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Knych HK, Weiner D, McKemie DS, Traynham M, Blea J. Population pharmacokinetics of butorphanol following intramuscular administration to exercised thoroughbred horses. J Vet Pharmacol Ther 2024. [PMID: 38687131 DOI: 10.1111/jvp.13450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
Butorphanol is commonly administered, both by the intravenous and intramuscular routes, to racehorses to facilitate handling for diagnostic procedures. As the administration of butorphanol for therapeutic purposes is considered appropriate, in order to avoid inadvertent positive drug tests, a thorough understanding of the pharmacokinetics of this drug is necessary. In the current study, 12, exercised Thoroughbred horses were administered a single intramuscular dose of 0.1 mg/kg butorphanol, and serum and urine samples were collected at various times post drug administration for determination of butorphanol concentrations using a highly sensitive liquid chromatography tandem mass spectrometry method. Serum data were modeled using a nonlinear mixed effect population PK model. The maximum concentration (Cmax) and time to maximum concentration (Tmax) were 139.9 ± 72.8 ng/mL and 0.43 ± 0.44 h (mean ± SD), respectively. Although likely not clinically relevant, but important for drug testing purposes, a prolonged terminal phase was observed, yielding a terminal half-life of 7.67 ± 1.86 h. Using the blood screening limits proposed by the Horseracing Integrity and Welfare Unit, the detection time for intramuscular administration of butorphanol was estimated to be 96 h.
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Affiliation(s)
- Heather K Knych
- K.L Maddy Equine Analytical Chemistry Laboratory (Pharmacology Section), School of Veterinary Medicine, University of California Davis, Davis, California, USA
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Daniel Weiner
- Pharmacometrics Consultant, Chapel Hill, North Carolina, USA
| | - Daniel S McKemie
- K.L Maddy Equine Analytical Chemistry Laboratory (Pharmacology Section), School of Veterinary Medicine, University of California Davis, Davis, California, USA
| | - Megan Traynham
- K.L Maddy Equine Analytical Chemistry Laboratory (Pharmacology Section), School of Veterinary Medicine, University of California Davis, Davis, California, USA
| | - Jeff Blea
- School of Veterinary Medicine, University of California, Davis, California, USA
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Chen J, Li X, Hu Z, Zheng Y, Mai Y, Zhang Z. ED 50 of remimazolam combined with different doses butorphanol for first trimester artificial abortion. Front Med (Lausanne) 2024; 11:1385998. [PMID: 38698777 PMCID: PMC11063231 DOI: 10.3389/fmed.2024.1385998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/09/2024] [Indexed: 05/05/2024] Open
Abstract
Introduction Remimazolam (RMZ) is a novel intravenous sedative drug of ultra-short benzodiazepine. The optimal dose of RMZ plus butorphanol for sedation during first trimester artificial abortion is unknown. Therefore, the present study aimed to evaluate the median effective dose (ED50) of RMZ combined with different doses of butorphanol on the sedative effect for first-trimester artificial abortion. Methods Sixty-one female patients were randomly assigned to Group B10 (31 patients) and Group B15 (30 patients). RMZ was administered 5 min after IV butorphanol at doses of 10 μg/kg (Group B10) and 15 μg/kg (Group B15). Cervical dilatation at the time of using a cervical dilating rod, if the patient has body movement and affects the gynecologist's operation, we define it as "Ineffective." Therefore, the dose of RMZ was increased in the next patient. Otherwise, it was defined as "Effective," and the dose of RMZ was reduced in the next patient. According to the pre-experiment, the first dose of RMZ in the first patient was 0.35 mg/kg, and the adjacent geometric dose ratio was 0.9. The centered isotonic regression was performed to determine the ED50 of RMZ. The total RMZ dose administered, recovery time, and anesthesia-related adverse events were all recorded. Results The ED50 (90% CI) of RMZ was 0.263 (0.215-0.310) mg/kg in Group B10, and 0.224 (0.191-0.261) mg/kg in Group B15, respectively. The recovery time in Group B10 was significantly shorter than in Group B15 (9.8 ± 2.3 vs. 12.5 ± 3.6 min, p ≤ 0.001). There was no significant difference in the incidence rate of all anesthesia-related adverse events between the two groups (p > 0.05). Conclusion The ED50 of RMZ combined with a 10 μg/kg or 15 μg/kg dose of butorphanol was 0.263 and 0.224 mg/kg during painless first trimester artificial abortion. However, RMZ combined with a 10 μg/kg dose of butorphanol seems to have a shorter recovery time. Clinical trial registration https://www.chictr.org.cn/bin/project/edit?pid=166623.
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Affiliation(s)
- Jinming Chen
- Department of Anesthesiology, The Affiliated Shunde Hospital of Jinan University, Foshan, China
| | - Xiaoling Li
- Department of Anesthesiology, The Affiliated Shunde Hospital of Jinan University, Foshan, China
| | - Zilan Hu
- Department of Gynecology, The Affiliated Shunde Hospital of Jinan University, Foshan, China
| | - Yuling Zheng
- Department of Anesthesiology, The Affiliated Shunde Hospital of Jinan University, Foshan, China
| | - Ying Mai
- Department of Anesthesiology, The Affiliated Shunde Hospital of Jinan University, Foshan, China
| | - Zhongqi Zhang
- Department of Anesthesiology, The Affiliated Shunde Hospital of Jinan University, Foshan, China
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Buss P, Miller M, Fuller A, Haw A, Thulson E, Olea-Popelka F, Meyer L. Effects of Butorphanol on Respiration in White Rhinoceros (Ceratotherium simum) Immobilized with Etorphine-Azaperone. J Wildl Dis 2024; 60:388-400. [PMID: 38268196 DOI: 10.7589/jwd-d-23-00034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/10/2023] [Indexed: 01/26/2024]
Abstract
This article reports on respiratory function in white rhinoceros (Ceratotherium simum) immobilized with etorphine-azaperone and the changes induced by butorphanol administration as part of a multifaceted crossover study that also investigated the effects of etorphine or etorphine-butorphanol treatments. Six male white rhinoceros underwent two immobilizations by using 1) etorphine-azaperone and 2) etorphine-azaperone-butorphanol. Starting 10 min after recumbency, arterial blood gases, limb muscle tremors, expired minute ventilation, and respiratory rate were evaluated at 5-min intervals for 25 min. Alveolar to arterial oxygen gradient, expected respiratory minute volume, oxygen consumption, and carbon dioxide production were calculated. Etorphine-azaperone administration resulted in hypoxemia and hypercapnia, with increases in alveolar to arterial oxygen gradient, oxygen consumption, and carbon dioxide production, and a decrease in expired minute ventilation. Muscle tremors were also observed. Intravenous butorphanol administration in etorphine-azaperone-immobilized white rhinoceros resulted in less hypoxemia and hypercapnia; a decrease in oxygen consumption, carbon dioxide production, and expired minute ventilation; and no change in the alveolar to arterial oxygen gradient and rate of breathing. We show that the immobilization of white rhinoceros with etorphine-azaperone results in hypoxemia and hypercapnia and that the subsequent intravenous administration of butorphanol improves both arterial blood oxygen and carbon dioxide partial pressures.
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Affiliation(s)
- Peter Buss
- Veterinary Wildlife Services, South African National Parks, Kruger National Park, Private Bag X402, Skukuza 1350, South Africa
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 29 Princess of Wales Terrace, Private Bag 3, 2050, Parktown, South Africa
- Department of Paraclinical Sciences and Centre for Veterinary Wildlife Research, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Wildlife Hub Building, Private Bag X04, Onderstepoort 0110, South Africa
| | - Michele Miller
- Department of Science and Innovation, National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for TB Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Cape Town 8000, South Africa
| | - Andrea Fuller
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 29 Princess of Wales Terrace, Private Bag 3, 2050, Parktown, South Africa
- Department of Paraclinical Sciences and Centre for Veterinary Wildlife Research, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Wildlife Hub Building, Private Bag X04, Onderstepoort 0110, South Africa
| | - Anna Haw
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 29 Princess of Wales Terrace, Private Bag 3, 2050, Parktown, South Africa
| | - Emily Thulson
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Science, Colorado State University, 300 W. Drake Road, Fort Collins, Colorado 80523, USA
| | - Francisco Olea-Popelka
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine & Dentistry, Dental Sciences Building Room 4044, Western University, 1151 Richmond Street, London, Ontario N6A5C1, Canada
| | - Leith Meyer
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 29 Princess of Wales Terrace, Private Bag 3, 2050, Parktown, South Africa
- Department of Paraclinical Sciences and Centre for Veterinary Wildlife Research, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Wildlife Hub Building, Private Bag X04, Onderstepoort 0110, South Africa
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Li C, Shi L, Su M, Li X, Zhu Q, Ge RS, Li H. Butorphanol inhibits androgen biosynthesis and metabolism in rat immature Leydig cells in vitro. Can J Physiol Pharmacol 2024; 102:270-280. [PMID: 38258745 DOI: 10.1139/cjpp-2023-0191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Butorphanol is a synthetic opioid analgesic medication that is primarily used for the management of pain. Butorphanol may have an inhibitory effect on androgen biosynthesis and metabolism in rat immature Leydig cells. The objective of this study was to investigate the influence of butorphanol on androgen secretion by rat Leydig cells isolated from the 35-day-old male rats. Rat Leydig cells were cultured with 0.5-50 μM butorphanol for 3 h in vitro. Butorphanol at 5 and 50 μM significantly inhibited androgen secretion in immature Leydig cells. At 50 μM, butorphanol also blocked the effects of luteinizing hormone (LH) and 8bromo-cAMP-stimulated androgen secretion and 22R-hydroxycholesterol- and pregnenolone-mediated androgen production. Further analysis of the results showed that butorphanol downregulated the expression of genes involved in androgen production, including Lhcgr (LH receptor), Cyp11a1 (cholesterol side-chain cleavage enzyme), Srd5a1 (5α-reductase 1), and Akr1c14 (3α-hydroxysteroid dehydrogenase). Additionally, butorphanol directly inhibited HSD3B1 (3β-hydroxysteroid dehydrogenase 1) and SRD5A1 activity. In conclusion, butorphanol may have side effects of inhibiting androgen biosynthesis and metabolism in Leydig cells.
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Affiliation(s)
- Changchang Li
- Department of Anesthesiology, Ninth People Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Shi
- Department of Anesthesiology and Perioperative Medicine, the Second Affiliated Hospital and Yuying Children's Hospital; Key Laboratory of Pediatric Anesthesiology, Ministry of Education, Key Laboratory of Anesthesiology of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Ming Su
- Department of Anesthesiology and Perioperative Medicine, the Second Affiliated Hospital and Yuying Children's Hospital; Key Laboratory of Pediatric Anesthesiology, Ministry of Education, Key Laboratory of Anesthesiology of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Xiaoheng Li
- Department of Anesthesiology and Perioperative Medicine, the Second Affiliated Hospital and Yuying Children's Hospital; Key Laboratory of Pediatric Anesthesiology, Ministry of Education, Key Laboratory of Anesthesiology of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Qiqi Zhu
- Department of Anesthesiology and Perioperative Medicine, the Second Affiliated Hospital and Yuying Children's Hospital; Key Laboratory of Pediatric Anesthesiology, Ministry of Education, Key Laboratory of Anesthesiology of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Ren-Shan Ge
- Department of Anesthesiology and Perioperative Medicine, the Second Affiliated Hospital and Yuying Children's Hospital; Key Laboratory of Pediatric Anesthesiology, Ministry of Education, Key Laboratory of Anesthesiology of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Huitao Li
- Department of Anesthesiology and Perioperative Medicine, the Second Affiliated Hospital and Yuying Children's Hospital; Key Laboratory of Pediatric Anesthesiology, Ministry of Education, Key Laboratory of Anesthesiology of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
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Haralambus R, Juri M, Mokry A, Jenner F. The impact of opioid administration on the incidence of postanaesthetic colic in horses. Front Pain Res (Lausanne) 2024; 5:1347548. [PMID: 38440199 PMCID: PMC10910105 DOI: 10.3389/fpain.2024.1347548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/08/2024] [Indexed: 03/06/2024] Open
Abstract
Effective management of postoperative pain is essential to ensure patient welfare, reduce morbidity and optimize recovery. Opioids are effective in managing moderate to severe pain in horses but concerns over their adverse effects on gastrointestinal (GI) motility and associated increased colic risk limit their widespread use. Studies investigating the impact of systemic opioids on both GI motility and colic incidence in horses have yielded inconclusive outcomes. Therefore, this retrospective study aims to assess the influence of systemic administration of butorphanol, morphine, and methadone on post-anaesthetic colic (PAC) incidence. Horses undergoing general anaesthesia for non-gastrointestinal procedures that were hospitalized for at least 72 h post-anaesthesia were included in this study. Anaesthetised horses were stratified by procedure type into horses undergoing diagnostic imaging without surgical intervention, emergency or elective surgery. In addition, patients were grouped by opioid treatment regime into horses receiving no opioids, intraanaesthetic, short- (<24 h) or long-term (>24 h) postoperative opioids. Administered opioids encompassed butorphanol, morphine and methadone. The number of horses showing signs of colic in the 72 h after anaesthesia was assessed for each group. A total of 782 horses were included, comprising 659 undergoing surgical procedures and 123 undergoing diagnostic imaging. The overall PAC incidence was 15.1%. Notably, horses undergoing diagnostic imaging without surgery had a significantly lower PAC rate of 6.5% compared to those undergoing surgery (16.7%, p = 0.0146). Emergency surgeries had a significantly lower PAC rate of 5.8% compared to elective procedures (18%, p = 0.0113). Of the 782 horses, 740 received intraoperative opioids and 204 postoperative opioids, 102 of which long-term (≥24 h). Neither intraoperative (p = 0.4243) nor short-term postoperative opioids (p = 0.5744) increased PAC rates. Notably, only the long-term (≥24 h) administration of morphine significantly increased PAC incidence to 34% (p = 0.0038). In contrast, long-term butorphanol (5.3% PAC, p = 0.8482) and methadone (18.4% PAC, p = 0.6161) did not affect PAC rates. In summary, extended morphine administration was the only opioid treatment associated with a significantly increased risk of PAC.
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Affiliation(s)
- Rhea Haralambus
- Equine Surgery Unit, University Equine Hospital, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | | | | | - Florien Jenner
- Equine Surgery Unit, University Equine Hospital, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
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KAMIO T, ODANI Y, OHTOMO W, OGUSHI A, AKUNE Y, KURITA M, OKADA A, INOSHIMA Y. Midazolam and butorphanol combination for sedating beluga whales (Delphinapterus leucas). J Vet Med Sci 2024; 86:207-210. [PMID: 38104973 PMCID: PMC10898986 DOI: 10.1292/jvms.23-0307] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023] Open
Abstract
Safe sedation doses for performing minor procedures such as bronchoscopy, endoscopy, and tooth extraction for beluga whales (Delphinapterus leucas) require elucidation. This study aimed to provide suggestions for determining appropriate midazolam and butorphanol doses to adequately sedate beluga whales to complete procedures and minimize the risk of side effects. We administered midazolam and butorphanol to six captive beluga whales (9-44 years old). Topical lidocaine anesthesia was administered during bronchoscopy. The sedation doses for the beluga whales varied from 0.020 to 0.122 mg/kg for midazolam and from 0.020 to 0.061 mg/kg for butorphanol. In beluga whales, optimal midazolam and butorphanol doses were lowest in old whales. These findings contribute to knowledge regarding appropriate sedation and prevention of overdose accidents during minor procedures in beluga whales.
