
Abstract
Tumescent anesthesia (TUM) is a technique that was initially used to perform liposuction under local anesthesia, which consists of the injection of such large volumes of local anesthetic until to produce swelling and firmness (tumescence) of the surgical area. The aim of this study was to compare the intraoperative analgesic efficacy of lidocaine (LID) constant rate infusion (CRI), of TUM, or their combination (LID/TUM) and the postoperative pain and analgesic requirement in dogs undergoing unilateral mastectomy. Twenty-four dogs were premedicated with dexmedetomidine (3 μg/kg) and methadone (0.2 mg/kg) intravenously (IV). After induction with propofol IV to effect, dogs were randomly allocated to receive a loading dose of lidocaine (2 mg/kg) followed by a CRI of 100 μg/kg/min (Group LID) in addition to an equivalent volume of lactated Ringer's solution instead of local TUM; a loading dose of lactated Ringer's solution followed by a CRI of Ringer's solution in addition to TUM (Group TUM); a loading dose of lidocaine (2 mg/kg) followed by a CRI of 100 μg/kg/min in addition to TUM (Group LID/TUM). Anesthesia was maintained with isoflurane in oxygen. Postoperative pain scores were assessed once the dogs had fully recovered from the sedative effects, and following 15, 30, 45 and 60 min. The results of the current study allow us to assert that all three treatments provided satisfactory intraoperative antinociceptive effects but administration of LID/TUM induced greater inhibition on sympathetic stimulating effect up to 60 min from recovery, thus, providing better early postoperative pain relief in dogs undergoing mastectomy.
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Affiliation(s)
- Cecilia Vullo
- Department of ChiBioFarm, University of Messina, 98168 Messina, Italy
- Correspondence:
| | - Adolfo Maria Tambella
- School of Bioscience and Veterinary Medicine, University of Camerino, 62024 Matelica, Italy;
| | - Annastella Falcone
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy; (A.F.); (G.M.); (G.C.)
| | - Gabriele Marino
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy; (A.F.); (G.M.); (G.C.)
| | - Giuseppe Catone
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy; (A.F.); (G.M.); (G.C.)
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Evaluation of the analgesic effect of fentanyl-ketamine and fentanyl-lidocaine constant rate infusions in isoflurane-anesthetized dogs undergoing thoracolumbar hemilaminectomy. Vet Anaesth Analg 2021; 48:407-414. [PMID: 33736938 DOI: 10.1016/j.vaa.2021.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 01/13/2021] [Accepted: 01/26/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate anesthetic conditions and postoperative analgesia with the use of intraoperative constant rate infusions (CRIs) of fentanyl-lidocaine or fentanyl-ketamine in dogs undergoing thoracolumbar hemilaminectomy. STUDY DESIGN Prospective, randomized, blinded, clinical study. ANIMALS A total of 32 client-owned dogs. METHODS Dogs were premedicated with fentanyl (5 μg kg-1) administered intravenously (IV), anesthesia was induced with IV alfaxalone and maintained with isoflurane. Fentanyl (0.083 μg kg-1 minute-1) was infused IV with either ketamine (0.5 mg kg-1; then 40 μg kg-1 minute-1; group KF) or lidocaine (2 mg kg-1; then 200 μg kg-1 minute-1; group LF) assigned randomly. Heart rate, noninvasive arterial pressures, respiratory rate, esophageal temperature, end-tidal partial pressure of carbon dioxide and isoflurane concentration were recorded throughout anesthesia. Maintenance of anesthesia, recovery and postoperative pain (Glasgow Composite Pain Scale) were scored. Cardiopulmonary data were analyzed using a two-way anova with repeated measures, demographics of the two groups with a t test, and scores with Mann-Whitney U test, with p < 0.05. RESULTS All dogs recovered from anesthesia without complications. No significant difference was found between groups for cardiopulmonary variables, total anesthesia time, sedation score and requirement for postoperative sedation or for rescue analgesia. Anesthetic maintenance score was of lower quality in KF than in LF [median (interquartile range): 0 (0-0.5) versus 0 (0-0); p = 0.032)], but still considered ideal. Recovery score was higher and indicative of less sedation in LF than in KF [1 (1-1.5) versus 0.5 (0-1); p < 0.0001]. Pain score was higher in KF than in LF [2 (1-3) versus 1 (1-2); p = 0.0009]. CONCLUSIONS AND CLINICAL RELEVANCE Both CRIs of KF and LF provided adequate anesthetic conditions in dogs undergoing thoracolumbar hemilaminectomy. Based on requirement for rescue analgesia, postoperative analgesia was adequate in both groups.
