• 1.

    Craig DB. Post-operative recovery of pulmonary function. Anesth Analg 1981; 60: 4652.

  • 2.

    Dahl JB, Kehlet H. Non-steroidal and anti-inflammatory drugs: rationale for use in severe post-operative pain. Br J Anaesth 1991; 66: 703712.

    • Search Google Scholar
    • Export Citation
  • 3.

    Berg RJ, Orton EC. Pulmonary function in dogs after intercostal thoracotomy: comparison of morphine, oxymorphone, and selective intercostal nerve block. Am J Vet Res 1986; 47: 471474.

    • Search Google Scholar
    • Export Citation
  • 4.

    Luketich JD, Land SR, Sullivan EA, et al. Thoracic epidural versus intercostal nerve catheter plus patient-controlled analgesia: a randomized study. Ann Thorac Surg 2005; 70: 18451850.

    • Search Google Scholar
    • Export Citation
  • 5.

    Thompson SE, Johnson JM. Analgesia in dogs after intercostal thoracotomy: a comparison of morphine, selective intercostal nerve block, and interpleural regional analgesia with bupivacaine. Vet Surg 1991; 20: 7377.

    • Search Google Scholar
    • Export Citation
  • 6.

    Pascoe PJ, Dyson DH. Analgesia after lateral thoracotomy in dogs. Epidural morphine vs. intercostal bupivacaine. Vet Surg 1994; 22: 141147.

    • Search Google Scholar
    • Export Citation
  • 7.

    Reiestad F, Stromkag KE, Kjell E. Interpleural catheter in the management of postoperative pain: a preliminary report. Reg Anesth 1986; 11: 8991.

    • Search Google Scholar
    • Export Citation
  • 8.

    Conzemius MG, Brockman DJ, King LG, et al. Analgesia in dogs after intercostal thoracotomy: a clinical trial comparing intravenous buprenorphine and interpleural bupivacaine. Vet Surg 1994; 23: 291298.

    • Search Google Scholar
    • Export Citation
  • 9.

    James EC, Kolberg BS, Iwen GW, et al. Epidural analgesia for post-thoracotomy patients. J Thorac Cardiovasc Surg 1981; 82: 898903.

  • 10.

    Liu S, Carpenter RL, Neal JM. Epidural anesthesia and analgesia. Anesthesiology 1995; 82: 14741506.

  • 11.

    Gunter JB, Eng C. Thoracic epidural anesthesia via the caudal approach in children. Anesthesiology 1992; 76: 935938.

  • 12.

    DeRossi R, Ruzzon RHS, Verde-Selva AB, et al. Evaluation of segmental dorsolumbar epidural analgesia with ketamine hydrochloride administered by use of nonstyletted multiple-port catheters via the caudal approach in cattle. Am J Vet Res 2010; 71: 1723.

    • Search Google Scholar
    • Export Citation
  • 13.

    Valairucha S, Seefelder C, Houck C. Thoracic epidural catheter placed by the caudal route in infants: the importance of radio-graphic confirmation. Paediatr Anaesth 2002; 12: 424428.

    • Search Google Scholar
    • Export Citation
  • 14.

    Hodgson PS, Neal JM, Pollock JE, et al. The neurotoxicity of drugs given intrathecally (spinal). Anesth Analg 1999; 88: 797809.

  • 15.

    Klide AM, Soma LR. Epidural analgesia in the dog and cat. J Am Vet Med Assoc 1968; 153: 165173.

  • 16.

    Evers WH. Epidural anesthesia in the dog: a review of 224 cases with emphasis on cesarean section. Vet Med Small Anim Clin 1968; 63: 11211124.

    • Search Google Scholar
    • Export Citation
  • 17.

    Skarda RT, Tranquilli WJ. Local and regional anesthetic and analgesic techniques: dogs. In: Tranquilli WJ, Thurmon JC, Grimm KA, eds. Lumb & Jones' veterinary anesthesia and analgesia. 4th ed. Ames, Iowa: Blackwell Publishing Ltd, 2007; 273593.

    • Search Google Scholar
    • Export Citation
  • 18.