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Affiliation(s)
- Takashi KAMIO
- Port of Nagoya Public Aquarium, Aichi, Japan
- Joint Graduate School of Veterinary Sciences, Gifu
University, Gifu, Japan
- Laboratory of Food and Environmental Hygiene, Cooperative
Department of Veterinary Medicine, Gifu University, Gifu, Japan
| | | | | | | | | | | | - Ayaka OKADA
- Laboratory of Food and Environmental Hygiene, Cooperative
Department of Veterinary Medicine, Gifu University, Gifu, Japan
| | - Yasuo INOSHIMA
- Joint Graduate School of Veterinary Sciences, Gifu
University, Gifu, Japan
- Laboratory of Food and Environmental Hygiene, Cooperative
Department of Veterinary Medicine, Gifu University, Gifu, Japan
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Watanabe M, Nikaido Y, Sasaki N. Validation of the anesthetic effect of a mixture of remimazolam, medetomidine, and butorphanol in three mouse strains. Exp Anim 2024:23-0158. [PMID: 38246607 DOI: 10.1538/expanim.23-0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024] Open
Abstract
Proper administration of anesthesia is indispensable for the ethical treatment of lab animals in biomedical research. Therefore, selecting an effective anesthesia protocol is pivotal for the design and success of experiments. Hence, continuous development and refinement of anesthetic agents are imperative to improve research outcomes and elevate animal welfare. "Balanced anesthesia" involves using multiple drugs to optimize efficacy while minimizing side effects. The medetomidine, midazolam, and butorphanol, called MMB, and medetomidine, alfaxalone, and butorphanol, called MAB, are popular in Japan. However, the drawbacks of midazolam, including its extended recovery time, and the narrow safety margin of MAB, have prompted research for suitable alternatives. This study replaced midazolam in the MMB combination with remimazolam (RMZ), which is noted for its ultra-short half-life. The resulting combination, called MRB, was effective inproviding a wider safety margin compared to MAB while maintaining an anesthesia depth equivalent level to that of MMB in mice. Notably, MRB consistently exhibited better recovery scores after antagonist administration in contrast to MMB. Furthermore, the re-sedation phenomenon observed with MMB was not observed with MRB. The rapid metabolism of RMZ enables reliable anesthesia induction, circumventing the complications linked to MAB. Overall, MRB excelled in providing extended surgical anesthesia and swift post-antagonist recovery. These results highlight the potential of RMZ for broader animal research applications.
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Affiliation(s)
- Masaki Watanabe
- Laboratory of Laboratory Animal Science and Medicine, School of Veterinary Medicine, Kitasato University
| | - Yuko Nikaido
- Laboratory of Laboratory Animal Science and Medicine, School of Veterinary Medicine, Kitasato University
| | - Nobuya Sasaki
- Laboratory of Laboratory Animal Science and Medicine, School of Veterinary Medicine, Kitasato University
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Sun L, Jin L, Jiao C, Wang L, Xu Q, Wu H, Chen X. Comparison of the ED50 of prophylactic butorphanol in preventing morphine-induced pruritus with or without palonosetron: a prospective, double-blinded, randomized dose-response trial using an up-down sequential allocation method. Ann Med 2024; 55:2304671. [PMID: 38233748 PMCID: PMC10798291 DOI: 10.1080/07853890.2024.2304671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/02/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Butorphanol has been used to reduce the incidence and severity of neuraxial morphine-induced pruritus. Palonosetron is a commonly used antiemetic for the prevention of postoperative nausea and vomiting. The aim of our study was to compare the effective dose in 50% of subjects (ED50) of intravenous butorphanol infusion with or without a single intravenous bolus of palonosetron for preventing pruritus induced by epidural administration of morphine. METHODS A total of 120 parturients were randomly assigned to receive an intravenous bolus injection of palonosetron plus continuous infusion of butorphanol (Group P + B) or an intravenous bolus of saline plus continuous infusion of butorphanol (Group B) after epidural administration of morphine. The antipruritic effect was graded as satisfactory (numerical rating scale (NRS) of pruritus ≤3) or unsatisfactory (NRS >3) within 48 h after morphine treatment. The first patient in each group received butorphanol infusion at a rate of 4 µg/kg/h. The infusion dose for each subsequent patient in the corresponding group was increased by 0.2 µg/kg/h after an unsatisfactory response or decreased by 0.2 µg/kg/h after a satisfactory response. The ED50 was calculated for each group and compared using up-down sequential analysis. RESULTS The ED50 (mean [95% confidence interval (CI)]) of the dose of intravenous butorphanol infusion for preventing moderate to severe pruritus was lower in Group P + B (3.29 µg/kg/min [3.25-3.34 µg/kg/min]) than in Group B (3.57 µg/kg/min [3.47-3.67 µg/kg/min]) (p < 0.05). CONCLUSIONS Under the conditions of the present study, a prophylactic use of 0.25 mg palonosetron reduced the ED50 of prophylactic infusion of butorphanol by approximately 8% to achieve a satisfactory antipruritic effect after epidural morphine for post-caesarean analgesia.
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Affiliation(s)
- LiHong Sun
- Department of Anesthesiology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lin Jin
- Department of Anesthesiology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Cuicui Jiao
- Department of Anesthesiology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - LuYang Wang
- Department of Anesthesiology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qi Xu
- Department of Anesthesiology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hui Wu
- Department of Anesthesiology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - XinZhong Chen
- Department of Anesthesiology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Dzikiti TB, Maney JK, Thorogood J, Segabinazzi L, Peterson E, Dzikiti LN, Escobar A. Sedation with dexmedetomidine- butorphanol or xylazine-butorphanol continuous intravenous infusions during unilateral ovariectomy in standing donkeys. Equine Vet J 2024. [PMID: 38173139 DOI: 10.1111/evj.14052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/02/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Intravenous infusions of alpha-2 adrenoceptor sedatives and opioids can potentially facilitate surgery in donkeys while standing. Literature on this subject matter is scant. OBJECTIVES Evaluation of efficacy of sedation from α2 -adrenoceptors (dexmedetomidine or xylazine) and butorphanol during ovariectomy in standing donkeys. STUDY DESIGN Randomised, masked in vivo experiment. METHODS Thirteen female donkeys were sedated with butorphanol (0.05 mg/kg bwt followed by 0.05 mg/kg bwt/h) IV. Concomitantly, 6 of the 13 jennies were sedated with dexmedetomidine 2.5 mcg/kg bwt followed by 2.5 mcg/kg bwt/h (Dex-B group), while seven jennies were sedated with xylazine 0.5 mg/kg bwt followed by 0.5 mg/kg bwt/h (Xyl-B group). A line block of the left flank and an infiltration block around uterine ligament were performed with lidocaine. While the jennies underwent ovariectomies standing, sedation scores and head height above ground were assessed at 2 and 10 min after sedative boluses and every 10 min thereafter. If sedation was too light or too deep, the dose of dexmedetomidine or xylazine was increased or decreased by 25% of the original infusion rate, while butorphanol infusion rate was constant. Physiological parameters were measured. Normally distributed data were compared using the two-sample t test while repeatedly measured data were tested for differences between and within groups using repeated measures analysis of variance (ANOVA) by ranks followed by a Wilcoxon test with Tukey Honest Significant Difference for multiple testing. Statistical significance was set at p < 0.05. RESULTS Both Dex-B and Xyl-B caused moderate to marked sedation adequate for ovariectomy in donkeys. Evident sedation was absent by 60 min of termination of infusions. No adverse physiological effects were observed. MAIN LIMITATIONS Study on ovariectomy cases only, no pharmacokinetic profiling. CONCLUSIONS Dexmedetomidine or xylazine and butorphanol sedation is feasible for ovariectomy in standing donkeys.
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Affiliation(s)
- Tarisai B Dzikiti
- Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Jill K Maney
- Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Jemma Thorogood
- Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Lorenzo Segabinazzi
- Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Erik Peterson
- Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - Loveness N Dzikiti
- Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | - André Escobar
- Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
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10
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Ji L, She Q, Zhou P, Qin Y. Butorphanol inhibits ferroptosis to attenuate PC12 cell injury by blocking JNK/p38 signaling. Exp Ther Med 2024; 27:8. [PMID: 38223326 PMCID: PMC10785043 DOI: 10.3892/etm.2023.12295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/16/2023] [Indexed: 01/16/2024] Open
Abstract
Butorphanol is a synthetic selective opioid receptor antagonist that exhibits substantial analgesic effects. The present study aimed to explore the effects of butorphanol on a neurodegenerative disease cell model and to investigate its specific regulatory mechanism. Cell viability of PC12 cells was assessed using the Cell Counting Kit-8 assay. Oxidative stress levels were measured by the corresponding kits and western blotting of specific protein markers. Apoptosis was determined using the terminal-deoxynucleoitidyl transferase mediated nick end labeling assay and by western blotting. Western blotting was used to analyze the expression levels of c-Jun NH2-terminal kinase (JNK)/p38 signaling pathway-related proteins. Thiobarbituric acid-reactive substances and Fe+2 content were detected using the corresponding assay kits and the expression levels of ferroptosis-associated proteins were assessed by western blotting following the addition of the JNK activator anisomycin (ANI). Oxidative stress and apoptosis were examined with the aforementioned assays following the supplementation of ANI or the ferroptosis inducer erastin (ERA). It was revealed that butorphanol dose-dependently enhanced the viability and suppressed the oxidative stress and apoptosis of H2O2-treated PC12 cells. In addition, butorphanol blocked JNK/p38 signaling and hampered ferroptosis, while this effect was reversed by ANI. ANI or ERA reversed the effects of butorphanol on oxidative stress and apoptosis of H2O2-treated PC12 cells. In summary, butorphanol suppressed ferroptosis by blocking JNK/p38 signaling to impart inhibitory effects on oxidative stress and apoptosis in a neurodegenerative disease cell model.
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Affiliation(s)
- Lulu Ji
- Department of Anesthesiology, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, P.R. China
| | - Qing She
- Department of Anesthesiology, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, P.R. China
| | - Ping Zhou
- Department of Anesthesiology, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, P.R. China
| | - Yibin Qin
- Department of Anesthesiology, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, P.R. China
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11
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Jacques CN, Klaver RW, DePerno CS, Rockhill AP. Comparing the Efficacy of Two Immobilization Drug Combinations for the Chemical Restraint of Bobcats (Lynx rufus). J Wildl Dis 2024; 60:86-94. [PMID: 37937480 DOI: 10.7589/jwd-d-22-00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 08/17/2023] [Indexed: 11/09/2023]
Abstract
Chemical immobilization agents that provide rapid induction time, short duration of action, wide margin of safety, and postreversal recovery are important attributes to the handling process of immobilized animals. We evaluated differences in induction, recovery, and physiologic parameters in 23 (13 female, nine adults and four yearlings; 10 male, nine adults and one yearling) free-ranging bobcats (Lynx rufus) chemically immobilized with an intramuscular combination of ketamine (10 mg/kg) and xylazine (KX; 1.5 mg/kg; n=11) or a combination of butorphanol (0.8 mg/kg), azaperone (0.27 mg/kg), and medetomidine (BAM; 0.32 mg/kg; n=12). Induction parameters, time to first effect, hemoglobin oxygen saturation, and anesthesia between bobcats administered KX and BAM were similar. Pulse rate was significantly higher for KX than for BAM. Time to standing and full recovery after reversal were faster for bobcats administered BAM than KX. Six of 11 (55%) bobcats given KX were effectively immobilized with a single injection, and five required additional drugs to allow adequate time for processing. Of 12 bobcats given BAM, six (50%) were effectively immobilized with a single injection, three (25%) individuals were not completely immobilized and required additional doses to allow adequate time for processing, and three (25%) required additional doses after complete arousal during processing. We found that BAM provided reduced sedation and processing times (<30 min), whereas KX provided extended sedation and processing times beyond 30 min. We suggest that researchers increase initial BAM drug volumes for yearling and adult bobcats at time of processing and consider taking appropriate safety precautions when handling free-ranging bobcats.
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Affiliation(s)
- Christopher N Jacques
- Department of Biological Sciences, Western Illinois University, 1 University Circle, Macomb, Illinois 61455, USA
- Current address: Illinois Department of Natural Resources, 8542 North Lake Road, Lena, Illinois 61048, USA
| | - Robert W Klaver
- US Geological Survey, Iowa Cooperative Fish and Wildlife Research Unit, 342 Science II, Iowa State University, Ames, Iowa 50011, USA
| | - Christopher S DePerno
- Department of Forestry and Environmental Resources, Fisheries, Wildlife, and Conservation Biology Program, North Carolina State University, Raleigh, North Carolina 27695, USA
| | - Aimee P Rockhill
- Department of Geosciences and Natural Resources, Western Carolina University, 308 Stillwell Building, Cullowhee, North Carolina 28723, USA
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12
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Sheldon JD, Zhu X, Williamson R, Blair C. Butorphanol-Azaperone-Medetomidine Is as Safe and Effective as Nalbuphine-Azaperone-Medetomidine for Immobilization of Juvenile American Black Bears (Ursus americanus). J Wildl Dis 2024; 60:188-192. [PMID: 37909402 DOI: 10.7589/jwd-d-23-00043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 09/28/2023] [Indexed: 11/03/2023]
Abstract
Immobilization kits including butorphanol-azaperone-medetomidine (BAM) and nalbuphine-azaperone-medetomidine can provide effective, safe, and easy-to-use protocols in bears. Nalbuphine-azaperone-medetomidine is not commercially available but may be useful for wildlife agencies because it does not contain controlled substances. This study directly compared BAM to nalbuphine-azaperone-medetomidine immobilization in 10 juvenile healthy black bears (10 mo old; four females, six males) undergoing prerelease examinations after rehabilitation. Bears were immobilized via remote delivery of 1 mL of BAM (n=5) or nalbuphine-azaperone-medetomidine (n=5) intramuscularly in the shoulder during December (randomized, blinded trial). Bears were intubated, monitored with an electrocardiogram, pulse oximeter, capnograph, noninvasive blood pressure cuff, and rectal thermometer, and underwent physical examination, sample collection, morphometrics, and ear-tag placement. Induction, physiologic, and recovery parameters were recorded, including arterial blood gas analysis. The anesthetic agents were antagonized with atipamezole and naltrexone. There were no differences between protocols in induction or recovery times. There were no differences between protocols in heart rate, respiratory rate, temperature, oxygen saturation, end-tidal CO2, mean arterial pressure, or blood gas analysis or any differences between male and female bears in any parameters. Bears were hypertensive and normoxemic with low oxygen saturation via pulse oximeter, but all recovered smoothly and were released within 2 h of recovery. This study supports that nalbuphine-azaperone-medetomidine is clini-cally as safe and effective as BAM in American black bears.