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Sliusarenko DV, Ilnitskiy МG, Bilyi DD, Bobrytska OM, Kovalova LO. Regional anesthesiological support for the implementation of surgical interventions in the abdomen of dogs. REGULATORY MECHANISMS IN BIOSYSTEMS 2021. [DOI: 10.15421/022108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Widespread use of surgical interventions in the abdomen of dogs determines the relevance of the study. The research tested the influence of therapeutic epidural blockade with 0.2% bupivacaine after surgical interventions on the background of potentiated local anaesthesia on the body of clinically healthy dogs undergoing ovariohysterectomy. In the control group postoperative analgesia was performed with the nonsteroidal anti-inflammatory drug rimadyl on the background of potentiated thiopental anaesthesia. Wound healing rates were determined in 10 animals of both control and experimental groups; blood counts and the level of inflammatory response were indicated in 5 animals of each group. The dynamics of reparative processes and complete wound healing in dogs of the experimental group occurred earlier than in animals of the control group, which confirmed the fact that the use of bupivacaine had a beneficial effect on tissue regeneration. The results of morphological and biochemical parameters of blood in animals of the experimental group manifested only an increase of leukocytes by 1.58 times, fibrinogen by 2.02 times, while in dogs of the control group the level of erythrocytes, haemoglobin and hematocrit decreased, leukocytes increased by 1.74 times, platelets decreased by 2.87 times and fibrinogen increased by 1.72 times. Among the stress response markers in the control group there was a 1.94 times increase in glucose level after surgery. In the experimental group there was a decrease in the intensity of the inflammatory reaction in dogs, accompanied by an increase of anti-inflammatory interleukin 4 (IL-4) only on the seventh day – 1.86 times, while in the control group the level of anti-inflammatory interleukin 1 receptor antagonist (IL-1RA) after three days increased by 2.30 times, after seven days – by 2.48 times, and the level of proinflammatory interleukin 6 (IL-6) after surgery increased by 2.57 times. It will be promising to conduct further research on the influence of therapeutic blockades with bupivacaine in animals in cases of various surgical interventions and pathological conditions, which will lead to faster recovery of animals and alleviate pathological processes.
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Pereira FS, Perotto AB, Pizzinatto FD, Sônego DA, Gomes LG, Ribeiro AP, Guimarães LD. Postoperative evaluation of analgesia promoted by the use of dexmedetomidine alone and associated with morphine as an intramuscular pre-anesthetic medication in bitches submitted for ovariohysterectomy. CIÊNCIA ANIMAL BRASILEIRA 2021. [DOI: 10.1590/1809-6891v22e-68826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract This study aimed to evaluate the postoperative analgesic efficacy of dexmedetomidine alone and when associated with morphine in patients under general inhalational anesthesia with isoflurane and undergoing elective ovariohysterectomy (OH). Twenty healthy bitches were selected via physical and laboratory examinations. Prior to the study, they underwent a 24-h period of adaptation to the environment and observers. They were then randomly divided into two groups: the dexmedetomidine group receiving a dose of 10 μg/kg, and dexmedetomidine group (10 μg/kg) associated with morphine receiving a dose of 0.3 mg/kg, administered via the intramuscular route. Thereafter, patients were induced with propofol and maintained with isoflurane diluted in 100% oxygen administered through a calibrated vaporizer. To verify postoperative analgesia, pain assessments were performed using the modified Glasgow (EGM) and Melbourne (EM) scales. For sedation assessment, the Dobbins scale was used at different times: before the administration of pre-anesthetic medication (T0) and at another six times in the postoperative period, 1 (T1), 2 (T2), 4 (T3), 8 (T4), 12 (T5), and 24 (T6) h after orotracheal extubation. No statistical differences were observed between groups in the scales according to Dunn’s Kruskal-Wallis post hoc test, and between the times a statistical difference was noticed by the Friedman test (p<0.05) for the EGM and EM scale scores, but there was no need for analgesic rescue. Therefore, we found that isolated dexmedetomidine and morphine produced adequate analgesic effects in the postoperative period of bitches submitted for OH.
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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.