    Yamamura T, Harada K, Okamura A, et al. Is the site of action of ketamine anesthesia the N-methyl-D-aspartate?. Anesthesiology 1990; 72: 704710.

    • Search Google Scholar
    • Export Citation
  • 19.

    Panjabi N, Prakash S, Gupta P, et al. Efficacy of three doses of ketamine with bupivacaine for caudal analgesia in pediatric inguinal herniotomy. Reg Anesth Pain Med 2004; 29: 2831.

    • Search Google Scholar
    • Export Citation
  • 20.

    Grubb TL, Riebold TW, Huber MJ. Evaluation of lidocaine, xylazine, and a combination of lidocaine and xylazine for epidural analgesia in llamas. J Am Vet Med Assoc 1993; 203: 14411444.

    • Search Google Scholar
    • Export Citation
  • 21.

    Aithal HP, Singh GRA, Kinjavdekar P, et al. Analgesic and cardiopulmonary effects of intrathecally administered romifidine or romifidine and ketamine in goats (Capra hircus). J S Afr Vet Assoc 2001; 72: 8491.

    • Search Google Scholar
    • Export Citation
  • 22.

    DeRossi R, Junqueira AL, Lopes RA, et al. Use of ketamine or lidocaine or in combination for subarachnoid analgesia in goats. Small Rumin Res 2005; 59: 95101.

    • Search Google Scholar
    • Export Citation
  • 23.

    Naguib M, Sharif A, Seraj M, et al. Ketamine for caudal analgesia in children: comparison with caudal bupivacaine. Br J Anaesth 1991; 67: 663666.

    • Search Google Scholar
    • Export Citation
  • 24.

    Cook B, Grubb DJ, Aldridge LA, et al. Comparison of the effects of adrenaline, clonidine and ketamine on the duration of caudal analgesia produced by bupivacaine in children. Br J Anaesth 1995; 75: 698701.

    • Search Google Scholar
    • Export Citation
  • 25.

    Findlow D, Aldridge LM, Doyle E. Comparison of caudal block using bupivacaine and ketamine with ilioinguinal nerve block for orchidopexy in children. Anaesthesia 1997; 52: 11101113.

    • Search Google Scholar
    • Export Citation
  • 26.

    Skarda RT, Muir WW III. Analgesic, hemodynamic, and respiratory effects of caudal epidurally administered xylazine hydrochloride solution in mares. Am J Vet Res 1996; 57: 193200.

    • Search Google Scholar
    • Export Citation
  • 27.

    Bion JF. Intrathecal ketamine for war surgery. A preliminary study under field conditions. Anaesthesia 1984; 39: 10231028.

  • 28.

    Reich DL, Silvay G. Ketamine: an update on the first 25 years of clinical experience. Can J Anaesth 1989; 36: 186197.

  • 29.

    Martin DD, Tranquilli WJ, Olson WA, et al. Hemodynamic effects of epidural ketamine in isoflurane-anesthetized dogs. Vet Surg 1997; 26: 505509.

    • Search Google Scholar
    • Export Citation
  • 30.

    Veering BT, Cousins MJ. Cardiovascular and pulmonary effects of epidural anaesthesia. Anaesth Intensive Care 2000; 28: 620635.

  • 31.

    Skarda RT, Muir WW. Hemodynamic effects of unilateral segmented lumbar epidural analgesia in cattle. Am J Vet Res 1979; 40: 645650.

  • 32.

    Brock-Utne JG, Mankowitz E, Kallichurum S, et al. Effects of intrathecal saline and ketamine with and without preservative on the spinal roots of monkeys. S Afr Med J 1982; 61: 360361.

    • Search Google Scholar
    • Export Citation
  • 33.

    Borgbjerg FM, Björn AS, Svensson A, et al. Histopathology after repeated intrathecal injections of preservative-free ketamine in the rabbit: a light and electron microscopic examination. Anesth Analg 1994; 79: 105111.

