Effects of perineural administration of ropivacaine combined with perineural or intravenous administration of dexmedetomidine for sciatic and saphenous nerve blocks in dogs

Vincent Marolf From the Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium (Marolf, Ida, Sandersen); and Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdańsk, Gdańsk, Poland (Siluk, Struck-Lewica, Markuszewski). Dr. Marolf's present address is Centre vétérinaire Medi-Vet SA, 1007 Lausanne, Switzerland. Dr. Ida's present address is the Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843.

Search for other papers by Vincent Marolf in
Current site
Google Scholar
PubMed Close
 DVM, PhD
,
Keila K. Ida From the Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium (Marolf, Ida, Sandersen); and Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdańsk, Gdańsk, Poland (Siluk, Struck-Lewica, Markuszewski). Dr. Marolf's present address is Centre vétérinaire Medi-Vet SA, 1007 Lausanne, Switzerland. Dr. Ida's present address is the Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843.

Search for other papers by Keila K. Ida in
Current site
Google Scholar
PubMed Close
 DVM, PhD
,
Danuta Siluk From the Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium (Marolf, Ida, Sandersen); and Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdańsk, Gdańsk, Poland (Siluk, Struck-Lewica, Markuszewski). Dr. Marolf's present address is Centre vétérinaire Medi-Vet SA, 1007 Lausanne, Switzerland. Dr. Ida's present address is the Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843.

Search for other papers by Danuta Siluk in
Current site
Google Scholar
PubMed Close
 PhD
,
Wiktoria Struck-Lewicka From the Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium (Marolf, Ida, Sandersen); and Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdańsk, Gdańsk, Poland (Siluk, Struck-Lewica, Markuszewski). Dr. Marolf's present address is Centre vétérinaire Medi-Vet SA, 1007 Lausanne, Switzerland. Dr. Ida's present address is the Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843.

Search for other papers by Wiktoria Struck-Lewicka in
Current site
Google Scholar
PubMed Close
 PhD
,
Michał J. Markuszewski From the Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium (Marolf, Ida, Sandersen); and Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdańsk, Gdańsk, Poland (Siluk, Struck-Lewica, Markuszewski). Dr. Marolf's present address is Centre vétérinaire Medi-Vet SA, 1007 Lausanne, Switzerland. Dr. Ida's present address is the Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843.

Search for other papers by Michał J. Markuszewski in
Current site
Google Scholar
PubMed Close
 PhD
, and
Charlotte Sandersen From the Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium (Marolf, Ida, Sandersen); and Department of Biopharmaceutics and Pharmacodynamics, Medical University of Gdańsk, Gdańsk, Poland (Siluk, Struck-Lewica, Markuszewski). Dr. Marolf's present address is Centre vétérinaire Medi-Vet SA, 1007 Lausanne, Switzerland. Dr. Ida's present address is the Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843.

Search for other papers by Charlotte Sandersen in
Current site
Google Scholar
PubMed Close
 DVM, PhD
DOI:
https://doi.org/10.2460/ajvr.82.6.449
Volume/Issue:
Volume 82: Issue 6
Online Publication Date:
Jun 2021
Restricted access
Sign In Reprints and Permissions Purchase Article

Abstract

OBJECTIVE

To evaluate the effects of using ropivacaine combined with dexmedetomidine for sciatic and saphenous nerve blocks in dogs.

ANIMALS

7 healthy adult Beagles.

PROCEDURES

In phase 1, dogs received each of the following 3 treatments in random order: perineural sciatic and saphenous nerve injections of 0.5% ropivacaine (0.4 mL/kg) mixed with saline (0.9% NaCl) solution (0.04 mL/kg; DEX0PN), 0.5% ropivacaine mixed with dexmedetomidine (1 µg/kg; DEX1PN), and 0.5% ropivacaine mixed with dexmedetomidine (2 µg/kg; DEX2PN). In phase 2, dogs received perineural sciatic and saphenous nerve injections of 0.5% ropivacaine and an IV injection of diluted dexmedetomidine (1 µg/kg; DEX1IV). For perineural injections, the dose was divided equally between the 2 sites. Duration of sensory blockade was evaluated, and plasma dexmedetomidine concentrations were measured.

