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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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Didier C, Faucher S, Sarra Ferrer M, Lapouge M, Junot S, Jourdan G. Postoperative opioid-free analgesia in dogs undergoing tibial plateau leveling osteotomy: a feasibility study. Front Vet Sci 2024; 11:1394366. [PMID: 39036794 PMCID: PMC11257878 DOI: 10.3389/fvets.2024.1394366] [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: 03/01/2024] [Accepted: 06/19/2024] [Indexed: 07/23/2024] Open
Abstract
Objectives This study was designed to prospectively evaluate the feasibility of an opioid-free anesthesia protocol and describe the quality of recovery and management of postoperative analgesia in dogs after a tibial plateau leveling osteotomy (TPLO). Methods In total, 20 dogs presented for TPLO were included. After premedication with intravenous (IV) medetomidine (0.005-0.007 mg/kg) and midazolam (0.2 mg/kg), the dogs were anesthetized using ketamine (2 mg/kg) and propofol and maintained with isoflurane and ketamine CRI (0.6 mg/kg/h). Sciatic and femoral nerve blocks were performed with bupivacaine 0.5% (0.087 +/- 0.01 and 0.09 +/- 0.02 mL/kg, respectively). Meloxicam (0.2 mg/kg IV) was administered intraoperatively, after osteotomy. Fentanyl (0.002 mg/kg IV) was administered intraoperatively, as rescue analgesia in the case of sustained increase in cardiorespiratory variables. Two pain scores (French 4A-VET and Glasgow short form) were performed at conscious sternal recumbency and 2, 4, 6, 8, 12, and 20 h after extubation and compared to baseline using a Friedman test followed by a Nemenyi post-hoc test. The time taken for the first food intake and urination was reported. Results Intraoperative opioid-free anesthesia was feasible in 11 dogs, whereas 9 dogs received fentanyl once during arthrotomy. No opioid postoperative rescue analgesia was required. Food intake occurred within 6 h, and all dogs were discharged after 24 h without any complication. Conclusion Total opioid-free postoperative analgesia was achieved in all dogs, with adequate recoveries. Although opioid-free anesthesia was feasible in 55% of the population, a single dose of fentanyl was necessary in 45% of the dogs during arthrotomy.
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Affiliation(s)
- Caroline Didier
- Department of Clinical Sciences, National Veterinary School of Toulouse, University of Toulouse, Toulouse, France
| | - Sarah Faucher
- Department of Clinical Sciences, National Veterinary School of Toulouse, University of Toulouse, Toulouse, France
| | - Marti Sarra Ferrer
- Department of Clinical Sciences, National Veterinary School of Toulouse, University of Toulouse, Toulouse, France
| | | | - Stéphane Junot
- Department of Veterinary Anesthesia and Analgesia, Université de Lyon, VetAgro Sup, Marcy l’Etoile, France
| | - Géraldine Jourdan
- Department of Clinical Sciences, National Veterinary School of Toulouse, University of Toulouse, Toulouse, France
- RESTORE Research Center, University of Toulouse, INSERM, CNRS, EFS, ENVT, Toulouse, France
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3
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Briley JD, Washington D, Westermeyer HD, Posner LP, Chiavaccini L. Comparison of a blind and an ultrasound-guided technique for Retrobulbar anesthesia in dogs undergoing unilateral subconjunctival enucleation. Vet Ophthalmol 2024; 27:79-85. [PMID: 37021439 DOI: 10.1111/vop.13092] [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: 12/01/2022] [Revised: 02/16/2023] [Accepted: 03/16/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVE This study compared the quality of retrobulbar anesthesia using a blind inferior-temporal palpebral approach (ITP) with an ultrasound-guided supratemporal (ST) technique in dogs undergoing unilateral enucleation. ANIMAL STUDIED Twenty-one client-owned dogs were undergoing enucleation. PROCEDURES Dogs were randomly assigned to receive ITP (n = 10) or ST (n = 11) with 0.5% ropivacaine at 0.1 mL/cm of neurocranial length. The anesthetist was blinded to the technique. Intraoperative data included cardiopulmonary variables, inhalant anesthetics requirement, and requirement for rescue analgesia (intravenous fentanyl 2.5 mcg/kg). Postoperative data included pain scores, sedation scores, and need for intravenous hydromorphone (0.05 mg/kg). Treatments were compared using Wilcoxon's rank sum test or Fisher's exact test as appropriate. Comparison of variables over time were tested using a mixed effect linear model on rank. Significance was set at p = 0.05. RESULTS Intraoperative cardiopulmonary variables and inhalant requirements were not different between groups. Dogs receiving ITP required median (interquartile range, IQR) 1.25 (0, 2.5) mcg/kg intraoperative fentanyl while those receiving ST required none (p < 0.01). Intraoperative fentanyl was required in 5/10 and 0/11 of dogs in the ITP and ST groups, respectively (p = 0.01). Postoperative analgesia requirements were not significantly different between groups; 2/10 and 1/10 dogs in the ITP and ST groups, respectively. Sedation score negatively affected pain score (p < 0.01). CONCLUSIONS The ultrasound-guided ST technique was more effective at decreasing intraoperative opioid requirements than the blind ITP approach in dogs undergoing unilateral enucleation.