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Affiliation(s)
- Julie D Sheldon
- Department of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, 2407 River Drive, Knoxville, Tennessee 37996, USA
| | - Xiaojuan Zhu
- Office of Information Technology, University of Tennessee, 2309 Kingston Pike, Knoxville, Tennessee 37919, USA
| | - Ryan Williamson
- Great Smoky Mountains National Park, National Park Services, 107 Park Headquarters Road, Gatlinburg, Tennessee 37738, USA
| | - Coy Blair
- Appalachian Bear Rescue, 121 Painted Trillium Way, Townsend, Tennessee 37882, USA
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13
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Johnson SR, Ellis CK, Wickham CK, Selleck MR, Gilbert AT. Comparison of Ketamine-Xylazine, Butorphanol-Azaperone-Medetomidine, and Nalbuphine-Medetomidine-Azaperone for Raccoon (Procyon lotor) Immobilization. J Wildl Dis 2024; 60:95-104. [PMID: 37924235 DOI: 10.7589/jwd-d-23-00060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 10/05/2023] [Indexed: 11/06/2023]
Abstract
Raccoons (Procyon lotor) are frequently handled using chemical immobilization in North America for management and research. In a controlled environment, we compared three drug combinations: ketamine-xylazine (KX), butorphanol-azaperone-medetomidine (BAM), and nalbuphine-medetomidine-azaperone (NalMed-A) for raccoon immobilization. In crossover comparisons, raccoons received a mean of the following: 8.66 mg/kg ketamine and 1.74 mg/kg xylazine (0.104 mL/kg KX); 0.464 mg/kg butorphanol, 0.155 mg/kg azaperone, and 0.185 mg/kg medetomidine (0.017 mL/kg BAM); and 0.800 mg/kg nalbuphine, 0.200 mg/kg azaperone, and 0.200 mg/kg medetomidine (0.020 mL/kg NalMed-A). Induction time was shortest with KX (mean±SE, 10.0±0.7 min) and longest with NalMed-A (13.0±1.3 min). A sampling procedure was completed on 89% (16/18), 72% (13/18), and 89% (16/18) of the raccoons administered KX, BAM, and NalMed-A, respectively. Reasons for incomplete sampling included inadequate immobilization (one KX and one NalMed-A), responsive behaviors (one each with KX, BAM, NalMed-A), or animal safety (four BAM). Mean recovery time for KX was 32.8±7.1 min without antagonizing and 28.6±5.2 min following delivery of an antagonist. Mean recovery time was 6.2±0.8 min for BAM and 5.1±0.5 min for NalMed-A after antagonizing. Only with KX were raccoons observed to recover without use of an antagonist. Supplemental oxygen was provided to 23% (3/13), 72% (13/18), and 71% (12/17) of raccoons immobilized with KX, BAM, and NalMed-A, respectively. Hypoxemia at <80% oxygen saturation occurred in 0% (0/17), 27% (4/15), and 6% (1/16) of the raccoons administered KX, BAM, and NalMed-A, respectively; all raccoons fully recovered from chemical immobilization. All combinations could be used for raccoon immobilization; however, the need for delivery of supplemental oxygen to a majority of raccoons immobilized with BAM and NalMed-A may limit broader use of these agents for certain field studies involving capture, sample, and release of free-ranging animals from a practical standpoint.
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Affiliation(s)
- Shylo R Johnson
- US Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, National Wildlife Research Center, 4101 LaPorte Avenue, Fort Collins, Colorado 80521, USA
| | - Christine K Ellis
- US Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, National Wildlife Research Center, 4101 LaPorte Avenue, Fort Collins, Colorado 80521, USA
- Current address: US Department of Agriculture, Animal and Plant Health Inspection Service, Veterinary Services, 2150 Centre Avenue, Building B, Fort Collins, Colorado 80526, USA
| | - Chad K Wickham
- US Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, National Wildlife Research Center, 4101 LaPorte Avenue, Fort Collins, Colorado 80521, USA
- Current address: US Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, 3375 Koapaka Street, Suite H-420, Honolulu, Hawaii 96819, USA
| | - Molly R Selleck
- US Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, National Wildlife Research Center, 4101 LaPorte Avenue, Fort Collins, Colorado 80521, USA
| | - Amy T Gilbert
- US Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, National Wildlife Research Center, 4101 LaPorte Avenue, Fort Collins, Colorado 80521, USA
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14
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Xu X, Tao Y, Yang Y, Zhang J, Sun M. Application of Butorphanol versus Sufentanil in Multimode Analgesia via Patient Controlled Intravenous Analgesia After Hepatobiliary Surgery: A Retrospective Cohort Study. Drug Des Devel Ther 2023; 17:3757-3766. [PMID: 38144418 PMCID: PMC10749102 DOI: 10.2147/dddt.s433136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/13/2023] [Indexed: 12/26/2023] Open
Abstract
Purpose We investigate the efficacy and safety of butorphanol in multimodal analgesia combined with dexmedetomidine and ketorolac via patient-controlled intravenous analgesia (PCIA) after hepatobiliary surgery, as compared with sufentanil. Patients and Methods Postoperative follow-up data of hepatobiliary surgery patients in Henan Provincial People's Hospital from March 2018 to June 2021 were collected retrospectively and divided into butorphanol group (group B) or sufentanil group (group S) according to the postoperative intravenous controlled analgesia scheme. The baseline characteristics and surgical information of the two groups were matched through propensity score matching (PSM). Results A total of 3437 patients were screened, and PSM yielded 1816 patients after matching, including 908 in the butorphanol group and 908 in the sufentanil group. Compared with group S, the incidence of moderate-to-severe pain on the first postoperative day and the second postoperative day was lower in group B during rest (3.2% vs 10.9%, P<0.001; 1.2% vs 4.6%, P<0.001), and during movement (7.0% vs 18.9%, P<0.001; 2.6% vs 8.7%, P<0.001). Patients receiving butorphanol had a lower morphine consumption (50mg vs 120mg, P<0.001). The bolus attempts of an analgesic pump in group B were significantly lower than in group S (1 vs 2, P<0.001). Postoperative hospital length of stay was shortened in group B (11d vs 12d, P=0.017). The occurrence of postoperative vomiting was lower in group B (1.4% vs 3.0%, P=0.025) than in group S. However, more patients in group B experienced dizziness (0.9% vs 0.1%, P=0.019). Conclusion Compared with sufentanil, the application of butorphanol in multimodal analgesia combined with dexmedetomidine and ketorolac via PCIA ameliorated postoperative pain after hepatobiliary surgery, with reduced opioid consumption and shorter postoperative hospital length of stay.
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Affiliation(s)
- Xiaodong Xu
- Department of Anesthesiology and Perioperative Medicine, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, 450003, People’s Republic of China
| | - Yuan Tao
- Department of Anesthesiology and Perioperative Medicine, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, 450003, People’s Republic of China
| | - Yitian Yang
- Department of Anesthesiology and Perioperative Medicine, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, 450003, People’s Republic of China
| | - Jiaqiang Zhang
- Department of Anesthesiology and Perioperative Medicine, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, 450003, People’s Republic of China
| | - Mingyang Sun
- Department of Anesthesiology and Perioperative Medicine, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou, 450003, People’s Republic of China
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15
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Wan JX, Li XC, Zeng SS, Li YQ, Wang FJ. Comparison of intravenous butorphanol vs. tramadol for post-spinal anesthesia shivering: a meta-analysis and systematic review. Front Med (Lausanne) 2023; 10:1271664. [PMID: 38116041 PMCID: PMC10729005 DOI: 10.3389/fmed.2023.1271664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/13/2023] [Indexed: 12/21/2023] Open
Abstract
Background Patients often experience shivering after spinal anesthesia. In recent years, more and more studies have compared the efficacy and side effects of intravenous butorphanol and tramadol in the treatment of shivering after spinal anesthesia. Therefore, we conducted a MATE analysis and systematic review to compare the efficacy and side effects of butorphanol vs. tramadol in the treatment of shivering after spinal anesthesia. Methods PubMed, Cochrane Library, and Embase databases were searched for randomized controlled trials (RCTs) from inception to 30 December 2022, comparing the effects of butorphanol vs. tramadol for the control of shivering after spinal anesthesia. Data assessment and collection were analyzed using the Review Manager 5.4 software. Results Five randomized controlled trials involving 302 adult patients were included in this meta-analysis. The results showed that butorphanol has a shorter time to cease shivering (standardized mean difference (SMD) = -0.53; 95% confidence interval (CI) [-0.89, -0.17], P = 0.004, I2 = 0%), a higher rate of cessation of shivering within 1 min after administering the study drugs (relative risk (RR), 1.69; 95% CI [1.15,2.48], P = 0.008, I2 = 0%), and higher incidences of sedation (RR, 2.98; 95% CI [2.11, 4.21], P <0.00001, I2 = 0%), compared with tramadol. Conclusion In the treatment of shivering after spinal anesthesia, butorphanol has a shorter onset time and a higher rate of cessation of shivering within 1 min after the study drugs were administered than tramadol. Therefore, butorphanol is superior to tramadol in the treatment of shivering after spinal anesthesia.
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Affiliation(s)
| | | | | | | | - Fang-Jun Wang
- Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
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16
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Guo Y, Ding X, Wang S, Wang F, Zheng Z, Zou L. Analgesic Effect of Esketamine Combined with Tramadol for Patient-Controlled Intravenous Analgesia After Cesarean Section: A Randomized Controlled Trial. J Pain Res 2023; 16:3519-3528. [PMID: 37881234 PMCID: PMC10595208 DOI: 10.2147/jpr.s427702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/26/2023] [Indexed: 10/27/2023] Open
Abstract
Purpose High rate of cesarean section (CS) bring challenges to analgesic management after CS. Previous studies state that adjuvant treatment with a low dose of esketamine intraoperatively could reduce postoperative pain and opioid consumption, and even prevent postpartum depression. However, few researches involve in patient-controlled intravenous analgesia (PCIA) with esketamine after CS. In this trial, we explored a new combination of esketamine with tramadol for PCIA after CS with the aim to provide a better analgesic regimen for use in the clinic. Patients and Methods 170 puerperae undergoing CS were recruited for this trial and randomly assigned into 2 groups (1:1): The control group received a formula of PCIA with butorphanol 0.1mg/kg and tramadol 400mg postoperatively, while the intervention group received a formula of PCIA with esketamine 1mg/kg and tramadol 400mg. The primary outcome was the mean numerical rating scale (NRS) scores at rest, sitting, and uterine contraction at 6 hours postoperatively. The second outcomes included the mean NRS scores at rest, sitting, and uterine contraction at 12, 24, and 48 hours postoperatively. The incidence of adverse events, postoperative sedation, postoperative sleep quality, maternal satisfaction regarding postoperative analgesia and the Edinburgh postnatal depression scale (EPDS) score were also be evaluated. Results The mean (SD) of the mean NRS scores at rest, sitting, and during uterine contraction at 6 hours postoperatively were 4.8 (0.7) points in the intervention group and 5.3 (0.5) points in the control group. The estimated mean difference between the two groups at 6 hours postoperatively was -0.5 points (95% confidence interval [CI], -0.7 to -0.3; P < 0.001). Compared with the control group, the patients in the intervention group had a significantly lower mean pain intensity at 12 and 24 hours postoperatively (-0.5 points [95% CI, -0.6 to -0.3]; P < 0.001 and -0.2 points [95% CI, -0.4 to 0]; P = 0.019 respectively). Otherwise, differences at 48 hours after surgery between the two groups were nonsignificant (0 points [95% CI, -0.2 to 0.2]; P = 0.802). The incidence of adverse events in the intervention group (11.8%) was significantly lower than in the control group (24.7%) (ratio difference -12.9, [95% CI, -24.3 to -1.5]; P = 0.029). No difference was found in postoperative sleep quality (P = 0.765), analgesic satisfaction (P= 0.818) and EPDS scores (P = 0.154) between the two groups. Conclusion In this trial, among patients undergoing CS, esketamine combined with tramadol by PCIA improved pain intensity 6 hours postoperatively compared with butorphanol combined with tramadol.
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Affiliation(s)
- Yihui Guo
- Department of Anesthesiology, The People’s Hospital of Pizhou, Xuzhou, Jiangsu, People’s Republic of China
- Department of Anesthesiology, Pizhou Hospital Affiliated to Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
| | - Xue Ding
- Department of Anesthesiology, The People’s Hospital of Pizhou, Xuzhou, Jiangsu, People’s Republic of China
- Department of Anesthesiology, Pizhou Hospital Affiliated to Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
| | - Sheng Wang
- Department of Anesthesiology, The People’s Hospital of Pizhou, Xuzhou, Jiangsu, People’s Republic of China
- Department of Anesthesiology, Pizhou Hospital Affiliated to Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
| | - Fei Wang
- Department of Anesthesiology, The People’s Hospital of Pizhou, Xuzhou, Jiangsu, People’s Republic of China
- Department of Anesthesiology, Pizhou Hospital Affiliated to Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
| | - Zhongyi Zheng
- Department of Anesthesiology, The People’s Hospital of Pizhou, Xuzhou, Jiangsu, People’s Republic of China
- Department of Anesthesiology, Pizhou Hospital Affiliated to Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
| | - Lifeng Zou
- Department of Anesthesiology, The People’s Hospital of Pizhou, Xuzhou, Jiangsu, People’s Republic of China
- Department of Anesthesiology, Pizhou Hospital Affiliated to Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
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Liu S, Liu S, Gu D, Zhao X, Zhang H, Deng C, Gu Y. Exploring the Effect of Pain Sensitive Questionnaire on Guiding Intravenous Analgesia After Cesarean Section: A Randomised Double Blind Controlled Trial. J Pain Res 2023; 16:3185-3196. [PMID: 37744183 PMCID: PMC10516306 DOI: 10.2147/jpr.s412131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023] Open
Abstract
Objective This study investigates the effect of the Pain Sensitivity Questionnaire (PSQ) in guiding patient controlled intravenous analgesia (PCIA) on postoperative analgesia in women undergoing cesarean section. Methods A total of 160 women who were to undergo a cesarean section under combined spinal and epidural anaesthesia were included in this study. Women with a preoperative PSQ <4 were randomly divided into a low pain-sensitive control group (LC group), and a low pain-sensitive observation group (LO group), and women with preoperative PSQ >6 were randomly divided into a high pain-sensitive control group (HC group) and a high pain-sensitive observation group (HO group). After the surgery, patients received the pump butorphanol concentration was 3.5 µg·kg-1·h-1 in the LC and HC groups, 3.0 µg·kg-1·h-1 in the LO group and 4.0 µg·kg-1·h-1 in the HO group.To compare the analgesic effects of postoperative PCIA and postoperative recovery in women. Results Wound pain and uterine contraction pain VAS scores at rest and activity were significantly lower in the LC group than in the LO group at 4 and 8 h postoperatively (P<0.05). Similarly, wound pain and uterine contraction pain VAS scores at rest and activity were significantly lower in the HO group than in the HC group at 8, 12, and 24 h postoperatively (P<0.05). The Ramsay scores were significantly higher in the LC than in the LO groups at 4, 8, 12, 24, and 48 h postoperatively (P<0.05), but there was no statistically significant difference between the Ramsay scores in the HC group and the HO group. There was no statistical difference in any of the post-operative recoveries (P>0.05). Conclusion Compared to the weight-based postoperative PCIA, the PSQ-based postoperative PCIA has better analgesic effects and can improve maternal satisfaction with postoperative analgesia.
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Affiliation(s)
- Shuxin Liu
- Department of Anesthesiology, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China
| | - Siqi Liu
- Department of Anesthesiology, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China
| | - Dengfeng Gu
- Department of Anesthesiology, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China
| | - Xiaona Zhao
- Department of Obstetrics, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China
| | - Hong Zhang
- Department of Anesthesiology, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China
| | - Chao Deng
- Department of Anesthesiology, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China
| | - Yajuan Gu
- Department of Obstetrics, First Affiliated Hospital, Shihezi University, Shihezi, People’s Republic of China
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Fernández Castañer J, Quirós Carmona S, Martínez Bernal C, Morgaz Rodríguez J, Navarrete Calvo R, Granados Machuca MDM. Sedation Quality and Cardiorespiratory, Echocardiographic, Radiographic and Electrocardiographic Effects of Intramuscular Alfaxalone and Butorphanol in Spanish Greyhound Dogs. Animals (Basel) 2023; 13:2937. [PMID: 37760337 PMCID: PMC10525580 DOI: 10.3390/ani13182937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/10/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
The quality of sedation and changes in cardiorespiratory variables after the intramuscular administration of alfaxalone and butorphanol in Spanish greyhound dogs were evaluated. Twenty-one adult dogs were included. The dogs received alfaxalone (2 mg/kg) and butorphanol (0.2 mg/kg) intramuscularly. Sedation scoring, cardiorespiratory parameters (including blood gas analysis), echocardiography, thoracic radiography and electrocardiography were performed before sedation and 30 min after drug administration. Moderate sedation was observed, and side effects, such as tremors, nystagmus and auditory hyperesthesia, were noticed. Statistically significant changes in heart rate, invasive blood pressure, pH, arterial saturation of O2 and partial pressure of O2 and CO2 were found. Echocardiographic variables, including end-diastolic volume, left ventricular diameter in diastole, aortic and pulmonic flow, diastolic transmitral flow and left atrial/aortic ratio, and electrocardiography parameters, including PQ interval and QT interval, showed statistically significant changes. In conclusion, the intramuscular administration of alfaxalone and butorphanol to healthy dogs produced moderate sedation with mild cardiorespiratory, echocardiographic and electrocardiographic changes, without alterations in cardiac size on radiographic images.