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Moreira CM, Oliveira RL, Costa GA, Corgozinho KB, Luna SP, Souza HJ. Evaluation of tumescent local anesthesia in cats undergoing unilateral mastectomy. Vet Anaesth Analg 2020; 48:134-141. [PMID: 33036890 DOI: 10.1016/j.vaa.2020.08.006] [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: 11/05/2019] [Revised: 08/13/2020] [Accepted: 08/22/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To evaluate the analgesic efficacy and safety of tumescent local anesthesia (TLA) in cats undergoing unilateral mastectomy. STUDY DESIGN Prospective clinical trial. ANIMALS A total of 12 ovariohysterectomized female cats. METHODS All animals were premedicated with pethidine (4 mg kg-1) intramuscularly (IM), followed by induction of anesthesia with propofol (5 mg kg-1) intravenously and maintenance with isoflurane in oxygen. A refrigerated TLA solution (15 mL kg-1, 8 °C) was injected using a Klein cannula. The solution was composed of 0.5 mL of epinephrine (1 mg mL-1) and 40 mL of 2% lidocaine added to 210 mL lactated Ringer's solution (final lidocaine concentration 0.32%). Heart and respiratory rates, systolic arterial blood pressure, temperature and oxygen saturation were measured during anesthesia. Blood samples were collected from the jugular vein for measurement of plasma lidocaine concentration using high performance liquid chromatography. Postoperative pain scores were evaluated hourly for 6 hours. Analgesic rescue was performed with tramadol (2 mg kg-1) IM and meloxicam (0.15 mg kg-1) subcutaneously. RESULTS Plasma lidocaine concentration peaked at 90 minutes after injection of TLA, but no concentration considered toxic for the species was measured. The median postoperative analgesia time was 6 hours after injection of TLA. CONCLUSIONS This study found that TLA prevented sympathetic response to noxious stimuli during anesthesia and provided satisfactory postoperative analgesia in cats submitted to total unilateral mastectomy, with no apparent signs of toxicity. CLINICAL RELEVANCE TLA can prevent sympathetic stimulation resulting from noxious stimuli during anesthesia, promoting good intraoperative conditions, proving to be a viable addition to analgesia in cats submitted to a total unilateral mastectomy.
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Affiliation(s)
- Clarissa Mr Moreira
- Graduate Program in Veterinary Medicine (Pathology and Clinical Sciences), Universidade Federal Rural do Rio de Janeiro, Seropédica, RJ, Brazil.
| | - Renato Ls Oliveira
- Graduate Program in Veterinary Medicine (Pathology and Clinical Sciences), Universidade Federal Rural do Rio de Janeiro, Seropédica, RJ, Brazil
| | | | | | - Stelio Pl Luna
- Department of Veterinary Surgery and Anaesthesiology, Faculty of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Heloisa Jm Souza
- Department of Veterinary Medicine and Surgery, Universidade Federal Rural do Rio de Janeiro, Seropédica, RJ, Brazil
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Di Salvo A, Conti MB, Nannarone S, Bufalari A, Giorgi M, Moretti G, Marenzoni ML, Della Rocca G. Pharmacokinetics and analgesic efficacy of intranasal administration of tramadol in dogs after ovariohysterectomy. Vet Anaesth Analg 2020; 47:557-566. [PMID: 32513525 DOI: 10.1016/j.vaa.2019.12.011] [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: 05/23/2019] [Revised: 11/15/2019] [Accepted: 12/02/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To assess analgesic efficacy and the pharmacokinetics of intranasal (IN) tramadol in dogs following ovariohysterectomy. STUDY DESIGN Randomized, blinded clinical study. ANIMALS A total of 30 bitches undergoing elective ovariohysterectomy. METHODS Dogs were randomly assigned to one of three experimental groups (10 dogs per group): IN tramadol 4 mg kg-1 (group T-IN), intravenous (IV) tramadol 4 mg kg-1 (group T-IV) and IV methadone 0.2 mg kg-1 (group M). Drugs were administered at extubation. At established time points (before surgery and up to 8 hours after drug administration) analgesia was assessed using the Italian version of the Glasgow Composite Measure Pain Scale Short Form and physiological variables were recorded. To determine the pharmacokinetics of IN tramadol, blood samples were collected at predetermined time points. Shapiro-Wilk test was used to assess whether data were normally distributed and consequently parametric or non parametric tests were applied. A p value < 0.05 was considered significant. RESULTS No significant intergroup differences were observed in the dogs that were administered rescue analgesia and time of its administration. Excluding dogs that were administered rescue analgesia, no significant intergroup differences emerged in pain scores and physiological variables, except for a lower rectal temperature in group M compared with the tramadol groups. After IN administration, tramadol was rapidly absorbed into the systemic circulation, reaching its maximum concentration (range 74.74-200.29 ng mL-1) within 30-60 minutes, it then decreased rapidly and was detectable in plasma for up to 2 hours after treatment in all dogs. CONCLUSIONS AND CLINICAL RELEVANCE IN tramadol administration appears to be as effective as IV tramadol and methadone treatments in pain management of dogs after elective ovariohysterectomy. Given its low concentrations and short detection time in plasma after the IN route, systemic tramadol action appears unlikely.