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Affiliation(s)
- Jessica D Briley
- Department of Molecular Biomedical Sciences, Anesthesiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | | | - Hans D Westermeyer
- Department of Clinical Sciences, Comparative Ophthalmology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Lysa P Posner
- Department of Molecular Biomedical Sciences, Anesthesiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Ludovica Chiavaccini
- Department of Comparative, Diagnostic and Population Medicine, Anesthesiology, College of Veterinary Medicine, University of Florida, Florida, Gainesville, USA
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Pinheiro AV, Petrucci GN, Dourado A, Pires I. Anaesthesia in Veterinary Oncology: The Effects of Surgery, Volatile and Intravenous Anaesthetics on the Immune System and Tumour Spread. Animals (Basel) 2023; 13:3392. [PMID: 37958147 PMCID: PMC10648213 DOI: 10.3390/ani13213392] [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: 09/16/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
Throughout the course of oncological disease, the majority of patients require surgical, anaesthetic and analgesic intervention. However, during the perioperative period, anaesthetic agents and techniques, surgical tissue trauma, adjuvant drugs for local pain and inflammation and other non-pharmacological factors, such as blood transfusions, hydration, temperature and nutrition, may influence the prognosis of the disease. These factors significantly impact the oncologic patient's immune response, which is the primary barrier to tumour progress, promoting a window of vulnerability for its dissemination and recurrence. More research is required to ascertain which anaesthetics and techniques have immunoprotective and anti-tumour effects, which will contribute to developing novel anaesthetic strategies in veterinary medicine.
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Affiliation(s)
- Ana Vidal Pinheiro
- Department of Veterinary Sciences, School of Agricultural and Veterinary Sciences (ECAV), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (A.D.); (I.P.)
| | - Gonçalo N. Petrucci
- 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
- CECAV—Veterinary and Animal Research Center, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal
| | - Amândio Dourado
- Department of Veterinary Sciences, School of Agricultural and Veterinary Sciences (ECAV), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (A.D.); (I.P.)
- Onevetgroup Hospital Veterinário do Porto (HVP), 4250-475 Porto, Portugal;
| | - Isabel Pires
- Department of Veterinary Sciences, School of Agricultural and Veterinary Sciences (ECAV), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (A.D.); (I.P.)
- CECAV—Veterinary and Animal Research Center, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal
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Pentsou J, Vagias M, Davies T, Hoey S, Huuskonen V. Thoracolumbar Retrolaminar Block: Anatomical and Radiological Study of Injectate Pattern Distribution in Canine Cadavers. Animals (Basel) 2023; 13:3008. [PMID: 37835614 PMCID: PMC10571983 DOI: 10.3390/ani13193008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
The retrolaminar block is a regional anaesthetic technique, first developed in humans, in which the local anaesthetic is deposited directly onto the dorsal aspect of the thoracic or lumbar vertebral lamina. This study aims to evaluate the distribution of landmark-guided thoracolumbar retrolaminar injections in greyhound cadavers. Thirteen injections of contrast-dye solution were performed in eight cadavers at the level of the twelfth thoracic vertebra (T12), with either 20 mL (n = 8, high volume, HV) or 10 mL (n = 5, low volume, LV) per site. The spread of the injectate was evaluated through computed tomography and transverse anatomical dissection. The groups were compared using the Mann-Whitney U test. The median (range) of the extent of the spread was 4 (2-5) and 3 (2-4) intervertebral foramina in the LV and HV groups, respectively. The median (range) of the spread along the retrolaminar space was 3 (2-3) retrolaminar segments in the LV and 3 (2-4) in the HV group. Epidural and retroperitoneal spread was identified in seven cadavers. Following landmark-guided retrolaminar injections, the injectate spread both in the retrolaminar and paravertebral spaces, without any obvious association between the volume of injectate and the extent of the spread. Further studies are warranted to determine the clinical efficacy of the technique.
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Affiliation(s)
- Julia Pentsou
- Department of Veterinary Anaesthesia and Analgesia, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh EH25 9RG, UK
| | - Michail Vagias
- Department of Small Animal Surgery, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh EH25 9RG, UK;
| | - Thomas Davies
- Bristol Vet Specialists, Unit 10, More Plus Central Park, Madison Way, Severn Beach, Bristol BS35 4ER, UK;
| | - Séamus Hoey
- Equine Clinical Studies, Diagnostic Imaging and Anaesthesia, UCD School of Veterinary Medicine, University College Dublin, D04 W6F6 Dublin, Ireland; (S.H.); (V.H.)
| | - Vilhelmiina Huuskonen
- Equine Clinical Studies, Diagnostic Imaging and Anaesthesia, UCD School of Veterinary Medicine, University College Dublin, D04 W6F6 Dublin, Ireland; (S.H.); (V.H.)
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Cubeddu F, Masala G, Sotgiu G, Mollica A, Versace S, Careddu GM. Cardiorespiratory Effects and Desflurane Requirement in Dogs Undergoing Ovariectomy after Administration Maropitant or Methadone. Animals (Basel) 2023; 13:2388. [PMID: 37508165 PMCID: PMC10376119 DOI: 10.3390/ani13142388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/08/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
General anesthesia for ovariectomy in dogs is based on a balanced anesthesia protocol such as using analgesics along with an inhalant agent. While opioids such as fentanyl and methadone are commonly used for their analgesic potency, other drugs can also have analgesic effects. Maropitant, an antiemetic for dogs and cats, has also been shown to exert analgesic effects, especially on visceral pain. The aim of this study was to compare the cardiorespiratory effects and analgesic properties of maropitant and methadone combined with desflurane in dogs undergoing ovariectomy. Two groups of 20 healthy mixed-breeds bitches undergoing elective ovariectomy received intravenous either maropitant at antiemetic dose of 1 mg kg-1 or methadone at the dose of 0.3 mg kg-1. Cardiorespiratory variables were collected before premedication, 10 min after sedation and during surgery. Recovery quality and postoperative pain were evaluated 15, 30, 60, 120, 240 and 360 min postoperatively. Results showed that maropitant produced analgesia and reduced the requirement of desflurane in amounts similar to those determined by methadone (5.39 ± 0.20% and 4.91 ± 0.26%, respectively) without significant difference, while maintaining heart rate, arterial blood pressure, respiratory rate and carbon dioxide end-tidal partial pressure even at a more satisfactory level. Therefore, maropitant may be recommended as an analgesic drug for abdominal surgery not only in healthy dogs but also in those with reduced cardiorespiratory compensatory capacities or at risk of hypotension, especially when combined with a sedative such as dexmedetomidine.