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Affiliation(s)
- Julio Fernández Castañer
- Veterinary Teaching Hospital, School of Veterinary Medicine, University of Córdoba, 14014 Córdoba, Spain; (J.F.C.); (C.M.B.)
| | - Setefilla Quirós Carmona
- Veterinary Teaching Hospital, School of Veterinary Medicine, University of Córdoba, 14014 Córdoba, Spain; (J.F.C.); (C.M.B.)
| | - Carmen Martínez Bernal
- Veterinary Teaching Hospital, School of Veterinary Medicine, University of Córdoba, 14014 Córdoba, Spain; (J.F.C.); (C.M.B.)
| | - Juan Morgaz Rodríguez
- Department of Animal Medicine and Surgery, School of Veterinary Medicine, University of Córdoba, 14014 Córdoba, Spain; (J.M.R.); (R.N.C.); (M.d.M.G.M.)
| | - Rocío Navarrete Calvo
- Department of Animal Medicine and Surgery, School of Veterinary Medicine, University of Córdoba, 14014 Córdoba, Spain; (J.M.R.); (R.N.C.); (M.d.M.G.M.)
| | - María del Mar Granados Machuca
- Department of Animal Medicine and Surgery, School of Veterinary Medicine, University of Córdoba, 14014 Córdoba, Spain; (J.M.R.); (R.N.C.); (M.d.M.G.M.)
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Rautela RS, Gulabani M, Kumar P, Salhotra R, Mohta M, Verma K. Comparative assessment of dexmedetomidine and butorphanol for attenuation of etomidate-induced myoclonus: A double-blind, randomised controlled study. Indian J Anaesth 2023; 67:815-820. [PMID: 37829775 PMCID: PMC10566664 DOI: 10.4103/ija.ija_414_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/17/2023] [Accepted: 08/01/2023] [Indexed: 10/14/2023] Open
Abstract
Background and Aims Etomidate is a popular induction agent, but its use is associated with myoclonus in 50%-80% of non-premedicated patients. This study aims to compare dexmedetomidine and butorphanol for their relative efficacy in preventing etomidate-induced myoclonus. Methods This randomised study was conducted after obtaining institutional ethical committee clearance and written informed consent from sixty American Society of Anesthesiologists (ASA) I or II consenting patients between 18 and 60 years of age of either sex who had been scheduled for elective surgeries under general anaesthesia. Patients were randomly allocated to dexmedetomidine 0.5 μg/kg (Group D) or butorphanol 0.015 mg/kg (Group B). Both the drugs were given as an infusion over a period of 10 min before induction of anaesthesia. The primary outcome was the incidence of myoclonic movements after etomidate, and the secondary outcomes were the severity of myoclonus, changes in the haemodynamic parameters and incidence of airway complications. Normally distributed variables were compared using Student's t-test, and non-normally distributed variables were compared using Mann-Whitney U test. Qualitative data were analysed using Chi-square/Fisher's exact test. A P-value <0.05 was considered significant. Results The incidence of etomidate-induced myoclonus was significantly higher in group B compared to group D (P = 0.035). The median (interquartile range [IQR]) of myoclonus grade in patients of group D was 0.00 (0.00-3.00), and group B was 2.50 (0.00-3.00) (P = 0.035). Haemodynamics and airway-related complications were comparable between the groups. Conclusion Dexmedetomidine was more effective than butorphanol in preventing etomidate-induced myoclonus.
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Affiliation(s)
- Rajesh S. Rautela
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Michell Gulabani
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Pramod Kumar
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Rashmi Salhotra
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Medha Mohta
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Kshitiz Verma
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Delhi, India
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Donaldson AC, Buss PE, Fuller A, Meyer LCR. Effects of three immobilizing drug combinations on ventilation, gas exchange and metabolism in free-living African lions ( Panthera leo). Conserv Physiol 2023; 11:coad059. [PMID: 37575612 PMCID: PMC10416691 DOI: 10.1093/conphys/coad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/26/2023] [Accepted: 07/23/2023] [Indexed: 08/15/2023]
Abstract
Free-living lions (12 per group) were immobilized with tiletamine-zolazepam-medetomidine (TZM), ketamine-medetomidine (KM), or ketamine-butorphanol-medetomidine (KBM). During immobilization, respiratory, blood gas and acid-base variables were monitored for 30 minutes. Respiratory rates were within expected ranges and remained constant throughout the immobilizations. Ventilation increased in lions over the immobilization period from 27.2 ± 9.5 to 35.1 ± 25.4 L/min (TZM), 26.1 ± 14.3 to 28.4 ± 18.4 L/min (KM) and 23.2 ± 10.8 to 26.7 ± 14.2 L/min (KBM). Tidal volume increased over the immobilization period from 1800 ± 710 to 2380 ± 1930 mL/breath (TZM), 1580 ± 470 to 1640 ± 500 mL/breath (KM) and 1600 ± 730 to 1820 ± 880 mL/breath (KBM). Carbon dioxide production was initially lower in KBM (0.4 ± 0.2 L/min) than in TZM (0.5 ± 0.2 L/min) lions but increased over time in all groups. Oxygen consumption was 0.6 ± 0.2 L/min (TZM), 0.5 ± 0.2 L/min (KM) and 0.5 ± 0.2 L/min (KBM) and remained constant throughout the immobilization period. Initially the partial pressure of arterial oxygen was lower in KBM (74.0 ± 7.8 mmHg) than in TZM (78.5 ± 4.7 mmHg) lions, but increased to within expected range in all groups over time. The partial pressure of arterial carbon dioxide was higher throughout the immobilizations in KBM (34.5 ± 4.2 mmHg) than in TZM (32.6 ± 2.2 mmHg) and KM (32.6 ± 3.8 mmHg) lions. Alveolar-arterial gradients were initially elevated, but decreased over time for all groups, although in KM lions it remained elevated (26.9 ± 10.4 mmHg) above the expected normal. Overall, all three drug combinations caused minor respiratory and metabolic side-effects in the immobilized lions. However, initially hypoxaemia occurred as the drug combinations, and possibly the stress induced by the immobilization procedure, hinder alveoli oxygen gas exchange.
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Affiliation(s)
- Ashleigh Claire Donaldson
- Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Onderstepoort, Pretoria, Gauteng, South Africa, 0110
- Centre for Veterinary Wildlife Research, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Onderstepoort, Pretoria, Gauteng, South Africa, 0110
- Center for Zoo and Wild Animal Health, Copenhagen Zoo, Frederiksberg, Denmark, 2000
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, York Road, Parktown, Johannesburg, Gauteng, South Africa, 2193
| | - Peter Erik Buss
- Centre for Veterinary Wildlife Research, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Onderstepoort, Pretoria, Gauteng, South Africa, 0110
- Veterinary Wildlife Services, South African National Parks, Kruger National Park, Skukuza, Mpumalanga, South Africa, 1350
- Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Onderstepoort, Pretoria, Gauteng, South Africa, 0110
| | - Andrea Fuller
- Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Onderstepoort, Pretoria, Gauteng, South Africa, 0110
- Centre for Veterinary Wildlife Research, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Onderstepoort, Pretoria, Gauteng, South Africa, 0110
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, York Road, Parktown, Johannesburg, Gauteng, South Africa, 2193
| | - Leith Carl Rodney Meyer
- Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Onderstepoort, Pretoria, Gauteng, South Africa, 0110
- Centre for Veterinary Wildlife Research, Faculty of Veterinary Science, University of Pretoria, Soutpan Road, Onderstepoort, Pretoria, Gauteng, South Africa, 0110
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, York Road, Parktown, Johannesburg, Gauteng, South Africa, 2193
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Georgiou SG, Sideri AI, Anagnostou TL, Gouletsou PG, Tsioli VG, Galatos AD. Effect of Classical Music on Depth of Sedation and Induction Propofol Requirements in Dogs. Vet Sci 2023; 10:433. [PMID: 37505838 PMCID: PMC10383266 DOI: 10.3390/vetsci10070433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/14/2023] [Accepted: 06/29/2023] [Indexed: 07/29/2023] Open
Abstract
The main objective of this prospective, randomized, blind, cross-over experimental study was to evaluate the effect of classical music on the depth of sedation and propofol requirements for the induction of anaesthesia in dogs. Twenty dogs were involved, and each was subjected to three different treatments with a 3-month gap: Chopin music, Mozart music, and no music, via loudspeakers. The dogs were premedicated with acepromazine and butorphanol by intramuscular injection, and anaesthesia was induced using propofol intravenously. To compare the depth of sedation and propofol requirements for the induction of anaesthesia among the different treatments, we utilized non-parametric tests (Kruskal-Wallis test) for the depth of sedation due to a slight deviation from the normal distribution and parametric (ANOVA) for propofol requirements. When exposed to music (Chopin or Mozart), dogs exhibited deeper sedation and required less propofol for their intubation compared to the no-music treatment (p < 0.05). Exposure to classical music had a positive impact on the level of sedation, and more profound central nervous system depression seemed to contribute to approximately 20% lower propofol dose requirements for tracheal intubation. Therefore, classical music during the preoperative period appeared to exert a beneficial effect, at least when applying the specific pre-anaesthetic medications used in the present study.
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Affiliation(s)
- Stefanos G Georgiou
- Clinic of Surgery, Faculty of Veterinary Science, School of Health Sciences, University of Thessaly, 43100 Karditsa, Greece
| | - Aikaterini I Sideri
- Clinic of Surgery, Faculty of Veterinary Science, School of Health Sciences, University of Thessaly, 43100 Karditsa, Greece
| | - Tilemachos L Anagnostou
- Anaesthesia and Intensive Care Unit, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece
| | - Pagona G Gouletsou
- Clinic of Obstetrics and Reproduction, Faculty of Veterinary Science, School of Health Sciences, University of Thessaly, 43100 Karditsa, Greece
| | - Vassiliki G Tsioli
- Clinic of Surgery, Faculty of Veterinary Science, School of Health Sciences, University of Thessaly, 43100 Karditsa, Greece
| | - Apostolos D Galatos
- Clinic of Surgery, Faculty of Veterinary Science, School of Health Sciences, University of Thessaly, 43100 Karditsa, Greece
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Mauthe von Degerfeld M, Serpieri M, Bonaffini G, Ottino C, Quaranta G. Intranasal Atomization of Ketamine, Medetomidine and Butorphanol in Pet Rabbits Using a Mucosal Atomization Device. Animals (Basel) 2023; 13:2076. [PMID: 37443874 DOI: 10.3390/ani13132076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
A non-invasive method of drug delivery, intranasal atomization, has shown positive results in human medicine and in some animal species. The objective of this study was to evaluate the effects of intranasal atomization, compared to intramuscular administration, of a mix of anesthetic drugs in pet rabbits. In total, 104 mixed-breed pet rabbits, undergoing various types of surgery, received a combination of ketamine, medetomidine, and butorphanol (20, 0.4, and 0.2 mg/kg) by intranasal atomization using a Mucosal Atomization Device (Group MAD) or intramuscular administration (Group IM). When required, isoflurane was dispensed through a face mask. At the end of the procedures, atipamezole was administered using the same routes in the respective Groups. There were no differences in time to loss of righting reflex between the groups, while differences were found for the need for isoflurane (higher in Group MAD) and recovery time, occurring earlier in Group MAD. The results suggest that intranasal atomization of a combination of ketamine, medetomidine, and butorphanol produces a lighter depth of anesthesia in pet rabbits, compared to intramuscular administration. Intranasal atomization can be performed to administer sedative and anesthetic drugs, avoiding the algic stimulus related to the intramuscular inoculation of drugs.
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Affiliation(s)
- Mitzy Mauthe von Degerfeld
- Centro Animali Non Convenzionali, Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Largo Paolo Braccini 2, 10095 Grugliasco, Italy
| | - Matteo Serpieri
- Centro Animali Non Convenzionali, Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Largo Paolo Braccini 2, 10095 Grugliasco, Italy
| | - Giuseppe Bonaffini
- Centro Animali Non Convenzionali, Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Largo Paolo Braccini 2, 10095 Grugliasco, Italy
| | - Chiara Ottino
- Centro Animali Non Convenzionali, Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Largo Paolo Braccini 2, 10095 Grugliasco, Italy
| | - Giuseppe Quaranta
- Centro Animali Non Convenzionali, Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Largo Paolo Braccini 2, 10095 Grugliasco, Italy
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Maidanskaia EG, Mirra A, Marchionatti E, Levionnois OL, Spadavecchia C. Antinociceptive, Sedative and Excitatory Effects of Intravenous Butorphanol Administered Alone or in Combination with Detomidine in Calves: A Prospective, Randomized, Blinded Cross-Over Study. Animals (Basel) 2023; 13:1943. [PMID: 37370454 DOI: 10.3390/ani13121943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/23/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Background: The diagnostic and therapeutic procedures performed under sedation or general anesthesia in bovines are numerous. The analgesic drugs that can be legally used are few, making perioperative analgesia challenging. (2) Methods: Calves were administered butorphanol 0.1 mg kg-1 alone (SB) or combined with 0.02 mg kg-1 of a detomidine (DB) IV. The antinociceptive effect (trigeminocervical reflex threshold (TCRt)), as well as the behavioral (sedation and excitation) and physiological (heart and respiratory rate) changes were investigated. Five time windows were defined: BL (30 min pre-injection), T1 (0-30 min post-injection (PI)), T2 (31-60 min PI), T3 (61-90 min PI) and T4 (91-120 min PI). (3) Results: Both groups had a significative increase in TCRt at T1-T4 compared to the BL. The TCRt was significatively higher in DB than in SB at T1, T2 and T4. Heart rate decreased significatively in DB compared to that in BL. Calves were significantly more sedated in the DB group, and significantly more excited in the SB group compared to the BL. (4) Conclusions: Butorphanol alone has a statistically significant antinociceptive effect, but it elicits marked excitation, limiting its clinical applicability under this dosing regimen. The co-administration of detomidine eliminated the excitatory effect and induced consistent sedation and a significantly more pronounced antinociceptive effect.