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Affiliation(s)
- Alessandra Di Salvo
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy; CeRiDA-Centro di Ricerca sul Dolore Animale, University of Perugia, Perugia, Italy
| | - Maria Beatrice Conti
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy; CeRiDA-Centro di Ricerca sul Dolore Animale, University of Perugia, Perugia, Italy
| | - Sara Nannarone
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy; CeRiDA-Centro di Ricerca sul Dolore Animale, University of Perugia, Perugia, Italy.
| | - Antonello Bufalari
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy; CeRiDA-Centro di Ricerca sul Dolore Animale, University of Perugia, Perugia, Italy
| | - Mario Giorgi
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Giulia Moretti
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - Maria Luisa Marenzoni
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy; CeRiDA-Centro di Ricerca sul Dolore Animale, University of Perugia, Perugia, Italy
| | - Giorgia Della Rocca
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy; CeRiDA-Centro di Ricerca sul Dolore Animale, University of Perugia, Perugia, Italy
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Monzem S, Spiller P, Dower N, Gomes L, Stocco M, Galceran J, Ens M, Cruz J, Flôres F, Guimarães L. Recuperação anestésica e analgesia residual da infusão continua intravenosa de fantanil, lidocaína, cetamina e fentanyl-lidocaína-cetamina associados à anesthesia total intravenosa com Propofol em cadelas submetidas à ovariossalpingo-histerectomia eletiva. ARQ BRAS MED VET ZOO 2019. [DOI: 10.1590/1678-4162-10172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Avaliou-se a recuperação anestésica e a analgesia residual da infusão contínua (IC) de fentanil (F), lidocaína (L), cetamina (K) e fentanil-lidocaína-cetamina (FLK), associados à anestesia total intravenosa com o propofol, em cadelas submetidas à ovariossalpingo-histerectomia. Foram utilizados 32 animais pré-medicados com acepromazina, distribuídos em quatro grupos de acordo com o tratamento analgésico: F: bolus de 0,0036mg/kg de fentanil e IC de 0,0036mg mg/kg/h; L: bolus de 3mg/kg de lidocaína e IC de 3mg/kg/h; K: bolus de 0,6mg/kg de cetamina e IC de 0,6mg/kg/h; e FLK: bolus e IC dos três fármacos nas doses supracitadas. Após o bolus do tratamento analgésico, foi realizada a indução e o início da IC do tratamento analgésico e do propofol. Para avaliação da recuperação anestésica, foram considerados os tempos de extubação, decúbito esternal, posição quadrupedal e os efeitos adversos. A avaliação da analgesia foi realizada por meio da escala visual analógica e modificada de Glasgow, durante seis horas. Os efeitos adversos observados foram vômito, sialorreia e tremor muscular. Receberam analgesia de resgate 100% dos animais do grupo F, 87,5% do K, 50% do L e 12,5% do FLK. O FLK demonstrou maior analgesia, e a recuperação anestésica foi semelhante em todos os grupos.
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Affiliation(s)
- S. Monzem
- Universidade Federal de Mato Grosso, Brazil
| | | | | | - L.G. Gomes
- Universidade Federal de Mato Grosso, Brazil
| | | | | | - M.T.B. Ens
- Universidade Federal de Mato Grosso, Brazil
| | - J.N. Cruz
- Universidade Federal de Mato Grosso, Brazil
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Abstract
Adjuvant analgesics (ie, gabapentin, tramadol, and ketamine) are commonly used in small animal practice. Most of these drugs are prescribed for outpatients, when pain is refractory to classic analgesics (ie, local anesthetics, opioids, and nonsteroidal antiinflammatory drugs [NSAIDs]), or when contraindications exist to the administration of other analgesics, including NSAIDs. This article reviews the mechanisms of action, clinical use, potential adverse effects, and current evidence of adjuvant analgesics in the treatment of acute pain in companion animals. These drugs should be considered as alternatives aimed at reducing or replacing opioids.
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Nascimento FF, Marques VI, Crociolli GC, Nicácio GM, Nicácio IPAG, Cassu RN. Analgesic efficacy of laser acupuncture and electroacupuncture in cats undergoing ovariohysterectomy. J Vet Med Sci 2019; 81:764-770. [PMID: 30905889 PMCID: PMC6541842 DOI: 10.1292/jvms.18-0744] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to compare the effects of laser acupuncture and electroacupuncture on postoperative pain and analgesic requirements in cats. In a prospective, randomized and
blinded clinical study, thirty cats undergoing ovariohysterectomy were sedated with intramuscular (IM) ketamine (5 mg/kg), midazolam (0.5 mg/kg), and tramadol (2 mg/ kg). Before the
induction of anesthesia, the animals were randomly distributed into three groups of ten cats each: LA: bilateral Stomach 36 (ST-36) and Spleen 6 (SP-6) acupoints were stimulated with an
infrared laser; EA: bilateral ST-36 and SP-6 acupoints were stimulated with an electrical stimulus; Control: no acupuncture was applied. Postoperative analgesia was evaluated in the first 24
hr post-extubation using the Interactive Visual Analogue Scale and UNESP-Botucatu Multidimensional Composite Pain Scale. Rescue analgesia was provided with IM tramadol (2 mg/kg), and the
pain scores were reassessed 30 min after the rescue intervention. If the analgesia remained insufficient, meloxicam (0.2 mg/kg IM, single dose) was administered. Data were analyzed using
t-tests, the Mann-Whitney U test, and Friedman test. P<0.05 was considered significant. The pain scores did not significantly differ between the
treatment groups at any time point (P>0.05). The prevalence of rescue analgesia was significantly higher in the Control group than in the LA and EA groups
(P=0.033). Preoperative laser and electroacupuncture reduced the need for rescue analgesia during the first 24 hr after ovariohysterectomy.