RESULTS

Duration of sensory blockade was significantly longer with DEX1PN and DEX2PN, compared with DEX0PN; DEX1IV did not prolong duration of sensory blockade, compared with DEX0PN. Peak plasma dexmedetomidine concentrations were reached after 15 minutes with DEX1PN (mean ± SD, 348 ± 200 pg/mL) and after 30 minutes DEX2PN (816 ± 607 pg/mL), and bioavailability was 54 ± 40% and 73 ± 43%, respectively. The highest plasma dexmedetomidine concentration was measured with DEX1IV (1,032 ± 415 pg/mL) 5 minutes after injection.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that perineural injection of 0.5% ropivacaine in combination with dexmedetomidine (1 µg/kg) for locoregional anesthesia in dogs seemed to balance the benefit of prolonging sensory nerve blockade while minimizing adverse effects.

Abstract

OBJECTIVE

To evaluate the effects of using ropivacaine combined with dexmedetomidine for sciatic and saphenous nerve blocks in dogs.

ANIMALS

7 healthy adult Beagles.

PROCEDURES

In phase 1, dogs received each of the following 3 treatments in random order: perineural sciatic and saphenous nerve injections of 0.5% ropivacaine (0.4 mL/kg) mixed with saline (0.9% NaCl) solution (0.04 mL/kg; DEX0PN), 0.5% ropivacaine mixed with dexmedetomidine (1 µg/kg; DEX1PN), and 0.5% ropivacaine mixed with dexmedetomidine (2 µg/kg; DEX2PN). In phase 2, dogs received perineural sciatic and saphenous nerve injections of 0.5% ropivacaine and an IV injection of diluted dexmedetomidine (1 µg/kg; DEX1IV). For perineural injections, the dose was divided equally between the 2 sites. Duration of sensory blockade was evaluated, and plasma dexmedetomidine concentrations were measured.

RESULTS

Duration of sensory blockade was significantly longer with DEX1PN and DEX2PN, compared with DEX0PN; DEX1IV did not prolong duration of sensory blockade, compared with DEX0PN. Peak plasma dexmedetomidine concentrations were reached after 15 minutes with DEX1PN (mean ± SD, 348 ± 200 pg/mL) and after 30 minutes DEX2PN (816 ± 607 pg/mL), and bioavailability was 54 ± 40% and 73 ± 43%, respectively. The highest plasma dexmedetomidine concentration was measured with DEX1IV (1,032 ± 415 pg/mL) 5 minutes after injection.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that perineural injection of 0.5% ropivacaine in combination with dexmedetomidine (1 µg/kg) for locoregional anesthesia in dogs seemed to balance the benefit of prolonging sensory nerve blockade while minimizing adverse effects.

Contributor Notes

Address correspondence to Dr. Marolf (vmarolf@medivetsa.ch).
Cover American Journal of Veterinary Research
American Journal of Veterinary Research
Publication Date:
01 Jun 2021
  • 1.