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Affiliation(s)
- Ekaterina Gámez Maidanskaia
- Anesthesiology and Pain Therapy Division, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland
| | - Alessandro Mirra
- Anesthesiology and Pain Therapy Division, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland
| | - Emma Marchionatti
- Clinic for Ruminants, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland
| | - Olivier Louis Levionnois
- Anesthesiology and Pain Therapy Division, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland
| | - Claudia Spadavecchia
- Anesthesiology and Pain Therapy Division, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland
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Okur S, Yanmaz LE, Golgeli A, Senocak MG, Ersoz U, Orhun OT, Gumurcinler B. Sedative and cardiopulmonary effects of intranasal butorphanol with midazolam or dexmedetomidine in New Zealand white rabbits. Vet Rec 2023:e2999. [PMID: 37183183 DOI: 10.1002/vetr.2999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/07/2023] [Accepted: 04/18/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND This study aimed to compare the sedative and cardiopulmonary effects of intranasal (IN) administration of dexmedetomidine-butorphanol (DB) and midazolam-butorphanol (MB) combinations in New Zealand white rabbits. METHODS Eight New Zealand white rabbits were sedated by IN administration of a combination of 0.1 mg/kg dexmedetomidine and 0.4 mg/kg butorphanol (DB treatment) and 2 mg/kg midazolam and 0.4 mg/kg butorphanol (MB treatment). The electrocardiogram, pulse rate (PR), respiratory frequency (fR ), arterial haemoglobin oxygen saturation (SpO2 ), fraction of expired carbon dioxide (EtCO2 ), rectal temperature (RT), noninvasive mean arterial pressure (MAP), noninvasive systolic arterial pressure (SAP) and diastolic arterial pressure (DAP) were recorded. The onset of sedation, duration of sedation and sedation score (SS) were also noted. RESULTS There were no significant differences in the EtCO2 , RT, MAP, SAP and DAP measurements between treatments. The PR significantly decreased in DB compared with MB over time (p = 0.001). Compared with baseline, SpO2 decreased over time in both treatments. The SS was significantly elevated over time in DB compared with MB (p = 0.002). LIMITATIONS No pharmacokinetic information was available for either treatment, so the findings should be interpreted cautiously. CONCLUSIONS IN DB provides more effective sedation than MB, but cardiopulmonary impairment was observed in both treatments.
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Affiliation(s)
- Sitkican Okur
- Department of Surgery, Faculty of Veterinary Medicine, Atatürk University, Erzurum, Turkey
| | - Latif Emrah Yanmaz
- Department of Surgery, Faculty of Veterinary Medicine, Burdur Mehmet Akif Ersoy University, Burdur, Turkey
| | - Ayse Golgeli
- Department of Surgery, Faculty of Veterinary Medicine, Atatürk University, Erzurum, Turkey
| | - Mumin Gokhan Senocak
- Department of Surgery, Faculty of Veterinary Medicine, Atatürk University, Erzurum, Turkey
| | - Ugur Ersoz
- Department of Surgery, Faculty of Veterinary Medicine, Atatürk University, Erzurum, Turkey
| | - Omer Tarik Orhun
- Department of Surgery, Faculty of Veterinary Medicine, Atatürk University, Erzurum, Turkey
| | - Burak Gumurcinler
- Department of Surgery, Faculty of Veterinary Medicine, Atatürk University, Erzurum, Turkey
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Schöndorfer B, Vogl C, Eberspächer-Schweda E. Sedative effects and changes in cardiac rhythm with intravenous premedication of medetomidine, butorphanol and ketamine in dogs. Vet Anaesth Analg 2023; 50:136-145. [PMID: 36754695 DOI: 10.1016/j.vaa.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 11/15/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To determine the sedative effects and characteristics of cardiac rhythm with intravenous (IV) premedication of medetomidine, butorphanol and ketamine in dogs. STUDY DESIGN Prospective, blinded, randomized clinical trial. ANIMALS A total of 116 client-owned healthy dogs undergoing elective surgery. METHODS Dogs were randomly allocated one of four groups: group M, medetomidine 5 μg kg-1; group B, butorphanol 0.2 mg kg-1; group MB, medetomidine 5 μg kg-1 and butorphanol 0.2 mg kg-1; or group MBK, medetomidine 5 μg kg-1, butorphanol 0.2 mg kg-1 and ketamine 1 mg kg-1 IV. Sedation was assessed using a numerical descriptive scale. Heart rate (HR) and rhythm were monitored; propofol dose (mg kg-1 IV) to allow orotracheal intubation was documented. Data were analysed using anova, accounting for multiple testing with the Tukey honest significant difference test. RESULTS Sedation scores varied significantly between all groups at all time points, except between groups MB and MBK at four time points. HR decreased in all groups: most in groups M and MB, least in group B. HR was initially higher in group MBK than in groups M and MB. Arrhythmias occurred in all groups: group B showed second-degree atrioventricular blocks occasionally, all other groups showed additionally ventricular escape complexes and bundle branch blocks. Dose of propofol required for orotracheal intubation was significantly higher in group B (5.0 ± 2.0 mg kg-1) than in group M (2.6 ± 0.6 mg kg-1). Although no difference could be demonstrated between groups MB (1.4 ± 0.6 mg kg-1) and MBK (0.9 ± 0.8 mg kg-1), both groups required significantly less propofol than group M. CONCLUSION AND CLINICAL RELEVANCE Medetomidine-based premedication protocols led to various bradyarrhythmias. Addition of subanaesthetic doses of ketamine to medetomidine-based protocols resulted in higher HRs, fewer bradyarrhythmias and fewer animals that required propofol for intubation without causing side effects in healthy dogs.
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Affiliation(s)
- Benedikt Schöndorfer
- Clinic of Anaesthesiology and Perioperative Intensive Care, Department of Small Animals and Horses, Veterinary University Vienna, Vienna, Austria
| | - Claus Vogl
- Institute of Animal Breeding and Genetics, Veterinary University Vienna, Vienna, Austria
| | - Eva Eberspächer-Schweda
- Clinic of Anaesthesiology and Perioperative Intensive Care, Department of Small Animals and Horses, Veterinary University Vienna, Vienna, Austria.
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Marzok M, Almubarak AI, Kandeel M, El-Deeb W, Babiker H, Fathi El-Hawari S. A randomized crossover study of the effect of butorphanol-lidocaine and tramadol-lidocaine on sevoflurane's minimum alveolar concentration in dogs. Front Vet Sci 2023; 9:1057580. [PMID: 36713864 PMCID: PMC9878290 DOI: 10.3389/fvets.2022.1057580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/19/2022] [Indexed: 01/15/2023] Open
Abstract
Inhalational anesthesia is routinely used in small animal surgery. Selecting a suitable drug combination is vital since it may negatively affect the patient's physiological condition. We conducted this study to examine the sparing effect of butorphanol-lidocaine (BUT-LID) and tramadol-lidocaine (TRM-LID) on sevoflurane's minimum alveolar concentration (MAC) in 10 healthy mongrel dogs aged 1-2 years and weighing 11.5 ± 0.8 kg (mean ± SD). Sevoflurane's MAC was measured on three separate occasions. The three dog treatment groups were control (CONT) anesthetized only with sevoflurane, TRM-LID (TRM, i.v. 1.5 mg kg-1, then 1.3 mg kg-1 h-1 and LID, i.v. 2 mg kg-1, then 3 mg kg-1 h-1) or BUT-LID treatment (BUT, i.v. 0.1 mg kg-1 then 0.2 mg kg-1 h-1 and LID, i.v. 2 mg kg-1, then 3 mg kg-1 h-1). We hypothesized that both TRM-LID and BUT-LID would result in a significant MAC sparing effect in healthy dogs. The TRM-LID treatment resulted in a non-significant MAC reduction. MAC was lowered significantly in the BUT-LID group (p = 0.009). The sevoflurane MAC-sparing effects of TRM-LID and BUT-LID treatments were 7.05 ± 22.20 and 19.90 ± 5.91%, respectively, a difference that was not statistically significant (p = 0.13). Bradycardia was observed in the TRM-LID (p < 0.001) treatment. The esophageal temperature was significantly higher for the TRM-LID treatment than the CONT (p < 0.001) treatment. No statistically significant changes were detected between the three groups in f R, Pe'CO2, and MABP. In conclusion, there was a significant sparing effect after adding BUT-LID co-infusion than the control group. No sparing effect was noticed when adding TRM-LID co-infusion. However, no difference in the MAC sparing percentages between the TRM-LID and BUT-LID treatments. The BUT-LID co-infusion resulted in a sevoflurane MAC reduction superior to TRM-LID in addition to minimal cardiorespiratory changes. Both BUT-LID and TRM-LID may be clinically beneficial to dogs during anesthesia. However, BUT-LID produced higher sparing effect and reduction of sevoflurane MAC value.
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Affiliation(s)
- Mohamed Marzok
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia,Department of Surgery, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt,*Correspondence: Mohamed Marzok ✉
| | - Adel I. Almubarak
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Mahmoud Kandeel
- Department of Pharmacology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt,Department of Biomedical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Wael El-Deeb
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia,Department of Internal Medicine, Infectious Diseases and Fish Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | - Hussein Babiker
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Sayed Fathi El-Hawari
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia,Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Sohag University, Sohag, Egypt
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Wang Y, Zhao K, Wu N, Ji T, Su G, Cui X, Dong Y, Chen X. Effect of Different Doses of Butorphanol on Postoperative Shivering in Elderly Patients: A Randomized, Double-Blind, Placebo-Controlled Trial. Drug Des Devel Ther 2023; 17:839-849. [PMID: 36969707 PMCID: PMC10038160 DOI: 10.2147/dddt.s396309] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 03/07/2023] [Indexed: 03/29/2023] Open
Abstract
Purpose This study was designed to investigate the effects of different doses of butorphanol on postoperative shivering and quality of recovery in elderly patients. Patients and Methods A total of 147 elderly patients (aged 60 or older) scheduled for elective transurethral resection of the prostate were enrolled in the current study. Patients were randomly and evenly assigned into four groups: Group C (0.9% normal saline), Group B1 (butorphanol 0.01 mg/kg), Group B2 (butorphanol 0.02 mg/kg) and Group B3 (butorphanol 0.03 mg/kg). All drugs were diluted to 5mL and injected intravenously slowly 5 min before induction of anesthesia. The primary outcome measure was the incidence of postoperative shivering in the post-anesthesia care unit. Quality of Recovery-40 (QoR-40) scores were assessed on postoperative day (POD) 1, 2 and 3. Perioperative core and skin temperature, extubation time and adverse events were also recorded. Results Patients among the four groups had comparable baseline characteristics. Compared with Group C, the incidence of shivering was significantly lower in Group B2 and B3 (P = 0.006 and P = 0.005, respectively). The QoR-40 scores on POD1 were significantly higher in all butorphanol groups than that in Group C (P < 0.0083). In Group B2 and B3, patients experienced lower pain intensity (P < 0.001). In addition, the incidence of catheter-related bladder discomfort (CRBD) was lower in all butorphanol groups than in Group C (P < 0.0083). Conclusion Butorphanol 0.02 or 0.03 mg/kg could effectively prevent the occurrence of postoperative shivering in elderly patients scheduled for transurethral resection of the prostate, provided effective postoperative recovery and postoperative analgesia.
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Affiliation(s)
- Yaolin Wang
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
| | - Kai Zhao
- Department of Anesthesiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (USTC), Hefei, Anhui, People’s Republic of China
- Department of Anesthesiology, Anhui Provincial Hospital, Hefei, Anhui, People’s Republic of China
| | - Nanling Wu
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
| | - Tao Ji
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
| | - Gaowei Su
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
| | - Xiaojie Cui
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
| | - Yushan Dong
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
| | - Xiuxia Chen
- NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
- Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China
- Correspondence: Xiuxia Chen, Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Medical University, Xuzhou, Jiangsu, 221000, People’s Republic of China, Tel +86 18052268332, Email
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Jiang X, Cheng X, Guo S, Du C, Zhang W. Analgesic efficacy of butorphanol combined with sufentanil after heart valve surgery: A propensity score-matching analysis. Medicine (Baltimore) 2022; 101:e32307. [PMID: 36550898 PMCID: PMC9771184 DOI: 10.1097/md.0000000000032307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Pain is common after heart valve surgery and can stimulate the sympathetic nervous system, causing hemodynamic instability and respiratory complications. Current treatments for postoperative pain are insufficient, and postoperative pain is difficult to control effectively with a single analgesic. Therefore, we investigated the analgesic efficacy of butorphanol with sufentanil after heart valve surgery and its hemodynamic effects. The records of 221 patients admitted to the intensive care unit after cardiac valve replacement between January 1, 2018, and May 31, 2021, were retrospectively analyzed. Patients were allocated to 2 groups based on the postoperative pain treatment they received: treatment group (administered butorphanol combined with sufentanil), and control group (administered conventional sufentanil analgesia). After propensity score matching for sex, age, Acute Physiology and Chronic Health Evaluation II score, type of valve surgery, and operation duration, 76 patients were included in the study, and analgesic efficacy, hemodynamic changes, and adverse drug reactions were compared between the 2 groups. After propensity score matching, the baseline characteristics were not significantly different between the groups. The histogram and jitter plot of the propensity score distribution indicated good matching. No significant differences were observed in the duration of mechanical ventilation, duration of stay in the intensive care unit, duration of total hospital stay, and hospitalization expenditure between the groups (P > .05). The treatment group had notably higher minimum systolic blood pressure (P = .024) and lower heart rate variability (P = .049) than those in the control group. Moreover, the treatment group exhibited better analgesic efficacy and had lower critical-care pain observation tool scores and consumption of sufentanil 24 hours after surgery than the control group (P < .05). The incidence of vomiting was notably lower in the treatment than in the control group (P = .028). Butorphanol combined with sufentanil can be used in patients after heart valve replacement. This combined treatment has good analgesic efficacy and is associated with reduced adverse drug reactions and, potentially, steady hemodynamics.
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Affiliation(s)
- Xuandong Jiang
- Intensive Care Unit, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, PR China
| | - Xuping Cheng
- Intensive Care Unit, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, PR China
| | - Shan Guo
- Intensive Care Unit, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, PR China
| | - Chaojian Du
- Intensive Care Unit, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, PR China
| | - Weimin Zhang
- Intensive Care Unit, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, PR China
- * Correspondence: Weimin Zhang, Intensive Care Unit, Affiliated Dongyang Hospital of Wenzhou Medical University, No. 60 Wuning West Road, Dongyang, Jinhua, Zhejiang 322100, China (e-mail: )
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Meng T, Lin X, Li X, Yue F, Zhang Y, Wang Y, Gu J, Yang Z, Yu H, Lv K, Liang S, Li X, Zhu W, Yu G, Li T, Ren Y, Li Y, Xu J, Xu W, Wang S, Wu J. Pre-anesthetic use of butorphanol for the prevention of emergence agitation in thoracic surgery: A multicenter, randomized controlled trial. Front Med (Lausanne) 2022; 9:1040168. [PMID: 36582294 PMCID: PMC9792474 DOI: 10.3389/fmed.2022.1040168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022] Open
Abstract
Background Emergence agitation (EA) is common in patients after general anesthesia (GA) and is associated with poor outcomes. Patients with thoracic surgery have a higher incidence of EA compared with other surgery. This study aimed to investigate the impact of pre-anesthetic butorphanol infusion on the incidence of EA in patients undergoing thoracic surgery with GA. Materials and methods This prospective randomized controlled trial (RCT) was conducted in 20 tertiary hospitals in China. A total of 668 patients undergoing elective video-assisted thoracoscopic lobectomy/segmentectomy for lung cancer were assessed for eligibility, and 620 patients were enrolled. In total, 296 patients who received butorphanol and 306 control patients were included in the intention-to-treat analysis. Patients in the intervention group received butorphanol 0.02 mg/kg 15 min before induction of anesthesia. Patients in the control group received volume-matched normal saline in the same schedule. The primary outcome was the incidence of EA after 5 min of extubation, and EA was evaluated using the Riker Sedation-Agitation Scale (RSAS). The incidence of EA was determined by the chi-square test, with a significance of P < 0.05. Results In total, 296 patients who received butorphanol and 306 control patients were included in the intention-to-treat analysis. The incidence of EA 5 min after extubation was lower with butorphanol treatment: 9.8% (29 of 296) vs. 24.5% (75 of 306) in the control group (P = 0.0001). Patients who received butorphanol had a lower incidence of drug-related complications (including injecting propofol pain and coughing with sufentanil): 112 of 296 vs. 199 of 306 in the control group (P = 0.001) and 3 of 296 vs. 35 of 306 in the control group (P = 0.0001). Conclusion The pre-anesthetic administration of butorphanol reduced the incidence of EA after thoracic surgery under GA. Clinical trial registration [http://www.chictr.org.cn/showproj.aspx?proj=42684], identifier [ChiCTR1900025705].