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Affiliation(s)
- Francesca Cubeddu
- Department of Veterinary Medicine, University of Sassari, Via Vienna 2, 07100 Sassari, Italy
| | - Gerolamo Masala
- Department of Veterinary Medicine, University of Sassari, Via Vienna 2, 07100 Sassari, Italy
| | - Giovanni Sotgiu
- Department of Surgical and Experimental Medical Sciences Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy
| | - Alessandra Mollica
- Department of Veterinary Medicine, University of Sassari, Via Vienna 2, 07100 Sassari, Italy
| | - Sylvia Versace
- Department of Veterinary Medicine, University of Sassari, Via Vienna 2, 07100 Sassari, Italy
| | - Giovanni Mario Careddu
- Department of Veterinary Medicine, University of Sassari, Via Vienna 2, 07100 Sassari, Italy
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Citarella G, Corona D, Parsons E, Giannikaki S, Rioja E. The Outcomes of an Opioid-Free Anaesthetic Plan in Fourteen Dogs Undergoing Enucleation Using an Ultrasound-Guided Supra-Temporal Retrobulbar Block: A Retrospective Case Series. Animals (Basel) 2023; 13:2059. [PMID: 37443857 DOI: 10.3390/ani13132059] [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: 05/08/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
The objective of this retrospective case series is to report the outcomes of an opioid-free anesthetic plan in dogs undergoing enucleation surgery. A total of 14 dogs were admitted for enucleation between March and December 2020. A multimodal approach to perioperative analgesia was used, with a focus on retrobulbar anesthesia. A combination of an ultrasound-guided retrobulbblock with a supratemporal approach in association with ketamine, dexmedetomidine and non-steroidal anti-inflammatory drugs was used in the reported cases. Intraoperative nociception was defined as an increase of 20% from the baseline in one or more of the following parameters: heart rate, respiratory rate or mean arterial pressure. An ultrasound-guided retrobulbar block in an opioid-free anesthesia regime was effective at managing the perioperative analgesia of 13 out of 14 dogs. In only one case, a bolus of fentanyl was administered to treat intraoperative nociception. Recovery was uneventful in all the dogs, and the postoperative pain scores remained below the intervention threshold at all time points. To the authors' knowledge, this is the first reported case series of opioid-free anesthesia for enucleation in dogs.
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Affiliation(s)
- Gerardo Citarella
- Section of Anaesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Daniele Corona
- Section of Anaesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | | | | | - Eva Rioja
- Optivet Referrals, Ltd., Havant, PO9 2NJ, UK
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Rufiange M, Ruel HLM, Monteiro BP, Watanabe R, Cruz Benedetti IC, Benito J, Steagall PVM. A randomized, prospective, masked clinical trial comparing an opioid-free vs. opioid-sparing anesthetic technique in adult cats undergoing ovariohysterectomy. Front Vet Sci 2022; 9:1002407. [PMID: 36439352 PMCID: PMC9691894 DOI: 10.3389/fvets.2022.1002407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/25/2022] [Indexed: 09/23/2023] Open
Abstract
This study aimed to compare the analgesic effects of an injectable protocol using multimodal analgesia with or without opioids in cats undergoing ovariohysterectomy (OVH). Thirty-two healthy cats were enrolled in a prospective, blinded, randomized trial after the caregiver's written consent. Cats received a combination of ketamine (4 mg/kg), midazolam (0.25 mg/kg) and dexmedetomidine (40 μg/kg), and either buprenorphine (20 μg/kg) or saline (same volume as buprenorphine) intramuscularly [opioid-sparing (OSA) and opioid-free anesthesia (OFA) groups, respectively]. Intraperitoneal bupivacaine 0.25% (2 mg/kg) and meloxicam (0.2 mg/kg subcutaneously) were administered before OVH. Atipamezole (400 μg/kg intramuscularly) was administered at the end of surgery. Pain and sedation were evaluated using the Feline Grimace Scale (FGS) and a dynamic interactive visual analog scale, respectively. Intravenous buprenorphine was administered as rescue analgesia if FGS scores ≥ 0.39/1. Statistical analysis included repeated measures linear mixed models, Fisher's exact test and Bonferroni adjustments when appropriate (p < 0.05). Twenty-seven cats were included. The prevalence of rescue analgesia was lower in OSA (n = 0/13) than in OFA (n = 5/14) (p = 0.04). The FGS scores (least square means and 95% CI) were higher in OFA at 1 [2.0 (1.3-2.7)] and 2 h [2.2 (1.5-2.9)] than baseline [0.7 (0.0-1.4)], but not in OSA. Sedation scores were not significantly different between groups. Opioid-free injectable anesthesia was appropriate for some cats using a multimodal approach. However, a single dose of intramuscular buprenorphine eliminated the need for rescue analgesia and assured adequate pain management after OVH in cats.