    Marhofer P, Brummett CM. Safety and efficiency of dexmedetomidine as adjuvant to local anesthetics. Curr Opin Anaesthesiol 2016;29:632–637.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Abdallah FW, Brull R. Facilitatory effects of perineural dexmedetomidine on neuraxial and peripheral nerve block: a systematic review and meta-analysis. Br J Anaesth 2013;110:915–925.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Vorobeichik L, Brull R, Abdallah FW. Evidence basis for using perineural dexmedetomidine to enhance the quality of brachial plexus nerve blocks: a systematic review and meta-analysis of randomized controlled trials. Br J Anaesth 2017;118:167–181.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Brummett CM, Norat MA, Palmisano JM, et al. Perineural administration of dexmedetomidine in combination with bupivacaine enhances sensory and motor blockade in sciatic nerve block without inducing neurotoxicity in rat. Anesthesiology 2008;109:502–511.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Akhondzadeh R, Rashidi M, Gousheh M, et al. The effect of adding dexmedetomidine as an adjuvant to lidocaine in forearm fracture surgeries by supraclavicular block procedure under ultrasound-guided. Anesth Pain Med 2018;8:e74355.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Fritsch G, Danninger T, Allerberger K, et al. Dexmedetomidine added to ropivacaine extends the duration of interscalene brachial plexus blocks for elective shoulder surgery when compared with ropivacaine alone: a single-center, prospective, triple-blind, randomized controlled trial. Reg Anesth Pain Med 2014;39:37–47.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Keplinger M, Marhofer P, Kettner SC, et al. A pharmacodynamic evaluation of dexmedetomidine as an additive drug to ropivacaine for peripheral nerve blockade: a randomised, triple-blind, controlled study in volunteers. Eur J Anaesthesiol 2015;32:790–796.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Bisui B, Samanta S, Ghoshmaulik S, et al. Effect of locally administered dexmedetomidine as adjuvant to levobupivacaine in supraclavicular brachial plexus block: double-blind controlled study. Anesth Essays Res 2017;11:981–986.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Jung HS, Seo KH, Kang JH, et al. Optimal dose of perineural dexmedetomidine for interscalene brachial plexus block to control postoperative pain in patients undergoing arthroscopic shoulder surgery: a prospective, double-blind, randomized controlled study. Medicine (Baltimore) 2018;97:e0440.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Abdallah FW, Dwyer T, Chan VW, et al. IV and perineural dexmedetomidine similarly prolong the duration of analgesia after interscalene brachial plexus block: a randomized, three-arm, triple-masked, placebo-controlled trial. Anesthesiology 2016;124:683–695.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Bartel AK, Campoy L, Martin-Flores M, et al. Comparison of bupivacaine and dexmedetomidine femoral and sciatic nerve blocks with bupivacaine and buprenorphine epidural injection for stifle arthroplasty in dogs. Vet Anaesth Analg 2016;43:435–443.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Trein TA, Floriano BP, Wagatsuma JT, et al. Effects of dexmedetomidine combined with ropivacaine on sciatic and femoral nerve blockade in dogs. Vet Anaesth Analg 2017;44:144–153.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Campoy L, Bezuidenhout AJ, Gleed RD, et al. Ultrasound-guided approach for axillary brachial plexus, femoral nerve, and sciatic nerve blocks in dogs. Vet Anaesth Analg 2010;37:144–153.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Hofmeister EH, Chandler MJ, Read MR. Effects of acepromazine, hydromorphone, or an acepromazine-hydromorphone combination on the degree of sedation in clinically normal dogs (Erratum published in J Am Vet Med Assoc 2011;238:182). J Am Vet Med Assoc 2010;237:1155–1159.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Szerkus O, Struck-Lewicka W, Kordalewska M, et al. HPLC-MS/MS method for dexmedetomidine quantification with design of experiments approach: application to pediatric pharmacokinetic study. Bioanalysis 2017;9:395–406.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    US Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research, Center for Veterinary Medicine. Guidance for industry: bioanalytical method validation. Available at: academy.gmp-compliance.org/guidemgr/files/4252FNL.PDF. Accessed Aug 9, 2020.

    • Search Google Scholar
    • Export Citation
  • 17.

    Kirksey MA, Haskins SC, Cheng J, et al. Local anesthetic peripheral nerve block adjuvants for prolongation of analgesia: a systematic qualitative review. PLoS One 2015;10:e0137312.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Lin YN, Li Q, Yang RM, et al. Addition of dexmedetomidine to ropivacaine improves cervical plexus block. Acta Anaesthesiol Taiwan 2013;51:63–66.

  • 19.

    Rancourt MP, Albert NT, Côté M, et al.. Posterior tibial nerve sensory blockade duration prolonged by adding dexmedetomidine to ropivacaine. Anesth Analg 2012;115:958–962.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Bloor BC, Ward DS, Belleville JP, et al. Effects of intravenous dexmedetomidine in humans. II Hemodynamic changes. Anesthesiology 1992;77:1134–1142.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Ebert TJ, Hall JE, Barney JA, et al. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology 2000;93:382–394.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Andersen JH, Grevstad U, Siegel H, et al. Does dexmedetomidine have a perineural mechanism of action when used as an adjuvant to ropivacaine?: a paired, blinded, randomized trial in healthy volunteers. Anesthesiology 2017;126:66–73.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Yoshitomi T, Kohjitani A, Maeda S, et al. Dexmedetomidine enhances the local anesthetic action of lidocaine via an alpha-2A adrenoceptor. Anesth Analg 2008;107:96–101.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Kosugi T, Mizuta K, Fujita T, et al. High concentrations of dexmedetomidine inhibit compound action potentials in frog sciatic nerves without alpha(2) adrenoceptor activation. Br J Pharmacol 2010;160:1662–1676.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Brummett CM, Hong EK, Janda AM, et al. Perineural dexmedetomidine added to ropivacaine for sciatic nerve block in rats prolongs the duration of analgesia by blocking the hyperpolarization-activated cation current. Anesthesiology 2011;115:836–843.

    • Crossref
    • Search Google Scholar
    • Export Citation

Advertisement