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Affiliation(s)
- Felipe F Nascimento
- Department of Veterinary Surgery and Anestesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Unoeste, 19067-175, Presidente Prudente, Brazil
| | - Vírginia I Marques
- Department of Veterinary Surgery and Anestesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Unoeste, 19067-175, Presidente Prudente, Brazil
| | - Giulianne C Crociolli
- Department of Veterinary Surgery and Anestesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Unoeste, 19067-175, Presidente Prudente, Brazil
| | - Gabriel M Nicácio
- Department of Veterinary Surgery and Anestesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Unoeste, 19067-175, Presidente Prudente, Brazil
| | - Isabela P A G Nicácio
- Department of Veterinary Surgery and Anestesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Unoeste, 19067-175, Presidente Prudente, Brazil
| | - Renata N Cassu
- Department of Veterinary Surgery and Anestesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Unoeste, 19067-175, Presidente Prudente, Brazil
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Thengchaisri N, Mahidol C. Evaluating the effects of continuous intravenous infusions of tramadol and tramadol-lidocaine on sevoflurane minimum alveolar concentration (MAC) and entropy values in dogs. J Vet Med Sci 2019; 81:682-688. [PMID: 30880302 PMCID: PMC6541834 DOI: 10.1292/jvms.18-0448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The sparing effects of tramadol and tramadol-lidocaine infusion on the minimum alveolar concentration (MAC) of sevoflurane in dogs as well as the entropy indices were investigated.
Anesthesia was induced in eight young, healthy German shepherds weighing 27.6 ± 3.2 kg (mean ± SD) and maintained with sevoflurane. A standard tail-clamp technique was used to determine
sevoflurane MAC during infusion with: sevoflurane alone to measure baseline MAC (MACB); tramadol (intravenous loading dose of 1.5 mg/kg and constant rate infusion [CRI] of 2.6
mg/kg/hr; MACT); and tramadol-lidocaine (tramadol CRI of 2.6 mg/kg/hr; and lidocaine intravenous loading dose of 1.0 mg/kg and CRI of 6 mg/kg/hr; MACTL). The state
entropy (SE), response entropy (RE), and RE-SE difference were recorded 5 min prior to and during tail clamping. MACB was 2.4 ± 0.2%. Tramadol and tramadol-lidocaine CRI decreased
MAC to 2.2 ± 0.3% and 1.7 ± 0.3%, respectively. The MAC-sparing effect of tramadol-lidocaine was greater than that of tramadol alone (8.2 ± 8.9% vs. 30.1 ± 10.7%;
P<0.01). SE and RE in all subjects, and RE-SE difference in most subjects, were increased (all P<0.05) when they responded purposefully to noxious
stimulation. A tramadol-lidocaine combination infusion can reduce anesthetic requirements to a higher degree than tramadol alone. Furthermore, MACentropy, MAC required to prevent increased
entropy in response to a painful stimulation, and MAC of sevoflurane were similar in dogs.