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Affiliation(s)
- Maxime Rufiange
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Helene L. M. Ruel
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Beatriz P. Monteiro
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Ryota Watanabe
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Inga-Catalina Cruz Benedetti
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Javier Benito
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Paulo V. M. Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
- Department of Veterinary Clinical Sciences and Centre for Companion Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
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Lima CMS, Segatto CZ, Zanelli GR, Nicácio GM, Cassu RN. Effects of Lidocaine Injection at Acupuncture Points on Perioperative Analgesia in Cats Undergoing Ovariohysterectomy. J Acupunct Meridian Stud 2022; 15:255-263. [DOI: 10.51507/j.jams.2022.15.4.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/21/2022] [Accepted: 06/01/2022] [Indexed: 11/03/2022] Open
Affiliation(s)
- Camila Menossi Sueza Lima
- Department of Veterinary Surgery and Anestesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
| | - Camila Zanetti Segatto
- Department of Veterinary Surgery and Anestesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
| | - Gustavo Ricci Zanelli
- Department of Veterinary Surgery and Anestesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
| | - Gabriel Montoro Nicácio
- Department of Veterinary Surgery and Anestesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
| | - Renata Navarro Cassu
- Department of Veterinary Surgery and Anestesiology, Faculty of Veterinary Medicine, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
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Herrera‐Linares ME, Martínez M. Transient respiratory arrest after quadratus lumborum block in a dog. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Miguel Martínez
- Anaesthesia Department Northwest Veterinary Specialists Runcorn UK
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11
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Aguilar‐Catalan A, Fresno Bermejo L, Murison PJ. Continuous mandibular nerve block as sole analgesia for postoperative pain management after a hemi‐mandibulectomy in a French bulldog. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Adrià Aguilar‐Catalan
- Hospital Clínic Veterinari, Universitat Autònoma de Barcelona Bellaterra Barcelona Spain
| | - Laura Fresno Bermejo
- Hospital Clínic Veterinari, Universitat Autònoma de Barcelona Bellaterra Barcelona Spain
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12
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Libera N, McFadzean W. An opioid‐free anaesthesia (OFA) technique for dorsal laminectomy in a dog subsequent to severe bradycardia and hypothermia after previous subcutaneous methadone administration. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Natalia Libera
- Small Animal Teaching Hospital, University of Liverpool Neston UK
- Cave Veterinary Specialists, George's Farm West Buckland UK
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13
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Morgaz J, Latorre DF, Serrano-Rodríguez JM, Granados MM, Domínguez JM, Fernández-Sarmiento JA, Quiros-Carmona S, Navarrete-Calvo R. Preperitoneal ropivacaine infusion versus epidural ropivacaine-morphine for postoperative analgesia in dogs undergoing ovariohysterectomy: a randomized clinical trial. Vet Anaesth Analg 2021; 48:935-942. [PMID: 34561181 DOI: 10.1016/j.vaa.2021.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 04/02/2021] [Accepted: 04/21/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the effect of continuous wound infusion (CWI) with preperitoneal ropivacaine on postoperative analgesia and compare it with the epidural administration of ropivacaine and morphine in bitches undergoing ovariohysterectomy. STUDY DESIGN A parallel, randomized, clinical, prospective and nonblinded study. ANIMALS A group of 38 Greyhound bitches. METHODS In the catheter group (CathG), CWI with ropivacaine 1% (1 mg kg-1 + 0.8 mg kg-1 hour-1) was applied to the preperitoneal space over the surgical incision. In the epidural group (EpiG), ropivacaine 0.5% (1.3 mg kg-1) and morphine (0.1 mg kg-1) were epidurally administered. Occipital-coccygeal length was used to calculate the volume for the epidural. Pain was scored using a dynamic interactive visual analogue scale (DIVAS) and Glasgow composite measure pain scale-short form (CMPS-SF) before anaesthesia and at 2, 4, 6, 18, 21 and 24 hours after extubation. Incisional sensitivity using a dynamometer (MWTs-incision) was evaluated simultaneously. Plasma ropivacaine and cortisol concentrations, degree of sedation, motor blockade and response to interdigital clamping were measured or assessed. A two-way mixed analysis of variance and a Mann-Whitney U test were used to analyse data; p < 0.05. RESULTS No differences were detected in the DIVAS (p = 0.301), CMPS-SF (p = 0.600) scores, MWTs-incision measurements (p = 0.257) and cortisol values (p = 0.878) between the groups. Rescue analgesia was required in two dogs, one in each group, at 2 hours. Sedation, motor blockade and negative response to interdigital clamping were detected in EpiG at 2, 4 and 6 hours. Mean plasma ropivacaine values were higher in CathG (0.475 ± 0.164 ng mL-1) than in EpiG (0.184 ± 0.213 ng mL-1; p = 0.001). CONCLUSION AND CLINICAL RELEVANCE Compared with epidural ropivacaine and morphine, CWI with preperitoneal ropivacaine is an effective analgesic technique for postoperative pain management in bitches undergoing ovariohysterectomy without motor blockade.
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Affiliation(s)
- Juan Morgaz
- Department of Animal Medicine and Surgery, Veterinary Faculty, University of Córdoba, Córdoba, Spain.
| | - David F Latorre
- Health Sciences Faculty in the Technology University of Pereira, Pereira, Colombia
| | - Juan M Serrano-Rodríguez
- Department of Nursing, Pharmacology and Physiotherapy, Pharmacology Area, University of Córdoba, Córdoba, Spain
| | - María M Granados
- Department of Animal Medicine and Surgery, Veterinary Faculty, University of Córdoba, Córdoba, Spain
| | - Juan M Domínguez
- Department of Animal Medicine and Surgery, Veterinary Faculty, University of Córdoba, Córdoba, Spain
| | | | - Setefilla Quiros-Carmona
- Department of Animal Medicine and Surgery, Veterinary Faculty, University of Córdoba, Córdoba, Spain
| | - Rocío Navarrete-Calvo
- Department of Animal Medicine and Surgery, Veterinary Faculty, University of Córdoba, Córdoba, Spain
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Lazzarini E, Gioeni D, Del Prete G, Brioschi F, Agostinetto G, Carotenuto A. Sedative Effects of Intramuscular Dexmedetomidine and Ketamine at Sub-Anesthetic Dose Alone or in Combination with Methadone in Healthy Dogs. Top Companion Anim Med 2021; 45:100579. [PMID: 34400381 DOI: 10.1016/j.tcam.2021.100579] [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: 10/06/2020] [Revised: 06/18/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
The aim of the present study was to compare sedation quality and cardiorespiratory parameters in healthy dogs after intramuscular injection of dexmedetomidine and ketamine with or without methadone. Forty client-owned dogs were randomly divided into two groups and received IM dexmedetomidine (5 µg kg-1) and ketamine (1 mg kg-1), associated (DKM group) or not (DK group) with methadone (0.2 mg kg-1). Sedation, heart rate (HR), respiratory rate (ƒR), mucous membrane and rectal temperature were recorded at baseline (T0) and after 5 (T5), 10 (T10) and 20 (T20) minutes. From T10, cardiac rhythm was monitored with a continuous lead II electrocardiogram. Ease of venous catheter placement, total propofol dose and any apnea episodes were recorded. Sedation was significantly greater in the DKM group, and a significant increase from T5 to T20 within DKM (P = .0002) and DK (P = .008) was also observed. Within each group, HR was significantly lower at all time points compared to baseline. No significant differences between groups were found in the number of arrhythmogenic events (atrioventricular blocks). In both group ƒR decreased over time. The propofol dose required for anesthesia induction was significantly lower (P = .027) in the DKM group. In conclusion, a good level of sedation was achieved in both groups, although this was greater in DKM. Smooth animal-operator interaction and ease of venous catheter placement showed that DK was a useful sedative protocol in healthy patients.