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Affiliation(s)
- Tao Meng
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, China
| | - Xiaowen Lin
- Department of Pain Management, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Ximing Li
- Department of Anesthesiology, Linyi People’s Hospital, Linyi, China
| | - Fangli Yue
- Department of Anesthesiology, Weifang People’s Hospital, Weifang, China
| | - Yuzhu Zhang
- Department of Anesthesiology, Zibo Central Hospital, Zibo, China
| | - Yingbin Wang
- Department of Anesthesiology, Lanzhou University Second Hospital, Lanzhou, China
| | - Jianhua Gu
- Department of Anesthesiology, Jinan People’s Hospital, Jinan, China
| | - Zaiqi Yang
- Department of Anesthesiology, Taian City Central Hospital, Taian, China
| | - Hongli Yu
- Department of Anesthesiology, Tianjin First Central Hospital, Tianjin, China
| | - Kun Lv
- Department of Anesthesiology, Jining No.1 People’s Hospital, Jining, China
| | - Shengyong Liang
- Department of Anesthesiology, Feicheng People’s Hospital, Feicheng, China
| | - Xingda Li
- Department of Anesthesiology, Linyi Central Hospital, Linyi, China
| | - Weibo Zhu
- Department of Anesthesiology, Binzhou People’s Hospital, Binzhou, China
| | - Gang Yu
- Department of Anesthesiology, Binzhou Central Hospital, Binzhou, China
| | - Tao Li
- Department of Anesthesiology, Yantai Yuhuangding Hospital, Yantai, China
| | - Yujia Ren
- Department of Anesthesiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yandong Li
- Department of Anesthesiology, Affiliated Hospital of Jining Medical University, Jining, China
| | - Jianjun Xu
- Department of Anesthesiology, Daqing Oilfield General Hospital, Daqing, China
| | - Weimin Xu
- Department of Anesthesiology, Shengli Oilfield Central Hospital, Dongying, China
| | - Shu Wang
- Department of Anesthesiology, Benxi Central Hospital, Benxi, China
| | - Jianbo Wu
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, China,Department of Anesthesiology and Perioperative Medicine, Qilu Hospital Dezhou Hospital, Shandong University, Dezhou, China,*Correspondence: Jianbo Wu,
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Opioids for pain. Med Lett Drugs Ther 2022; 64:193-200. [PMID: 36541938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Springfield D, KuKanich B, Gray M, KuKanich K, Lai P. Dosing protocols to increase the efficacy of butorphanol in dogs. J Vet Pharmacol Ther 2022; 45:516-529. [PMID: 36164256 PMCID: PMC10949855 DOI: 10.1111/jvp.13095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/01/2022] [Accepted: 09/10/2022] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to improve butorphanol dosing in dogs. Twelve Beagles (6 males, 6 females) were enrolled. Six were randomly allocated to each butorphanol treatment: IV (0.4 mg/kg), IV loading dose (0.2 mg/kg) with IV CRI (0.2 mg/kg/h for 8 h), SC (0.4 mg/kg), SC (0.8 mg/kg) with an equal volume sodium bicarbonate (SC-bicarbonate), and IV after CYP inhibitors. We hypothesized that the CRI would produce longer durations than IV bolus, and SC-bicarbonate suspension would produce longer durations than SC. Hypothermia, an opioid effect paralleling antinociception in dogs, and sedation were evaluated. Pharmacokinetics and CYP inhibitor effects on butorphanol pharmacokinetics were determined. Rectal temperatures were significantly lower than baseline from 1.5-4 h (IV), 1-5 h (CRI), and 2-7 h (SC-bicarbonate), but not after SC. Dogs in all treatments had sedation. Butorphanol's half-life was ~1.5 h. SC-bicarbonate had lower bioavailability (61%) relative to SC, with no sustained release, and the CRI mean steady-state plasma concentration was 43.1 ng/ml. CYP inhibitors had minor pharmacokinetic effects on butorphanol. Butorphanol 0.4 mg/kg IV and 0.2 mg/kg loading dose with 0.2 mg/kg/h CRI decreased rectal temperature, but 0.4 mg/kg SC did not. Further studies are required to determine clinical analgesia of butorphanol.
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Affiliation(s)
- Dariyan Springfield
- Department of Anatomy and Physiology, Kansas State University College of Veterinary Medicine, Manhattan, KS, USA
| | - Butch KuKanich
- Department of Anatomy and Physiology, Kansas State University College of Veterinary Medicine, Manhattan, KS, USA
| | - Mackenzie Gray
- Department of Anatomy and Physiology, Kansas State University College of Veterinary Medicine, Manhattan, KS, USA
| | - Kate KuKanich
- Department of Clinical Sciences, Kansas State University College of Veterinary Medicine, Manhattan, KS, USA
| | - Poyu Lai
- Department of Clinical Sciences, Kansas State University College of Veterinary Medicine, Manhattan, KS, USA
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Salla KM, Turunen HA, Kallio-Kujala IJ, Pekkola V, Casoni DC, Lepajoe J, Björkenheim P, Raekallio MR, Vainio O. Effects of vatinoxan in dogs premedicated with medetomidine and butorphanol followed by sevoflurane anaesthesia: a randomized clinical study. Vet Anaesth Analg 2022:S1467-2987(22)00129-5. [PMID: 36115767 DOI: 10.1016/j.vaa.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate effects of vatinoxan in dogs, when administered as intravenous (IV) premedication with medetomidine and butorphanol before anaesthesia for surgical castration. STUDY DESIGN A randomized, controlled, blinded, clinical trial. ANIMALS A total of 28 client-owned dogs. METHODS Dogs were premedicated with medetomidine (0.125 mg m-2) and butorphanol (0.2 mg kg-1) (group MB; n = 14), or medetomidine (0.25 mg m-2), butorphanol (0.2 mg kg-1) and vatinoxan (5 mg m-2) (group MB-VATI; n = 14). Anaesthesia was induced 15 minutes later with propofol and maintained with sevoflurane in oxygen (targeting 1.3%). Before surgical incision, lidocaine (2 mg kg-1) was injected intratesticularly. At the end of the procedure, meloxicam (0.2 mg kg-1) was administered IV. The level of sedation, the qualities of induction, intubation and recovery, and Glasgow Composite Pain Scale short form (GCPS-SF) were assessed. Heart rate (HR), respiratory rate (fR), mean arterial pressure (MAP), end-tidal concentration of sevoflurane (Fe'Sevo) and carbon dioxide (Pe'CO2) were recorded. Blood samples were collected at 10 and 30 minutes after premedication for plasma medetomidine and butorphanol concentrations. RESULTS At the beginning of surgery, HR was 61 ± 16 and 93 ± 23 beats minute-1 (p = 0.001), and MAP was 78 ± 7 and 56 ± 7 mmHg (p = 0.001) in MB and MB-VATI groups, respectively. No differences were detected in fR, Pe'CO2, Fe'Sevo, the level of sedation, the qualities of induction, intubation and recovery, or in GCPS-SF. Plasma medetomidine concentrations were higher in group MB-VATI than in MB at 10 minutes (p = 0.002) and 30 minutes (p = 0.0001). Plasma butorphanol concentrations were not different between groups. CONCLUSIONS AND CLINICAL RELEVANCE In group MB, HR was significantly lower than in group MB-VATI. Hypotension detected in group MB-VATI during sevoflurane anaesthesia was clinically the most significant difference between groups.
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Reed R, Trenholme N, Skrzypczak H, Chang K, Ishikawa Y, Barletta M, Quandt J, Knych H, Sakai D. Comparison of hydromorphone and butorphanol for management of pain in equine patients undergoing elective arthroscopy: a randomized clinical trial. Vet Anaesth Analg 2022; 49:490-498. [PMID: 35752564 DOI: 10.1016/j.vaa.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/27/2022] [Accepted: 05/27/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare the effects of hydromorphone and butorphanol in horses undergoing arthroscopy and describe the pharmacokinetics of hydromorphone in anesthetized horses. STUDY DESIGN Randomized controlled clinical trial. ANIMALS A total of 40 adult horses admitted for elective arthroscopy. METHODS Horses were randomly assigned to be administered intravenous hydromorphone (0.04 mg kg-1; group TxH; n = 19) or butorphanol (0.02 mg kg-1; group TxB; n = 21) prior to surgery as part of a standardized anesthetic protocol. Pain was scored by two observers unaware of group assignment using the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP) and a composite pain scale (CPS) prior to surgery (baseline), 2 hours (P2) and 4 hours (P4) following recovery from anesthesia. Blood samples were collected at various time points for determination of plasma hydromorphone concentration using liquid chromatography-tandem mass spectrometry. Data were analyzed with a mixed-effect model. RESULTS Median (range) baseline EQUUS-FAP was 1.2 (0.0-4.0) with no effect of group, time points or interaction. Baseline CPS was similar between groups. Group TxH baseline CPS was 2.5 (0.0-10.0), increased at P2 [4.5 (0-10.0); p = 0.046] and returned to baseline values at P4 [3.0 (0.0-11.0)]. Group TxB baseline CPS was 2.0 (0.0-8.0), increased at P2 [3.5 (0.0-11.0); p = 0.009] and P4 [5.0 (0.0-11.0); p < 0.001]. Pharmacokinetic terminal half-life was 774 ± 82.3 minutes, area under the curve was 1362 ± 314 ng minutes mL-1, clearance was 30.7 ± 7.23 mL minute-1 kg-1 and volume of distribution at steady state was 884 ± 740 mL kg-1. CONCLUSIONS Hydromorphone, but not butorphanol, decreased CPS back to baseline at P4 after recovery. CLINICAL RELEVANCE Hydromorphone may provide superior postoperative analgesia compared with butorphanol in horses undergoing arthroscopy.
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Affiliation(s)
- Rachel Reed
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
| | - Nicole Trenholme
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Heather Skrzypczak
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Kevin Chang
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Yushun Ishikawa
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Michele Barletta
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Jane Quandt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Heather Knych
- K.L. Maddy Equine Analytical Pharmacology Laboratory, University of California-Davis, Davis, CA, USA
| | - Daniel Sakai
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
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Giannettoni G, Moretti G, Menchetti L, Pepe A, Bellocchi F, Bufalari A, Nannarone S. Sedation quality of alfaxalone associated with butorphanol, methadone or pethidine in cats injected into the supraspinatus or the quadriceps muscle. J Feline Med Surg 2022; 24:e269-e280. [PMID: 35762271 DOI: 10.1177/1098612x221104747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this study was to compare the quality of sedation with three different anaesthetic protocols (alfaxalone combined with butorphanol, methadone or pethidine) administered intramuscularly in cats, and to evaluate the influence of the injection site (between supraspinatus and quadriceps muscles) on the onset and quality of sedation. METHODS A total of 151 cats were selected for this study. Cats were sedated with alfaxalone (3 mg/kg) combined with either butorphanol (0.3 mg/kg; n = 50), methadone (0.3 mg/kg; n = 53) or pethidine (5 mg/kg; n = 48). The combination was injected intramuscularly into the supraspinatus (n = 79) or quadriceps muscle (n = 72). The data included a scoring system for the quality of sedation and physiological parameters, such as heart rate (HR), respiratory rate, body temperature and occurrence of mydriasis, monitored during the first 30 mins of anaesthesia. RESULTS The opioid associated with alfaxalone influenced the overall sedation score, the degree of myorelaxation, the occurrence of mydriasis and HR. The overall sedation score was poorer with butorphanol than with methadone (P = 0.008), and butorphanol induced a lower degree of myorelaxation than methadone (P = 0.013). The injection into the supraspinatus showed better qualitative results for sedation and a faster onset time (in about 3 mins) than that into the quadriceps (P <0.001). HR decreased from baseline (P <0.001) and over time (P <0.001), mainly in cats of the butorphanol-supraspinatus and pethidine-quadriceps groups (P = 0.004). The occurrence of mydriasis was lower after butorphanol than after methadone and pethidine (P = 0.025), while the incidence of side effects did not differ among groups. CONCLUSIONS AND RELEVANCE All three protocols provided a good quality of sedation and allowed performing the scheduled procedure. Moreover, the injection into the supraspinatus muscle showed superior results in all the qualitative scores of sedation and quicker onset time than that into the quadriceps muscle.
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Affiliation(s)
- Giacomo Giannettoni
- ADVETIA Centre Hospitalier Vétérinaire, Vélizy-Villacoublay, Île-de-France, France
| | - Giulia Moretti
- Department of Veterinary Medicine, Perugia University, Perugia, Italy
| | - Laura Menchetti
- Department of Agricultural and Food Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Arianna Pepe
- Department of Veterinary Medicine, Perugia University, Perugia, Italy
| | | | | | - Sara Nannarone
- Department of Veterinary Medicine, Perugia University, Perugia, Italy
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Cui P, Xin D, Li F, Deng L, Gao Y. Butorphanol Suppresses the Proliferation and Migration of Osteosarcoma by Promoting the Expression of piRNA hsa_piR_006613. Front Oncol 2022; 12:775132. [PMID: 35280771 PMCID: PMC8912933 DOI: 10.3389/fonc.2022.775132] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/20/2022] [Indexed: 12/21/2022] Open
Abstract
Butorphanol, a partial agonist of opioid receptor κ 1 receptor, can and is widely used as an analgesic drug to relieve moderate and severe pain in clinic. Osteosarcoma is one of the most common malignant bone tumor in adolescents under the age of 20. To our knowledge no study has investigated the effect of butorphanol on the proliferation of osteosarcoma cells. In this study, The proliferation of osteosarcoma cells was measured by CCK-8 and colony formation assays, and the migration of osteosarcoma cells were detected by scratch and transwell assays. The expression of piRNA was detected by RNA sequencing and real-time PCR. PiRNA mimics or inhibitors have been used to upregulate or inhibit piRNA expression in osteosarcoma cells, respectively. We found that butorphanol, at the concentration of 10ug/ml or higher, could significantly inhibit the proliferation and migration of osteosarcoma cells. Our resuslts indicated that butorphanol promoted the expression of piRNA hsa_piR_006613 and overexpression of piRNA hsa_piR_006613 inhibited the proliferation and migration of osteosarcoma cells. our study also showed that inhibition of the expression of piRNA hsa_piR_006613 could promote the proliferation and migration of osteosarcoma cells. Butorphanol played the regulatory role on osteosarcoma cells in dependent of piRNA hsa_piR_006613. Butorphanol was found to inhibit the proliferation and migration of osteosarcoma cells by promoting piRNA hsa_piR_006613 expression. Bioinformatics analysis showed that hsa_piR_006613 downregulated FN1 protein expression by binding with 3’-UTR of FN1 mRNA. In all, the present research indicated that butorphanol suppresses the proliferation of osteosarcoma by promoting the expression of piRNA hsa_piR_006613, which downregulated the expression of FN1. Has_piR_006613 may become a new therapeutic target for osteosarcoma.