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Affiliation(s)
- Naris Thengchaisri
- Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Bangkok 10900, Thailand
| | - Chulabhorn Mahidol
- Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Bangkok 10900, Thailand
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Watanabe R, Monteiro BP, Evangelista MC, Castonguay A, Edge D, Steagall PV. The analgesic effects of buprenorphine (Vetergesic or Simbadol) in combination with carprofen in dogs undergoing ovariohysterectomy: a randomized, blinded, clinical trial. BMC Vet Res 2018; 14:304. [PMID: 30290820 PMCID: PMC6173890 DOI: 10.1186/s12917-018-1628-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 09/25/2018] [Indexed: 11/17/2022] Open
Abstract
Background Buprenorphine is a potent lipophilic opioid analgesic that is largely used in the multimodal treatment of acute pain. Simbadol (buprenorphine hydrochloride) is the first and only FDA-approved high-concentration formulation of buprenorphine for use in cats. The aim of this study was to evaluate the analgesic efficacy of carprofen in combination with one of two commercial formulations of buprenorphine (Simbadol and Vetergesic, 1.8 mg/mL and 0.3 mg/mL, respectively) in dogs undergoing ovariohysterectomy. Twenty-four dogs were included in a randomized, prospective, controlled, clinical trial. Patients were randomly divided into 2 groups as follows. Dogs were premedicated with acepromazine (0.02 mg/kg) and either 0.02 mg/kg of Vetergesic or Simbadol intramuscularly (Vetergesic group – VG; Simbadol group – SG, respectively; n = 12/group). General anesthesia was induced with propofol and maintained with isoflurane in 100% oxygen. Carprofen (4.4 mg/kg SC) was administered after induction of anesthesia. Heart rate, respiratory rate, blood pressure, pulse oximetry, pain scores using the Glasgow Composite Pain Scale Short Form (CMPS-SF), sedation scores using a dynamic interactive visual analogue scale and adverse events were evaluated before and after ovariohysterectomy by an observer who was unaware of treatment administration. If CMPS-SF scores were ≥ 5/20, dogs were administered rescue analgesia (morphine 0.5 mg/kg IM). Statistical analysis was performed using linear mixed models and Fisher’s exact test (p < 0.05). Results Pain and sedation scores and physiological parameters were not significantly different between treatments. Three dogs in VG (25%) and none in SG (0%) required rescue analgesia (p = 0.109). Adverse effects (i.e. vomiting and melena) were observed in two dogs in SG and were thought to be related to stress and/or nonsteroidal anti-inflammatory drug toxicity. Conclusions The administration of buprenorphine with carprofen preoperatively provided adequate postoperative analgesia for the majority of dogs undergoing OVH without serious adverse events. Prevalence of rescue analgesia was not significantly different between groups; however, it could be clinically relevant and explained by a type II error (i.e. small sample size). Future studies are necessary to determine if analgesic efficacy after Simbadol and Vetergesic is related to individual variability or pharmacokinetic differences.
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Affiliation(s)
- Ryota Watanabe
- Department of Clinical Sciences and Animal Pharmacology Research Group of Quebec (GREPAQ; Groupe de recherche en pharmacologie animale du Québec), Faculty of Veterinary Medicine, Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, QC, J2S 2M2, Canada
| | - Beatriz P Monteiro
- Department of Clinical Sciences and Animal Pharmacology Research Group of Quebec (GREPAQ; Groupe de recherche en pharmacologie animale du Québec), Faculty of Veterinary Medicine, Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, QC, J2S 2M2, Canada
| | - Marina C Evangelista
- Department of Clinical Sciences and Animal Pharmacology Research Group of Quebec (GREPAQ; Groupe de recherche en pharmacologie animale du Québec), Faculty of Veterinary Medicine, Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, QC, J2S 2M2, Canada
| | - Amélie Castonguay
- Department of Clinical Sciences and Animal Pharmacology Research Group of Quebec (GREPAQ; Groupe de recherche en pharmacologie animale du Québec), Faculty of Veterinary Medicine, Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, QC, J2S 2M2, Canada
| | | | - Paulo V Steagall
- Department of Clinical Sciences and Animal Pharmacology Research Group of Quebec (GREPAQ; Groupe de recherche en pharmacologie animale du Québec), Faculty of Veterinary Medicine, Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, QC, J2S 2M2, Canada.
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25
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Effects of ketamine constant rate infusions on cardiac biomarkers and cardiac function in dogs. Vet Anaesth Analg 2018. [DOI: 10.1016/j.vaa.2017.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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26
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Bradbrook C, Clark L. State of the art analgesia-Recent developments pharmacological approaches to acute pain management in dogs and cats: Part 2. Vet J 2018; 236:62-67. [PMID: 29871752 DOI: 10.1016/j.tvjl.2018.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/12/2018] [Accepted: 04/13/2018] [Indexed: 10/17/2022]
Abstract
There has been considerable interest in the area of acute pain management over recent years, focusing on pain assessment, pharmacological and non-pharmacological interventions. The evidence base for our clinical decision making and treatment of patients is ever increasing and becoming more robust. There is still a tendency to base some aspects of pain management on poor quality evidence and this requires further input in years to come. With new literature come new ideas and this review will detail the current knowledge base behind pharmacological management of acute pain in dogs and cats. The known mechanisms of action of each analgesic and its evidence will be considered. The second part of this review will consider the non-traditional analgesics, describing their component drugs individually, thereby focusing on their mechanisms of action and the current evidence for their use in acute pain management.