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Affiliation(s)
| | | | | | | | - Giulia Agostinetto
- Zooplantlab, Department of Biotechnology and Biosciences, University of Milano Bicocca, Milano, Italy
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15
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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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16
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Transversal approach for the lumbar erector spine plane block in a dog undergoing dorsal hemilaminectomy. Vet Anaesth Analg 2021; 48:625-627. [PMID: 34092498 DOI: 10.1016/j.vaa.2021.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/04/2021] [Accepted: 02/02/2021] [Indexed: 11/20/2022]
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17
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Garbin M, Bertolizio G, Portela DA. Thoracic paravertebral block for an opioid-free thoracotomy in a dog. Vet Anaesth Analg 2021; 48:622-623. [PMID: 34006494 DOI: 10.1016/j.vaa.2021.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/05/2021] [Accepted: 03/06/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Marta Garbin
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA; Department of Clinical Science, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.
| | - Gianluca Bertolizio
- Department of Anesthesia, Montreal Children's Hospital, McGill University, Montreal, QC, Canada
| | - Diego A Portela
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
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18
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Use of acupuncture as adjuvant analgesic technique in dogs undergoing thoracolumbar hemilaminectomy. Vet J 2020; 264:105536. [PMID: 33012443 DOI: 10.1016/j.tvjl.2020.105536] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 11/23/2022]
Abstract
The aim of this study was to investigate the analgesic efficacy of a preoperative acupuncture treatment in 24 client-owned dogs undergoing thoracolumbar hemilaminectomy. Dogs were randomly assigned to either group A (Acupuncture) or group C (Control). Before skin incision, group A was treated with acupuncture, performed under general anaesthesia for 30 min. Rescue intraoperative fentanyl was administered following a 20% increase in cardiovascular parameters compared to baseline values, measured before incision. An observer masked to the treatment assessed pain, pre- and postoperatively, with the Glasgow (GCPS), the Colorado (CPS) pain scales and a Visual Analogue Scale (VAS); additionally, the mechanical thresholds (MT) were measured with the Electronic von Frey Anaesthesiometer (EVF) at four points located near the herniated disc. The groups were compared with respect to intraoperative cardiovascular and respiratory variables, rescue fentanyl administered in total and at different surgical events (first incision [FI], drilling [DR], disc removal [RE] and skin suturing [ST]), and pre- and postoperative pain scores and MT. Group A received less fentanyl than group C (P = 0.014); this difference was significant at FI P = 0.035) and RE (P = 0.004). The improvement in postoperative CPS score (P = 0.013), VAS score (P = 0.003) and MT (P = 0.001) compared to preoperative values was greater for group A than for group C, whereas the treatment assignment had no effect on postoperative changes in GCPS compared to baseline. Pre-operative acupuncture may help improving perioperative analgesia in dogs with intervertebral disc herniation undergoing thoracolumbar hemilaminectomy.
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Diep TN, Monteiro BP, Evangelista MC, Balleydier A, Watanabe R, Ruel HLM, Doodnaught GM, Le Quang T, Steagall PV. Anesthetic and analgesic effects of an opioid-free, injectable protocol in cats undergoing ovariohysterectomy: A prospective, blinded, randomized clinical trial. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2020; 61:621-628. [PMID: 32675814 PMCID: PMC7238485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study evaluated the effects of ketamine-dexmedetomidine-midazolam as part of an opioid-free, multimodal protocol in cats undergoing ovariohysterectomy. In a prospective, blinded, randomized clinical trial, cats received either 1 of 2 doses of ketamine [5 mg/kg body weight (BW), n = 10, K5 or 7 mg/kg BW, n = 13, K7] with midazolam (0.25 mg/kg BW) and dexmedetomidine (40 μg/kg BW) intramuscularly, intraperitoneal bupivacaine (2 mg/kg BW) and subcutaneous meloxicam (0.2 mg/kg BW) after surgery. Buprenorphine (0.02 mg/kg BW, intravenously) was administered if pain scores exceeded intervention scores with 2 pain scoring systems. Similar prevalence of rescue analgesia was observed (K5 = 6/10; K7 = 7/13) with significantly lower requirements in kittens (2/8) than adults (11/15). Tachypnea (K5 = 7/10 and K7 = 9/13) and desaturation (K5 = 3/10 and K7 = 4/13) were the 2 most common complications. Age influenced the prevalence of rescue analgesia. Most adult cats required opioids for postoperative pain relief.