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Affiliation(s)
- Pengfei Cui
- Department of Anesthesiology, Yantaishan Hospital, Yantai, China
| | - Deqian Xin
- Department of Anesthesiology, YanTai Yuhuangding Hospital, Yantai, China
| | - Fu Li
- Department of Traumatology, Shu Guang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lin Deng
- Department of Traumatology, Shu Guang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yujie Gao
- Department of Clinical Laboratory, YanTai Yuhuangding Hospital, Yantai, China
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Deflers H, Gandar F, Bolen G, Detilleux J, Sandersen C, Marlier D. Effects of a Single Opioid Dose on Gastrointestinal Motility in Rabbits ( Oryctolagus cuniculus): Comparisons among Morphine, Butorphanol, and Tramadol. Vet Sci 2022; 9:28. [PMID: 35051113 DOI: 10.3390/vetsci9010028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 02/01/2023] Open
Abstract
The aim of this study was to evaluate and compare the effects of single doses of butorphanol, morphine, and tramadol on gastrointestinal motility in rabbits (Oryctolagus cuniculus) using non-invasive imaging methods, such as radiographic barium follow through and ultrasonographic contraction counts. Time-lapse radiographic and ultrasound examinations were performed before and after a single intramuscular dose of 5 mg kg−1 butorphanol, 10 mg kg−1 morphine, or 10 mg kg−1 tramadol. Pyloric and duodenal contraction counts by ultrasonography and radiographic repletion scores for the stomach and caecum were analysed using a mixed linear model. No significant effect was noted on ultrasound examinations of pyloric and duodenal contractions after administration of an opioid treatment. Morphine had a significant effect on the stomach and the caecum repletion scores, whereas butorphanol had a significant effect only on the caecum repletion score. Tramadol had no significant effect on the stomach or caecum repletion scores. The present findings suggest that a single dose of 5 mg kg−1 butorphanol or 10 mg kg−1 morphine temporarily slows gastrointestinal transit in healthy rabbits, preventing physiological progression of the alimentary bolus without the induction of ileus. In contrast, a single dose of 10 mg kg−1 tramadol has no such effects.
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Zhang X, Qi S, Lin Z, Zhang Y, Dai W, Tian W, Tian J, Zheng L, Su D, Huai X. Pre-operative administration of butorphanol mitigates emergence agitation in patients undergoing functional endoscopic sinus surgery: A randomized controlled clinical trial. Front Psychiatry 2022; 13:1090149. [PMID: 36733413 PMCID: PMC9887110 DOI: 10.3389/fpsyt.2022.1090149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 12/30/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND This study explored the effectiveness of pre-operative intravenous injection of butorphanol in the alleviation of emergence agitation (EA) in patients undergoing functional endoscopic sinus surgery (FESS). METHODS Patients (n = 708) were randomized into two groups. The butorphanol group (Group B, n = 358) received butorphanol infusion (20 ug/kg) before anesthesia induction, while the control group (Group C, n = 350) received an equal volume of normal saline infusion. General anesthesia was induced with sufentanil, propofol, and rocuronium, and was maintained with sevoflurane and remifentanil. Vasoactive drugs maintained the hemodynamic indices within 20% of the baseline. RESULTS The incidence of EA was significantly lower in Group B than that in Group C (Group B vs. C: 24.3% vs. 31.4%, respectively; P = 0.034). The times to spontaneous breathing (26.5 min vs. 23.7 min, P = 0.011), verbal response (36.0 min vs. 33.4 min, P = 0.012), and extubation (31.0 min vs. 28.7 min, P = 0.025) were longer in Group B, and the grade of cough (0.33 vs. 0.43, P = 0.024) at extubation in Group B was lower than that in Group C (P = 0.024). The mean arterial pressure at the end of the operation (P = 0.004) and at 5 min after extubation (P = 0.008) was higher and hypotension was less prominent (0.6% vs. 2.6%, P = 0.030) in Group B. CONCLUSION Pre-operative intravenous injection of butorphanol decreased the incidence of EA after FESS and provided smooth and hemodynamically stable emergence without extending the stay in post-anesthesia care unit. CLINICAL TRIAL REGISTRATION https://www.clinicaltrials.gov/, identifier NCT03398759.
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Affiliation(s)
- Xiao Zhang
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Siyi Qi
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhen Lin
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,Department of Anesthesiology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China
| | - Yizhe Zhang
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wanbing Dai
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weitian Tian
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jie Tian
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li Zheng
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Diansan Su
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaorong Huai
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Pypendop BH, Goich M, Shilo-Benjamini Y. Effect of intravenous butorphanol infusion on the minimum alveolar concentration of isoflurane in cats. Vet Anaesth Analg 2021; 49:165-172. [PMID: 35033447 DOI: 10.1016/j.vaa.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 12/06/2021] [Accepted: 12/14/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the effect of butorphanol, administered by intravenous (IV) infusion, on the minimum alveolar concentration of isoflurane (MACISO) in cats and to examine the dosage dependence of this effect. STUDY DESIGN Randomized, placebo-controlled, crossover experimental study. ANIMALS A group of six healthy adult male neutered cats. METHODS Cats were anesthetized with isoflurane in oxygen. A venous catheter was placed for fluid and drug administration, and an arterial catheter was placed for measurement of arterial pressure and blood sampling. Four treatments were administered at random with at least 2 week interval between treatments: saline (control), butorphanol low dosage (treatment LD; 0.25 mg kg-1 IV bolus followed by 85 μg kg-1 minute-1 for 20 minutes, then 43 μg kg-1 minute-1 for 40 minutes, then 19 μg kg-1 minute-1), medium dosage (treatment MD, double the dosages in LD) and high dosage (treatment HD, quadruple the dosages in LD). MACISO was determined in duplicate using the bracketing technique and tail clamping. Pulse rate, arterial pressure, hemoglobin oxygen saturation, end-tidal partial pressure of carbon dioxide and arterial blood gas and pH were measured. RESULTS Butorphanol reduced MACISO in a dosage-dependent manner, by 23 ± 8%, 37 ± 12% and 68 ± 10% (mean ± standard deviation) in treatments LD, MD and HD, respectively. The main cardiopulmonary effect observed was a decrease in pulse rate, significant in treatment HD compared with control. CONCLUSIONS AND CLINICAL RELEVANCE Butorphanol caused a dosage-dependent MACISO reduction in cats. IV infusion of butorphanol may be of interest for partial IV anesthesia in cats.
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Affiliation(s)
- Bruno H Pypendop
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA.
| | - Mariela Goich
- School of Veterinary Medicine, Facultad de Ciencias de la Vida, Universidad Andrés Bello, Santiago, Chile
| | - Yael Shilo-Benjamini
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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Zhang XH, Liu S, Liao WM. Combination of Dexmedetomidine and Butorphanol Optimized Sedation in Drug-Induced Sleep Endoscopy: A Randomized, Double-Blind Trial. Curr Med Sci 2021; 41:1247-51. [PMID: 34921663 DOI: 10.1007/s11596-021-2492-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/03/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Drug-induced sleep endoscopy (DISE) allows for the evaluation of dynamic airway collapse in patients with obstructive sleep apnea. However, a standardized sedation regimen for DISE is not yet available. This study aimed to investigate the safety profiles and efficacies of dexmedetomidine combined with butorphanol for DISE. METHODS Sixty patients with obstructive sleep apnea scheduled to undergo DISE were randomly divided into Group D and Group DB. All recipients were initially given intravenous butorphanol (1 mg) (Group DB) or saline (Group D). Subsequently, both groups were sedated using a loading dose of 1.0 µg/kg/h of dexmedetomidine. Hemodynamic and respiratory parameters, the time to attain sufficient sedation, wakeup time, and adverse events during DISE were recorded. RESULTS Compared with Group D, the time until sufficient sedation and wakeup time in Group DB were significantly reduced. A higher performer satisfaction level was achieved in Group DB. Patients in Group DB showed a higher incidence of bradycardia compared with Group D. However, the bradycardia resolved spontaneously in both groups without any treatment. There was no instance of cough, hypotension, arrhythmia, nausea or vomiting in either group. CONCLUSION Compared to dexmedetomidine alone, a small dose of butorphanol infusion (1 mg) as an adjunct treatment to dexmedetomidine during DISE can reduce the dosage of dexmedetomidine, shorten the time until sufficient sedation and enhance the performer satisfaction level. This synergistic combination could be a promising sedation regimen for DISE in terms of procedural convenience and patient safety.
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Sasaki K, Ishikawa T, Ikeda K, Kasai S. Antinociceptive effects of the combined use of butorphanol and buprenorphine in mice. Neuropsychopharmacol Rep 2021; 41:522-525. [PMID: 34505754 PMCID: PMC8698687 DOI: 10.1002/npr2.12202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/29/2021] [Accepted: 08/06/2021] [Indexed: 11/25/2022] Open
Abstract
Butorphanol and buprenorphine are mixed opioid receptor agonist-antagonist drugs widely used as analgesics in people and animals. There are few reports concerning the interaction of multiple opioids, and their antinociceptive effects, when combined with other opioids, remain unclear. Therefore, we report the preliminary findings of the antinociceptive effects of the combined use of butorphanol and buprenorphine in C57BL/6JJcl mice. Both drugs were administered either simultaneously or in different orders. Compared with the baseline values, the tail-flick and hot-plate test latencies increased regardless of the order of administration. Furthermore, enhanced latencies were observed on administration of butorphanol followed by buprenorphine. Combined use of these drugs may not attenuate analgesic efficacy. Besides, enhancement of these effects can be obtained by changing the order of the administration of these drugs. It is necessary to further investigate the molecular basis of the underlying mechanism in future definitive studies.
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Affiliation(s)
- Kazumasu Sasaki
- Research Institute for Brain and Blood VesselsAkita Cerebrospinal and Cardiovascular CenterAkitaJapan
- Addictive Substance ProjectTokyo Metropolitan Institute of Medical ScienceTokyoJapan
| | - Tatsuya Ishikawa
- Research Institute for Brain and Blood VesselsAkita Cerebrospinal and Cardiovascular CenterAkitaJapan
| | - Kazutaka Ikeda
- Addictive Substance ProjectTokyo Metropolitan Institute of Medical ScienceTokyoJapan
| | - Shinya Kasai
- Addictive Substance ProjectTokyo Metropolitan Institute of Medical ScienceTokyoJapan
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Wu Q, Liu F, Shen T, Zhang W. Multiple pathways are responsible to the inhibitory effect of butorphanol on OGD/R-induced apoptosis in AC16 cardiomyocytes. J Appl Toxicol 2021; 42:830-840. [PMID: 34708435 DOI: 10.1002/jat.4260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 09/28/2021] [Accepted: 10/11/2021] [Indexed: 12/15/2022]
Abstract
Ischemic heart disease is the leading cause of cardiovascular mortality, which is related to cardiac myocyte apoptosis. Butorphanol is an opioid receptor agonist with potential cardioprotective function. The purpose of this work is to explore the function and mechanism of butorphanol in oxygen and glucose deprivation/reperfusion (OGD/R)-induced cardiomyocyte apoptosis. The overlapping targets of ischemic heart disease and butorphanol were analyzed according to GeneCards, ParmMapper, Cytoscape, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Human cardiomyocyte AC16 cells were incubated with butorphanol and then stimulated with OGD/R. Cell injury was investigated by Cell Counting Kit-8, lactate dehydrogenase (LDH) assay kit, TUNEL staining, caspase-3 activity assay kit, and Western blotting. The proteins in signaling pathways were measured using Western blotting. A total of 93 overlapping targets of ischemic heart disease and butorphanol were obtained. Pathway analysis exhibited that these targets might be involved in multiple signaling pathways. Butorphanol alone showed little cytotoxicity to cardiomyocytes, and it protected against OGD/R-induced viability inhibition, LDH release, cell apoptosis, and increase of caspase-3 activity and expression levels of cleaved caspase-3 and Bim. Butorphanol promoted the activation of the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt)/forkhead box O (FoxO) and hypoxia-inducible factor-1α (HIF-1α)/vascular endothelial growth factor (VEGF) pathways and attenuated the activation of the mitogen-activated protein kinase (MAPK) signaling in OGD/R-treated cardiomyocytes. In conclusion, butorphanol prevents OGD/R-induced cardiomyocyte apoptosis through activating the PI3K/Akt/FoxO and HIF-1α/VEGF pathways and inactivating the MAPK pathway.
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Affiliation(s)
- Qiaoling Wu
- Department of Anesthesiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Feifei Liu
- Department of Anesthesiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Tu Shen
- Department of Anesthesiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Wei Zhang
- Department of Anesthesiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
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Abstract
The use of procedural sedation in birds has become a routine practice in veterinary medicine during the past 10 years, with a corresponding increase in avian sedation research. Sedation is most often used in a clinical setting for birds to facilitate examination and/or diagnostic sample collection, splint application, grooming, and minor surgical procedures. Sedation provides several benefits over manual restraint or general anesthesia when performing clinical procedures. This review provides an overview of current studies on avian sedation and discusses common indications, protocols, and adverse effects of sedation in avian patients.
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Affiliation(s)
- Grayson Doss
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA,
| | - Christoph Mans
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
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Abstract
Alfaxalone is a safe and effective anesthetic drug for the induction of general anesthesia in many nonavian companion animal species; however, its efficacy has not been fully evaluated in birds. In premedicated trials, the chickens were sedated with butorphanol 2 mg/kg intramuscularly and midazolam 0.5 mg/kg intramuscularly, 15 minutes before intravenous administration of alfaxalone. The chickens were classified as anesthetized if endotracheal intubation was achieved without eliciting a cough reflex, provoking no patient resistance, and with minimal glottis movement within 15 seconds after the administration of alfaxalone. Qualitative and quantitative data were recorded, including duration of anesthesia, quality of induction, quality of recovery, reflexes, time to sternal recumbency, time to standing, and time to normal behaviors. Survival analysis was used to analyze the association between alfaxalone dosage and premedication with time-related variables. Out of the evaluated doses, the lowest intravenous alfaxalone dose required to achieve anesthetic induction and endotracheal intubation in unpremedicated and premedicated chickens was 7.5 and 4 mg/kg, respectively. The duration of anesthesia for all dose rates within the study ranged from 51 seconds to 4 minutes 45 seconds. Premedication generally improved the quality of induction and recovery, but significantly (P < .001) increased the time required for the chickens to stand after being anesthetized and to return to normal behaviors. Most chickens exhibited varying degrees of hyperactivity on anesthetic induction and recovery. No postinduction apnea or deaths of the subject birds occurred during this investigation.
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Affiliation(s)
- Alexandr Mastakov
- The University of Queensland-Gatton Campus, The University of Queensland, Gatton QLD 4343, Australia,
| | - Joerg Henning
- The University of Queensland-Gatton Campus, The University of Queensland, Gatton QLD 4343, Australia
| | - Rebecca de Gier
- The University of Queensland-Gatton Campus, The University of Queensland, Gatton QLD 4343, Australia
| | - Robert Doneley
- The University of Queensland-Gatton Campus, The University of Queensland, Gatton QLD 4343, Australia
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Pypendop BH, Shilo-Benjamini Y. Pharmacokinetics of butorphanol in male neutered cats anesthetized with isoflurane. J Vet Pharmacol Ther 2021; 44:883-887. [PMID: 34558086 PMCID: PMC9293126 DOI: 10.1111/jvp.13014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/16/2021] [Accepted: 09/12/2021] [Indexed: 11/29/2022]
Abstract
This study characterized the pharmacokinetics of butorphanol in cats anesthetized with isoflurane. Six young healthy male neutered cats were used. Cats were anesthetized with isoflurane in oxygen. Catheters were placed in a jugular vein for blood sampling and in a medial saphenous vein for butorphanol and lactated Ringer's solution administration. Butorphanol tartrate (1 mg/kg over 5 min) was administered intravenously. Blood samples were collected prior to butorphanol administration and at various times up to 365 min following administration. Plasma butorphanol concentration was measured using liquid chromatography/tandem mass spectrometry. Compartment models were fitted to the time‐concentration data using nonlinear mixed effect modeling. A three‐compartment model best fitted the data. Typical value (% interindividual variability) for the three volumes of distribution, the metabolic clearance, and the two distribution clearances were 230 (72), 1095 (not estimated), and 2596 (not estimated) ml/kg, and 18.4 (72), 169.6 (52), and 55.0 (43), respectively. Pharmacokinetic simulation suggested that a loading dose (µg/kg) calculated as 0.287 × target plasma concentration in ng/ml (CT) followed by intravenous infusions (µg/kg/min) of 0.098 × CT for 20 min, 0.049 × CT for 40 min, and 0.022 × CT thereafter would rapidly achieve and maintain CT ± 10% for up to 6.5 h.