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Affiliation(s)
| | - L Clark
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Herts, SG5 3HR, UK
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27
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Kaka U, Rahman NA, Abubakar AA, Goh YM, Fakurazi S, Omar MA, Chen HC. Pre-emptive multimodal analgesia with tramadol and ketamine-lidocaine infusion for suppression of central sensitization in a dog model of ovariohysterectomy. J Pain Res 2018; 11:743-752. [PMID: 29695926 PMCID: PMC5905489 DOI: 10.2147/jpr.s152475] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives The effects of pre-emptive infusion of ketamine-lidocaine with tramadol on the suppression of central sensitization were investigated in a dog ovariohysterectomy model. Patients and methods Twelve dogs were randomly assigned to two groups: ketamine-lidocaine-tramadol (KLT) and tramadol (T) groups. Both groups received intravenous tramadol 4 mg/kg body weight as premedication. Immediately after induction, the KLT group received ketamine and lidocaine at 0.5 and 2 mg/kg loading dose, followed by continuous rate infusion of 50 and 100 µg/kg/min, respectively, for 2 hours. Dogs in T group received saline bolus and continuous rate infusion at equi-volume. Intraoperatively, hemodynamic responses to surgical stimulation were recorded, whereas postoperative pain was evaluated using an algometer and short form of the Glasgow composite measure pain scale. Results Intraoperatively, hemodynamic responses to surgical stimulation were obtunded to a greater degree in KLT compared to T group. Postoperatively, the pain scores increased only for the first hour in KLT group, compared to 12 hours in T group. Mechanical thresholds at the abdomen decreased postoperatively between 12 and 60 hours in KLT group versus the entire 72 hours in T group. Thresholds at tibia and radius in both groups increased in the immediate 1 hour postoperatively, but decreased thereafter. Significant decrement of thresholds from baseline were detected in the tibia at 24, 42, and 60 hours in KLT group compared to 24-72 hours in T group, and in the radius between 36 and 48 hours in T group, but none in KLT group. Conclusion Addition of pre-emptive ketamine-lidocaine infusion to single intravenous dose of tramadol enhanced attenuation of central sensitization and improved intra- and postoperative analgesia.
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Affiliation(s)
- Ubedullah Kaka
- Department of Companion Animal Medicine and Surgery, Faculty of Veterinary Medicine.,Institute of Tropical Agriculture and Food Security, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nor-Alimah Rahman
- Department of Companion Animal Medicine and Surgery, Faculty of Veterinary Medicine
| | - Adamu Abdul Abubakar
- Department of Companion Animal Medicine and Surgery, Faculty of Veterinary Medicine.,Department of Veterinary Surgery and Radiology, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Yong Meng Goh
- Institute of Tropical Agriculture and Food Security, Universiti Putra Malaysia, Serdang, Malaysia.,Department of Preclinical Veterinary Sciences, Faculty of Veterinary Medicine
| | - Sharida Fakurazi
- Laboratory of Vaccines and Immunotherapeutics, Institute of Bioscience.,Department of Human Anatomy, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Serdang, Malaysia
| | - Mohamed Ariff Omar
- Department of Preclinical Veterinary Sciences, Faculty of Veterinary Medicine
| | - Hui Cheng Chen
- Department of Companion Animal Medicine and Surgery, Faculty of Veterinary Medicine
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28
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Nenadović K, Vučinić M, Radenković-Damnjanović B, Janković L, Teodorović R, Voslarova E, Becskei Z. Cortisol concentration, pain and sedation scale in free roaming dogs treated with carprofen after ovariohysterectomy. Vet World 2017; 10:888-894. [PMID: 28919678 PMCID: PMC5591474 DOI: 10.14202/vetworld.2017.888-894] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 07/05/2017] [Indexed: 12/02/2022] Open
Abstract
Background and Aim: One of the topic issues in animal welfare activities is the free roaming dog welfare especially in developing countries such as Serbia. The way of controlling population of free roaming dogs is their reproduction with the method of “Catch-Neuter-Release.” This complex process consists of capturing free roaming dogs in public areas, sterilizing, and returning them to the public area from which they were temporarily removed. Ovariohysterectomy present the period with a high intensity of stress reaction since many veterinarians in Serbia do not use analgesia for this group of dogs. The aim of this study was to compare the serum cortisol concentration before and after ovariohysterectomy and the level of post-operative pain and sedation in a group of free roaming female dogs treated with carprofen after surgical intervention and in a group with no treatment. Materials and Methods: The study was performed on a total of 20 female dogs under the program for free roaming dog control. Free-roaming dogs were captured in public areas by the communal animal hygiene service and were transported between 30 and 45 min to the clinic of a veterinary practice. Treatment began at 10:00 h on the next day and the bitches were kept in cages until they were returned to public locations from which they were temporarily removed to be sterilized. The G2 group received before closing the incision line carprofen in one dosage of 4 mg/kg given by subcutaneous injection into the scruff. Rescue protocol with carprofen was provided for G1 after 24 h following ovariohysterectomy same dosage as G2. Blood (2 ml) was collected from the cephalic vein of each dog in disposable plastic syringes, containing heparin (1:1000) 4 times: Before ovariohysterectomy, 30, 120 min and 24 h following ovariohysterectomy. Cortisol concentration was determined by enzyme-linked immunosorbent assay. The multifactorial pain and sedation scale were used for the assessment of pain and sedation. Results: In both groups, the lowest values of serum cortisol concentration were obtained before ovariohysterectomy. Cortisol levels in both groups were significantly higher (p<0.01) 30 and 120 min after ovariohysterectomy and showed a decreasing trend toward the end of the observation period (24 h). The results obtained 15 and 30 min after the surgical intervention have revealed a statistically significant difference between the groups (p<0.05) showing that female dogs treated with carprofen had a lower value on the pain scale and a higher value on the sedation scale compared to the group with no treatment. Conclusion: Carprofen provides both a restful consequence of sedation and a rapid return to a more normal physiological and behavioral state in dogs after ovariohysterectomy.