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Affiliation(s)
- Truc Ngoc Diep
- Department of Veterinary Clinical Sciences, Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Vietnam (Diep, Le Quang), Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec J2S 2M2 (Monteiro, Evangelista, Balleydier, Watanabe, Ruel, Doodnaught, Steagall)
| | - Beatriz P Monteiro
- Department of Veterinary Clinical Sciences, Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Vietnam (Diep, Le Quang), Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec J2S 2M2 (Monteiro, Evangelista, Balleydier, Watanabe, Ruel, Doodnaught, Steagall)
| | - Marina C Evangelista
- Department of Veterinary Clinical Sciences, Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Vietnam (Diep, Le Quang), Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec J2S 2M2 (Monteiro, Evangelista, Balleydier, Watanabe, Ruel, Doodnaught, Steagall)
| | - Aurelien Balleydier
- Department of Veterinary Clinical Sciences, Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Vietnam (Diep, Le Quang), Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec J2S 2M2 (Monteiro, Evangelista, Balleydier, Watanabe, Ruel, Doodnaught, Steagall)
| | - Ryota Watanabe
- Department of Veterinary Clinical Sciences, Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Vietnam (Diep, Le Quang), Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec J2S 2M2 (Monteiro, Evangelista, Balleydier, Watanabe, Ruel, Doodnaught, Steagall)
| | - Hélène L M Ruel
- Department of Veterinary Clinical Sciences, Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Vietnam (Diep, Le Quang), Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec J2S 2M2 (Monteiro, Evangelista, Balleydier, Watanabe, Ruel, Doodnaught, Steagall)
| | - Graeme M Doodnaught
- Department of Veterinary Clinical Sciences, Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Vietnam (Diep, Le Quang), Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec J2S 2M2 (Monteiro, Evangelista, Balleydier, Watanabe, Ruel, Doodnaught, Steagall)
| | - Thong Le Quang
- Department of Veterinary Clinical Sciences, Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Vietnam (Diep, Le Quang), Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec J2S 2M2 (Monteiro, Evangelista, Balleydier, Watanabe, Ruel, Doodnaught, Steagall)
| | - Paulo V Steagall
- Department of Veterinary Clinical Sciences, Faculty of Animal Science and Veterinary Medicine, Nong Lam University, Vietnam (Diep, Le Quang), Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec J2S 2M2 (Monteiro, Evangelista, Balleydier, Watanabe, Ruel, Doodnaught, Steagall)
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20
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Ferrero C, Borland K. Anaesthetic complications and management of a great dane presenting with acute respiratory distress. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-001048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Camilla Ferrero
- Anaesthesia DepartmentAnderson Moores Veterinary SpecialistsWinchesterUK
| | - Karla Borland
- Anaesthesia DepartmentAnderson Moores Veterinary SpecialistsWinchesterUK
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21
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Clinical evaluation of postoperative analgesia, cardiorespiratory parameters and changes in liver and renal function tests of paracetamol compared to meloxicam and carprofen in dogs undergoing ovariohysterectomy. PLoS One 2020; 15:e0223697. [PMID: 32059002 PMCID: PMC7021320 DOI: 10.1371/journal.pone.0223697] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/21/2020] [Indexed: 12/23/2022] Open
Abstract
Background In veterinary medicine, the administration of nonsteroidal anti-inflammatory analgesics (NSAIDs) for the control of postsurgical pain in dogs and cats is common given the anti-inflammatory, analgesic, and antipyretic effects of these drugs. This study compared the serum biochemical changes and postoperative analgesic effects of paracetamol, meloxicam, and carprofen in bitches submitted to an ovariohysterectomy using the Dynamic Interactive Visual Analog Scale (DIVAS) and Pain Scale of the University of Melbourne (UMPS) scoring systems. Methods Thirty bitches of different breeds underwent elective ovariohysterectomies and were randomly assigned to one of three treatment groups: a paracetamol group [15 mg kg-1 intravenous (IV)], a carprofen group (4 mg kg-1 IV), and a meloxicam group (0.2 mg kg-1 IV). All treatments were administered 30 minutes prior to surgery. Paracetamol was administered every 8 hours postoperatively for 48 hours total, while carprofen and meloxicam were intravenously administered every 24 hours. An evaluation of post-surgical pain was done with the DIVAS and the UMPS. The first post-surgical pain measurement was performed 1 hour after surgery and then 2, 4, 6, 8, 12, 16, 20, 24, 36, and 48 hours after surgery. Results All groups exhibited a gradual reduction in pain throughout the postoperative period in both scales; however, neither scale significantly differed between the three treatment groups (P > 0.05) during the 48 postoperative hours. Conclusions Paracetamol was as effective as meloxicam and carprofen for post-surgical analgesia in bitches subjected to elective ovariohysterectomy. The present study demonstrates that paracetamol may be considered a tool for the effective treatment of acute perioperative pain in dogs. Furthermore, this drug led to no adverse reactions or changes in the parameters assessed in the present study, indicating its safety.
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González-Blanco P, Canfrán S, Mota R, Gómez de Segura IA, Aguado D. Effects of a single paracetamol injection on the sevoflurane minimum alveolar concentration in dogs. CANADIAN JOURNAL OF VETERINARY RESEARCH = REVUE CANADIENNE DE RECHERCHE VETERINAIRE 2020; 84:37-43. [PMID: 31949328 PMCID: PMC6921988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 04/12/2019] [Indexed: 06/10/2023]
Abstract
This study aimed to determine the effect of a single injection of paracetamol on the sevoflurane minimum alveolar concentration (MAC) response to noxious mechanical stimulation. Seven healthy adult beagles were enrolled in a prospective, randomized, blinded, crossover experimental study. Anesthesia was induced with propofol [11.6 ± 2.4 mg/kg body weight (BW)] and maintained with sevoflurane. The MAC was determined before (MAC-1) and after (MAC-2) treatment with 15 mg/kg BW of intravenous (IV) paracetamol or saline over 15 minutes. Samples for plasma paracetamol determination were collected immediately after IV treatment administration and following MAC-2 determination (123 ± 27 minutes after starting paracetamol administration). The MAC-1 was similar between treatments (1.7% ± 0.4%). There were no differences between control and paracetamol groups at MAC-2 (2.0% ± 0.4% and 1.7% ± 0.5%, respectively; P = 0.285). Paracetamol plasma concentrations after paracetamol administration were 34.5 ± 9.9 μg/mL, decreasing at the end of the procedure (8.5 ± 4.2 μg/mL). In conclusion, 15 mg/kg BW of IV paracetamol did not significantly reduce sevoflurane MAC in healthy dogs.