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Affiliation(s)
- Bruno H Pypendop
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Yael Shilo-Benjamini
- Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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Tang W, Luo L, Hu B, Zheng M. Butorphanol alleviates lipopolysaccharide-induced inflammation and apoptosis of cardiomyocytes via activation of the κ-opioid receptor. Exp Ther Med 2021; 22:1248. [PMID: 34539844 PMCID: PMC8438658 DOI: 10.3892/etm.2021.10683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 04/16/2021] [Indexed: 12/25/2022] Open
Abstract
Sepsis-induced myocardial dysfunction is a leading cause of the high mortality rates associated with sepsis. The aim of the present study was to investigate the effect of butorphanol on sepsis-induced cardiomyocyte dysfunction. Lipopolysaccharide (LPS) was used to induce H9C2 cardiomyocytes to establish an in vitro sepsis model. The effect of butorphanol on the viability of LPS-induced H9C2 cells was analyzed using a Cell Counting Kit-8 assay. The levels of tumor necrosis factor-α, interleukin (IL)-1β and IL-6 were detected using ELISA. Western blotting was used to analyze the expression levels of inflammation-and apoptosis-related proteins. Cell apoptosis was measured using a TUNEL assay. The expression levels of κ-opioid receptor (KOR) were analyzed using reverse transcription-quantitative PCR analysis and western blotting. Following LPS induction, the levels of inflammatory cytokines and proapoptotic proteins were found to be upregulated in H9C2 cells, while butorphanol treatment downregulated these levels. The expression levels of KOR were also upregulated following butorphanol treatment in LPS-induced H9C2 cells. Addition of the KOR inhibitor, nor-binaltorphimine, alleviated the inhibitory effects of butorphanol on inflammation and apoptosis in LPS-induced H9C2 cells. In conclusion, the findings of the present study provided evidence indicating that butorphanol may alleviate LPS-induced inflammation and apoptosis in cardiomyocytes by upregulating KOR expression, which may provide a novel insight into the potential therapeutic effects of butorphanol and its underlying mechanism of action.
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Affiliation(s)
- Weiqing Tang
- Department of Anesthesiology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai 201399, P.R. China
| | - Liu Luo
- Department of Anesthesiology, The Affiliated Zhuzhou Hospital of Xiangya School of Medicine, Central South University, Zhuzhou Central Hospital, Zhuzhou, Hunan 412000, P.R. China
| | - Baoji Hu
- Department of Anesthesiology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai 201399, P.R. China
| | - Mingzhi Zheng
- Department of Anesthesiology, The Affiliated Zhuzhou Hospital of Xiangya School of Medicine, Central South University, Zhuzhou Central Hospital, Zhuzhou, Hunan 412000, P.R. China
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Nannarone S, Giannettoni G, Laurenza C, Giontella A, Moretti G. Methadone or Butorphanol as Pre-Anaesthetic Agents Combined with Romifidine in Horses Undergoing Elective Surgery: Qualitative Assessment of Sedation and Induction. Animals (Basel) 2021; 11:2572. [PMID: 34573538 DOI: 10.3390/ani11092572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/11/2021] [Accepted: 08/30/2021] [Indexed: 12/20/2022] Open
Abstract
Simple Summary When considering sedation or general anaesthesia in horses, a multimodal strategy is commonly preferred over a single drug. This includes the association of alpha-2 adrenoceptor agonists, phenothiazines or opioids, to improve the overall sedative and analgesic effects accordingly. However, the use of opioids alone is limited in horses due to the risk of sympathetic stimulation, central nervous system stimulation, excitement and head jerking. In some countries, butorphanol is currently the only licensed and most used opioid in equine medicine. We aimed to evaluate the pre-anaesthetic association of romifidine with either butorphanol or methadone. The two combinations were administered before induction of general anaesthesia, which included diazepam and ketamine. Evaluations involved the degree of sedation and ataxia, effects on physiological parameters, such as heart and respiratory rates, rectal temperature, quality of induction, ease of intubation and the need for top-up agents before transition to the operating theatre and the institution of a maintenance regimen. Abstract While butorphanol is the most commonly used opioid in horses, methadone is not licensed in most countries. Our aim was to compare the effects of both drugs, combined with romifidine, regarding the quality of sedation and induction in horses undergoing elective surgery. Results indicate the suitability of both methadone and butorphanol in this patient population. Animals were scored 10 min after intravenous injection of sedatives. Despite lower overall sedation (OS) score in horses receiving methadone (p = 0.002), the quality and time of induction and intubation remained unchanged. None of the horses had the lowest OS score (no sedation), nor the highest score for ataxia (horse falling). Methadone induced a tendency for minor noise reaction yet minor head lowering scores, the latter being probably the most influencing parameter when scoring OS. Measured physiological parameters decreased in both groups, with greater bradycardia recorded after methadone (p = 0.017), including a higher incidence of atrioventricular blocks that resolved during general anaesthesia. The quality of induction was good–excellent in most of the animals. While comparisons between the degree of antinociception were beyond the scope of this study, analgesic potency might influence the choice when considering opioids as pre-anaesthetic drugs in combination with romifidine before surgery in equines.
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Straticò P, Carluccio A, Varasano V, Guerri G, Suriano R, Robbe D, Cerasoli I, Petrizzi L. Analgesic Effect of Butorphanol during Castration in Donkeys under Total Intravenous Anaesthesia. Animals (Basel) 2021; 11:2346. [PMID: 34438803 PMCID: PMC8388773 DOI: 10.3390/ani11082346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 12/04/2022] Open
Abstract
Pain management is necessary for all surgical procedures. Little scientific evidence about drug efficacy in donkeys is available. The aim of this study was to evaluate the analgesic effect of butorphanol in donkeys undergoing orchiectomy under total intravenous anaesthesia with guaifenesin-ketamine-detomidine. A randomized blinded prospective clinical trial (Protocol n. 2021/0000338), was carried out on 18 clinically healthy donkeys undergoing bilateral orchiectomy. Patients were assigned to Group D (n = 8) or Group DB (n = 10) if receiving intravenous detomidine or detomidine-butorphanol respectively, before induction of general anaesthesia with ketamine-diazepam. Intraoperative muscle relaxation, nystagmus, palpebral reflex, heart and respiratory rate, and non-invasive blood pressure were evaluated every 2 min; time to prepare the patient, duration of surgery and anaesthesia and recovery score were recorded. Group D had significantly longer surgical time, higher heart rate, higher systolic and mean blood pressure (p < 0.05; repeated measure ANOVA), increased muscle rigidity and expression of palpebral reflex (p < 0.05; Mann-Whitney U test) than group DB. Top-ups with thiopental were statistically higher in Group D. Butorphanol and detomidine together produced a more stable anaesthetic plan. The low dosage of opioid and alpha-2-agonists and reduced rescue anaesthesia are responsible for a safer and more superficial anaesthesia, which is mandatory under field conditions.
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Affiliation(s)
- Paola Straticò
- Faculty of Veterinary Medicine, University of Teramo, Località Piano D’Accio, 64100 Teramo, Italy; (P.S.); (A.C.); (V.V.); (R.S.); (D.R.); (L.P.)
| | - Augusto Carluccio
- Faculty of Veterinary Medicine, University of Teramo, Località Piano D’Accio, 64100 Teramo, Italy; (P.S.); (A.C.); (V.V.); (R.S.); (D.R.); (L.P.)
| | - Vincenzo Varasano
- Faculty of Veterinary Medicine, University of Teramo, Località Piano D’Accio, 64100 Teramo, Italy; (P.S.); (A.C.); (V.V.); (R.S.); (D.R.); (L.P.)
| | - Giulia Guerri
- Faculty of Veterinary Medicine, University of Teramo, Località Piano D’Accio, 64100 Teramo, Italy; (P.S.); (A.C.); (V.V.); (R.S.); (D.R.); (L.P.)
| | - Riccardo Suriano
- Faculty of Veterinary Medicine, University of Teramo, Località Piano D’Accio, 64100 Teramo, Italy; (P.S.); (A.C.); (V.V.); (R.S.); (D.R.); (L.P.)
| | - Domenico Robbe
- Faculty of Veterinary Medicine, University of Teramo, Località Piano D’Accio, 64100 Teramo, Italy; (P.S.); (A.C.); (V.V.); (R.S.); (D.R.); (L.P.)
| | - Ilaria Cerasoli
- Clinica Veterinaria Borghesiana, Via di Vermicino 96, 00133 Roma, Italy;
| | - Lucio Petrizzi
- Faculty of Veterinary Medicine, University of Teramo, Località Piano D’Accio, 64100 Teramo, Italy; (P.S.); (A.C.); (V.V.); (R.S.); (D.R.); (L.P.)
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48
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Luan G, Pan F, Bu L, Wu K, Wang A, Xu X. Butorphanol Promotes Macrophage Phenotypic Transition to Inhibit Inflammatory Lung Injury via κ Receptors. Front Immunol 2021; 12:692286. [PMID: 34305926 PMCID: PMC8294090 DOI: 10.3389/fimmu.2021.692286] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/21/2021] [Indexed: 12/27/2022] Open
Abstract
Acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) is characterized by diffuse inflammation of the lung parenchyma and refractory hypoxemia. Butorphanol is commonly used clinically for perioperative pain relief, but whether butorphanol can regulate LPS-induced alveolar macrophage polarization is unclear. In this study, we observed that butorphanol markedly attenuated sepsis-induced lung tissue injury and mortality in mice. Moreover, butorphanol also decreased the expression of M1 phenotype markers (TNF-α, IL-6, IL-1β and iNOS) and enhanced the expression of M2 marker (CD206) in alveolar macrophages in the bronchoalveolar lavage fluid (BALF) of LPS-stimulated mice. Butorphanol administration reduced LPS-induced numbers of proinflammatory (M1) macrophages and increased numbers of anti-inflammatory (M2) macrophages in the lungs of mice. Furthermore, we found that butorphanol-mediated suppression of the LPS-induced increases in M1 phenotype marker expression (TNF-α, IL-6, IL-1β and iNOS) in bone marrow-derived macrophages (BMDMs), and this effect was reversed by κ-opioid receptor (KOR) antagonists. Moreover, butorphanol inhibited the interaction of TLR4 with MyD88 and further suppressed NF-κB and MAPKs activation. In addition, butorphanol prevented the Toll/IL-1 receptor domain-containing adaptor inducing IFN-β (TRIF)-mediated IFN signaling pathway. These effects were ameliorated by KOR antagonists. Thus, butorphanol may promote macrophage polarization from a proinflammatory to an anti-inflammatory phenotype secondary to the inhibition of NF-κB, MAPKs, and the TRIF-mediated IFN signaling pathway through κ receptors.
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Affiliation(s)
| | | | | | | | - Aizhong Wang
- Department of Anesthesiology, Affiliated Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaotao Xu
- Department of Anesthesiology, Affiliated Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai, China
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Widmer DR, Tacke S, Ternes K, Marcordes S, Kempf H. Injectable Anesthesia With Medetomidine, Ketamine, and Butorphanol in Captive Humboldt Penguins ( Spheniscus humboldti). J Avian Med Surg 2021; 35:167-179. [PMID: 34256547 DOI: 10.1647/2019-489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The effects of an injectable anesthesia with 0.05 mg/kg medetomidine, 5 mg/kg ketamine, and 0.5 mg/kg butorphanol administered together intramuscularly were evaluated in 22 captive Humboldt penguins (Spheniscus humboldti, 10 male and 12 female), with a mean age of 8.5 ± 8.23 years. The birds fasted for18-24 hours prior to the procedure. Induction was followed by 4 distinct progressive responses of the birds to the anesthetic effect, including onset of initial effects at 2.0 ± 1.7 minutes (x̄ ± SD), sternal recumbency with the head still elevated at 2.2 ± 1.6 minutes, lowering and placing the beak tip to the ground at 3.6 ± 3.4 minutes, and lateral positioning of the neck and head at 4.2 ± 3.4 minutes. A general state of sedation, muscle relaxation, and analgesia were noted 10.0 ± 2.8 minutes postinjection. However, according to an established scoring system for the assessment of anesthetic depth in avian patients, a surgical plane of anesthesia was not achieved. Muscle relaxation determined by the same scoring system lasted for 31.4 ± 17.1 minutes. The penguins' mean respiratory rate did not demonstrate significant change and spontaneous ventilation was present throughout the procedure. Relative peripheral arterial oxygen saturation decreased significantly from 92.83 ± 5.77% at 10 minutes to 90.91 ± 5.77% at 40 minutes following induction. The birds' heart rate also decreased significantly from 112.55 ± 23.97 beats/min at 10 minutes to 101.65 ± 25.42 beats/min at 40 minutes. The measured cloacal temperatures were maintained within normal range despite ambient temperatures of up to 28.3°C (82.9°F). Reversal of medetomidine with 0.25 mg/kg atipamezole was conducted after 45.1 ± 7.3 minutes. Recovery was smooth but of variable duration with patients being able or willing to stand steadily in an upright position after 50.1 ± 34.6 minutes. One penguin died during recovery from a ruptured left ventricle and consecutive pericardial tamponade, but no predisposing factors were identified. The anesthetic protocol proved to be effective for noninvasive and minor painful procedures (eg, diagnostic imaging, blood collection). Disadvantages to the administration of the combined anesthetic agents in the penguins included a short period of muscle relaxation and smooth but potentially prolonged recovery. The safety of the anesthetic protocol described for Humboldt penguins in this report has to be evaluated critically against the the death of 1 penguin during recovery.
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Affiliation(s)
| | - Sabine Tacke
- Justus-Liebig-Universitaet Giessen, D-35392 Giessen, Germany
| | | | | | - Hermann Kempf
- Tieraerztliche Praxis für Exoten, D-86167 Augsburg, Germany
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50
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Pavlovsky VH, Corona D, Hug PJ, Kümmerlen D, Graage R, Bettschart-Wolfensberger R. Butorphanol induces anxiety-like -behaviour and distress in piglets. SCHWEIZ ARCH TIERH 2021; 163:485-491. [PMID: 34193400 DOI: 10.17236/sat00309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION In a previous study that used butorphanol in pigs before castration performed under isoflurane anaesthesia, severe adverse effects were recorded. As in pigs, this has not been reported before, we aimed to investigate the effects of butorphanol in piglets. In this study ten 27 days old piglets were randomly allocated to receive either 0,2 mg/kg butorphanol (group B) or saline 0,9% (control group C) intramuscularly. Their behaviour was assessed for 60 minutes by two independent observers from videotapes. Two to 15 minutes after application, piglets in group B showed restlessness, distress and excessive vocalisation. Locomotor activity was increased, the piglets laid down considerably less frequently (p = 0,034) and for shorter time periods (p = 0,0014) during the first 40 minutes compared to group C. Group C animals slept most time of the experiment (45,1 ± 2,9 minutes in group C vs 12,7 ± 2,9 minutes in group B, p .
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Affiliation(s)
- V H Pavlovsky
- Department for Clinical Diagnostics and Services, Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich
| | - D Corona
- Department for Clinical Diagnostics and Services, Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich
| | - P J Hug
- Department for Clinical Diagnostics and Services, Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich
| | - D Kümmerlen
- Department for Farm Animals, Division of Swine Medicine, Vetsuisse Faculty, University of Zurich
| | - R Graage
- Department for Farm Animals, Division of Swine Medicine, Vetsuisse Faculty, University of Zurich
| | - R Bettschart-Wolfensberger
- Department for Clinical Diagnostics and Services, Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich
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