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Affiliation(s)
- Katarina Nenadović
- Department of Animal Hygiene, Faculty of Veterinary Medicine, University of Belgrade, Serbia
| | - Marijana Vučinić
- Department of Animal Hygiene, Faculty of Veterinary Medicine, University of Belgrade, Serbia
| | | | - Ljiljana Janković
- Department of Animal Hygiene, Faculty of Veterinary Medicine, University of Belgrade, Serbia
| | - Radislava Teodorović
- Department of Animal Hygiene, Faculty of Veterinary Medicine, University of Belgrade, Serbia
| | - Eva Voslarova
- Department of Animal Protection, Welfare and Behaviour, University of Veterinary and Pharmaceutical Sciences Brno, Czech Republic
| | - Zsolt Becskei
- Department of Animal Husbandry, Faculty of Veterinary Medicine, University of Belgrade, Serbia
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White DM, Mair AR, Martinez-Taboada F. Opioid-free anaesthesia in three dogs. Open Vet J 2017; 7:104-110. [PMID: 28616391 PMCID: PMC5440608 DOI: 10.4314/ovj.v7i2.5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 04/25/2017] [Indexed: 01/21/2023] Open
Abstract
Opioid-free anaesthesia (OFA) is a relatively new and growing field in human medicine. There are multiple motivations behind this emerging practice with the recognition of several serious potential opioid-related adverse effects including opioid induced hyperalgesia, opioid tolerance and immunomodulatory effects of opioids. Opioids have long been the mainstay of veterinary anaesthesia and pain management practice. The feasibility of OFA in veterinary patients is presented here. A case series of three dogs that underwent OFA for canine ovariohysterectomy is reported. The authors conclude OFA is possible in veterinary medicine; however the move away from the familiar effects of opioids perioperatively is challenging. Gaining experience with these types of protocols for standard procedures in healthy animals, such as neutering, will provide the anaesthetist with the building blocks for more invasive surgeries.
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Affiliation(s)
- Donna M White
- Department of Anaesthesia and Analgesia, Veterinary Teaching Hospital, University of Sydney, Evelyn Williams Building B10, 65 Parramatta Road, Camperdown, NSW. 2050. Australia
| | - Alastair R Mair
- Department of Anaesthesia and Analgesia, Veterinary Teaching Hospital, University of Sydney, Evelyn Williams Building B10, 65 Parramatta Road, Camperdown, NSW. 2050. Australia
| | - Fernando Martinez-Taboada
- Department of Anaesthesia and Analgesia, Veterinary Teaching Hospital, University of Sydney, Evelyn Williams Building B10, 65 Parramatta Road, Camperdown, NSW. 2050. Australia
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30
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Kushnir Y, Toledano N, Cohen L, Bdolah-Abram T, Shilo-Benjamini Y. Intratesticular and incisional line infiltration with ropivacaine for castration in medetomidine–butorphanol–midazolam sedated dogs. Vet Anaesth Analg 2017; 44:346-355. [DOI: 10.1016/j.vaa.2016.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 02/22/2016] [Accepted: 03/06/2016] [Indexed: 11/29/2022]
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Abstract
This paper is the thirty-eighth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2015 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia, stress and social status, tolerance and dependence, learning and memory, eating and drinking, drug abuse and alcohol, sexual activity and hormones, pregnancy, development and endocrinology, mental illness and mood, seizures and neurologic disorders, electrical-related activity and neurophysiology, general activity and locomotion, gastrointestinal, renal and hepatic functions, cardiovascular responses, respiration and thermoregulation, and immunological responses.
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
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