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Affiliation(s)
- Paula González-Blanco
- Department of Animal Medicine and Surgery, School of Veterinary Medicine, Complutense University of Madrid, Av. Puerta de Hierro, s/n, 28040 Madrid, Spain (González-Blanco, Canfrán, Gómez de Segura, Aguado); Comparative Medicine Unit, Fundación Centro Nacional de Investigaciones Cardiovasculares, Instituto de Salud Carlos III, 3 Melchor Fernández Almagro St., 28029 Madrid, Spain (Mota)
| | - Susana Canfrán
- Department of Animal Medicine and Surgery, School of Veterinary Medicine, Complutense University of Madrid, Av. Puerta de Hierro, s/n, 28040 Madrid, Spain (González-Blanco, Canfrán, Gómez de Segura, Aguado); Comparative Medicine Unit, Fundación Centro Nacional de Investigaciones Cardiovasculares, Instituto de Salud Carlos III, 3 Melchor Fernández Almagro St., 28029 Madrid, Spain (Mota)
| | - Rubén Mota
- Department of Animal Medicine and Surgery, School of Veterinary Medicine, Complutense University of Madrid, Av. Puerta de Hierro, s/n, 28040 Madrid, Spain (González-Blanco, Canfrán, Gómez de Segura, Aguado); Comparative Medicine Unit, Fundación Centro Nacional de Investigaciones Cardiovasculares, Instituto de Salud Carlos III, 3 Melchor Fernández Almagro St., 28029 Madrid, Spain (Mota)
| | - Ignacio A Gómez de Segura
- Department of Animal Medicine and Surgery, School of Veterinary Medicine, Complutense University of Madrid, Av. Puerta de Hierro, s/n, 28040 Madrid, Spain (González-Blanco, Canfrán, Gómez de Segura, Aguado); Comparative Medicine Unit, Fundación Centro Nacional de Investigaciones Cardiovasculares, Instituto de Salud Carlos III, 3 Melchor Fernández Almagro St., 28029 Madrid, Spain (Mota)
| | - Delia Aguado
- Department of Animal Medicine and Surgery, School of Veterinary Medicine, Complutense University of Madrid, Av. Puerta de Hierro, s/n, 28040 Madrid, Spain (González-Blanco, Canfrán, Gómez de Segura, Aguado); Comparative Medicine Unit, Fundación Centro Nacional de Investigaciones Cardiovasculares, Instituto de Salud Carlos III, 3 Melchor Fernández Almagro St., 28029 Madrid, Spain (Mota)
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Pascal M, Allison A, Kaartinen J. Opioid-sparing effect of a medetomidine constant rate infusion during thoraco-lumbar hemilaminectomy in dogs administered a ketamine infusion. Vet Anaesth Analg 2019; 47:61-69. [PMID: 31791743 DOI: 10.1016/j.vaa.2019.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 06/04/2019] [Accepted: 06/22/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To evaluate the perioperative opioid-sparing effect of a medetomidine (MED) infusion compared to a saline (SAL) infusion in otherwise healthy dogs undergoing thoraco-lumbar hemilaminectomy surgery. STUDY DESIGN Randomized, partially blinded, clinical study. ANIMALS A total of 44 client-owned adult dogs. METHODS All dogs were administered a 1 μg kg-1 MED loading dose, followed by a 1.7 μg kg-1 hour-1 constant rate infusion (CRI) intravenously or equivalent volumes of SAL. Infusions were started 10-15 minutes before surgical incision and continued throughout the surgical procedure. All dogs were administered a standardized anaesthetic and analgesic protocol (including a ketamine CRI). Multiparametric monitoring, including invasive arterial blood pressure, was performed. A trained investigator, unaware of the treatment, performed pain scores for 4 hours postoperatively. Rescue analgesia consisted of fentanyl administered intraoperatively and methadone postoperatively. Data were tested for normality and analysed with Fisher's exact test, Mann-Whitney U-test, analysis of variance and Kaplan-Meier survival analysis. Data are shown as median (interquartile range) and p-value was set at < 0.05. RESULTS The total dose of fentanyl was significantly lower with MED 0 (0-0.8) μg kg-1 hour-1 compared to SAL 3 (1.8-5.3) μg kg-1 hour-1 (p = 0.004). In the MED group, one dog compared to 12 dogs in the SAL group required a fentanyl CRI (p = 0.001). There were no statistically significant differences between groups regarding the total dose of methadone administered. CONCLUSIONS AND CLINICAL RELEVANCE The addition of a low-dose medetomidine CRI to the anaesthetic protocol decreased the need for a fentanyl CRI in otherwise healthy dogs undergoing thoraco-lumbar hemilaminectomy surgery during administration of a ketamine CRI.