    • Search Google Scholar
    • Export Citation

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Evaluation of thoracic epidural analgesia induced by lidocaine, ketamine, or both administered via a lumbosacral approach in dogs

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  • 1 Departments of Veterinary Medicine, Surgery and Anesthesiology, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil.
  • | 2 Veterinary Medicine, Faculty of Veterinary Medicine and Animal Science, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil.
  • | 3 Veterinary Medicine, Faculty of Veterinary Medicine and Animal Science, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil.
  • | 4 Department of Anesthesiology, School of Medicine, São Paulo University, São Paulo, Brazil.
  • | 5 Veterinary Medicine, Faculty of Veterinary Medicine and Animal Science, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil.
  • | 6 Veterinary Medicine, Faculty of Veterinary Medicine and Animal Science, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil.

Abstract

Objective—To determine the analgesic and systemic effects of thoracic epidural administration of ketamine, lidocaine, or both in conscious dogs.

Animals—6 adult mixed-breed dogs.

Procedures—Each dog received 2% lidocaine hydrochloride without epinephrine (3.8 mg/kg), 5% ketamine hydrochloride (3.0 mg/kg), or both in randomized order with ≥ 1 week between treatments. Drugs were administered in a total volume of 0.25 mL/kg through a thoracic epidural catheter implanted via the lumbosacral approach. Heart rate, blood pressure, respiratory rate, rectal temperature, analgesia, sedation, and ataxia were determined before treatment (baseline [time 0]) and at 5, 10, 15, 20, 30, 40, 50, 60, 90, 120, 150, and 180 minutes after administration.

Results—The main areas of analgesia for the 3 treatments were the thorax and forelimbs bilaterally. Median duration of analgesia was shorter after administration of ketamine (30 minutes) than after administration of lidocaine (40 minutes) and lidocaine plus ketamine (90 minutes). All treatments caused moderate motor blockade, and only the ketamine and lidocaine plus ketamine treatments caused mild sedation. Significant decreases in systolic and mean arterial blood pressure were observed only with the lidocaine plus ketamine treatment.

Conclusions and Clinical Relevance—Thoracic epidural administration of lidocaine plus ketamine resulted in longer duration of analgesia of the thorax and forelimbs bilaterally in conscious dogs, compared with administration of ketamine or lidocaine alone. Additional studies are needed to determine whether this technique adequately relieves postoperative pain after thoracic surgical procedures and whether it causes respiratory depression in dogs.

Abstract

Objective—To determine the analgesic and systemic effects of thoracic epidural administration of ketamine, lidocaine, or both in conscious dogs.

Animals—6 adult mixed-breed dogs.

Procedures—Each dog received 2% lidocaine hydrochloride without epinephrine (3.8 mg/kg), 5% ketamine hydrochloride (3.0 mg/kg), or both in randomized order with ≥ 1 week between treatments. Drugs were administered in a total volume of 0.25 mL/kg through a thoracic epidural catheter implanted via the lumbosacral approach. Heart rate, blood pressure, respiratory rate, rectal temperature, analgesia, sedation, and ataxia were determined before treatment (baseline [time 0]) and at 5, 10, 15, 20, 30, 40, 50, 60, 90, 120, 150, and 180 minutes after administration.

Results—The main areas of analgesia for the 3 treatments were the thorax and forelimbs bilaterally. Median duration of analgesia was shorter after administration of ketamine (30 minutes) than after administration of lidocaine (40 minutes) and lidocaine plus ketamine (90 minutes). All treatments caused moderate motor blockade, and only the ketamine and lidocaine plus ketamine treatments caused mild sedation. Significant decreases in systolic and mean arterial blood pressure were observed only with the lidocaine plus ketamine treatment.

Conclusions and Clinical Relevance—Thoracic epidural administration of lidocaine plus ketamine resulted in longer duration of analgesia of the thorax and forelimbs bilaterally in conscious dogs, compared with administration of ketamine or lidocaine alone. Additional studies are needed to determine whether this technique adequately relieves postoperative pain after thoracic surgical procedures and whether it causes respiratory depression in dogs.

Contributor Notes

Address correspondence to Dr. DeRossi (derossi@nin.ufms.br).