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Affiliation(s)
- Manuela Pascal
- Department of Veterinary Anaesthesia, Animal Health Trust, Newmarket, Suffolk, UK.
| | | | - Johanna Kaartinen
- Department of Veterinary Anaesthesia, Animal Health Trust, Newmarket, Suffolk, UK
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Arenillas M, Caro-Vadillo A, Gómez de Segura IA. Anesthetic management of a dog with severe subaortic stenosis and mitral valve disease complicated with atrial fibrillation undergoing ovariohysterectomy. Open Vet J 2019; 9:157-163. [PMID: 31360656 PMCID: PMC6626154 DOI: 10.4314/ovj.v9i2.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/09/2019] [Indexed: 11/17/2022] Open
Abstract
The anesthetic management in patients with subaortic stenosis and mitral valve disease should involve intensive monitoring and the anesthesiologist's main concern is to ensure oxygen delivery and tissue perfusion. Since anesthetic procedures in such patients are rare, there is no previous report about the anesthetic management. A 5.5-year old, 32-kg Boxer, suffering a severe heart disease due to a final stage subaortic stenosis and mitral insufficiency, was anesthetized for an ovariohysterectomy to remove an ovarian tumor that was producing high-volume ascites. Methadone (0.3 mg kg-1) was administered intramuscularly (IM) for pre-anesthetic medication, etomidate (1.3 mg kg-1) and midazolam (0.2 mg kg-1) were used for the induction of anesthesia and after endotracheal intubation, anesthesia was maintained with sevoflurane vaporized in oxygen and air. Fentanyl (5-10 μg kg-1 h-1) and paracetamol (15 mg kg-1) were administered to improve analgesia. Previous persistent atrial fibrillation was refractory to medication (digoxin, diltiazem, and pimobendan) and continued during the anesthetic procedure. Dobutamine (1.5-5 μg kg-1 minute-1) helped to maintain mean arterial blood pressure above 60 mmHg. Epidural morphine (0.1 mg kg-1) and incisional bupivacaine (2 mg kg-1) were administered at the end of surgery to provide postoperative analgesia. Anesthesia was otherwise uneventful, and recovery was considered excellent.
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Affiliation(s)
- Mario Arenillas
- Department of Animal Medicine and Surgery, Facultad de Veterinaria, Hospital Clínico Veterinario, Universidad Complutense de Madrid, Madrid, Spain
| | - Alicia Caro-Vadillo
- Department of Animal Medicine and Surgery, Facultad de Veterinaria, Hospital Clínico Veterinario, Universidad Complutense de Madrid, Madrid, Spain
| | - Ignacio A Gómez de Segura
- Department of Animal Medicine and Surgery, Facultad de Veterinaria, Hospital Clínico Veterinario, Universidad Complutense de Madrid, Madrid, Spain
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Geddes AT, Stathopoulou T, Viscasillas J, Lafuente P. Opioid‐free anaesthesia (OFA) in a springer spaniel sustaining a lateral humeral condylar fracture undergoing surgical repair. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2018-000681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Alexander Thomas Geddes
- Department of Surgical SciencesUniversity of Wisconsin Madison School of Veterinary MedicineMadisonWisconsinUSA
| | | | - Jaime Viscasillas
- Clinical Sciences and ServicesThe Royal Veterinary CollegeHatfieldUK
| | - Pilar Lafuente
- Clinical Sciences and ServicesThe Royal Veterinary CollegeHatfieldUK
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Kropf J, Hughes JML. Effects of midazolam on cardiovascular responses and isoflurane requirement during elective ovariohysterectomy in dogs. Ir Vet J 2018; 71:26. [PMID: 30568789 PMCID: PMC6297997 DOI: 10.1186/s13620-018-0136-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 12/03/2018] [Indexed: 11/25/2022] Open
Abstract
Background A prospective, randomized, placebo-controlled, blinded clinical study was conducted to determine whether a single dose of midazolam affects the cardiovascular response to surgical manipulation of the ovaries during elective ovariohysterectomy. Thirty-nine client-owned dogs undergoing elective ovariohysterectomy were recruited. After scoring cage demeanour, dogs were premedicated with acepromazine (0.03 mg kg-1) and pethidine (3 mg kg-1) intramuscularly into the quadriceps muscle and 20 min later sedation was scored. Anaesthesia was induced with propofol intravenously (IV) to effect. The study treatment (group M: midazolam (0.25 mg kg-1); or group P: placebo (Hartmann’s solution) (0.125 ml kg-1)) was administered IV before the intra-operative manipulation of the first ovary. Anaesthesia was maintained with isoflurane in oxygen. Morphine (0.3 mg kg-1 IV) was administered prior to the start of surgery. The vaporizer setting was adjusted according to the depth of anaesthesia. If an end-tidal isoflurane concentration (FE’Iso) above 1.6% was required additional analgesia was provided with fentanyl (2 μg kg-1). Dogs received meloxicam (0.2 mg kg-1 IV) at the end of procedure. Heart rate, mean arterial blood pressure, respiratory rate and end-tidal partial pressure of carbon dioxide as well as FE’Iso were recorded and analysed. Results A statistical significant difference between groups was detected in FE’Iso, with group M requiring a significantly lower FE’Iso than group P (14.3%) after administration of midazolam. No differences between groups was shown for percentage change in heart rate and mean arterial blood pressure, or end-tidal carbon dioxide and requirement for mechanical ventilation, or rescue analgesia. There was no statistically significant difference in the incidence of complications in group M and P. Group M received significantly more succinylated gelatin solution pre-administration of midazolam than group P, but no differences in fluid administration post-administration of the study treatment (midazolam/placebo) were detected. No statistical significant difference was demonstrated for the use of anticholinergic agents, dobutamine or noradrenaline. Conclusion No significant effect on cardiovascular parameters could be observed with administration of midazolam, but a modest (14.3%) isoflurane-sparing effect was detected.
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Affiliation(s)
- Josephine Kropf
- 1Anaesthesia Department, Small Animal Hospital, School of Veterinary Medicine, University of Glasgow, 464 Bearsden Road, Glasgow, G61 1QH UK
| | - J M Lynne Hughes
- 2Veterinary Anaesthesia, UCD Veterinary Hospital, UCD School of Veterinary Medicine, University College Dublin, DO4 W6F6 Dublin, Ireland
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