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Abstract

Objective—To evaluate the analgesic efficacy of epidural administration of morphine or a morphine-bupivacaine combination administered before orthopedic surgery in dogs that received opioid premedication.

Design—Prospective, randomized, blinded, clinical study.

Animals—36 healthy adult dogs that underwent elective orthopedic surgery on a pelvic limb.

Procedures—Each dog received 1 of 3 epidural treatments before surgery. Anesthetic and supportive care protocols were standardized. Dogs under going different surgical procedures were randomly allocated among the 3 treatment groups. Respiratory and cardiovascular variables, end-tidal isoflurane concentration, and requirements for rescue analgesia were monitored. Postsurgical analgesia was evaluated with a multiparametric pain scoring system and by determination of rescue analgesia requirements and cortisolemia.

Results—The morphine-bupivacaine combination was associated with lower values than morphine or a saline solution for intraoperative arterial blood pressure; minimum and maximum isoflurane requirements; and postoperative pain scores, rescue analgesia requirements, and plasma cortisol concentrations. Values obtained after administration of morphine alone were not significantly different from those obtained after administration of saline solution for most variables.

Conclusions and Clinical Relevance—The preoperative epidurally administered morphine-bupivacaine combination induced better analgesia than morphine alone and should be considered for use in clinical patients. The degree of hemodynamic depression associated with the combination was considered acceptable for healthy patients undergoing elective surgery.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective

To determine variations in minimal alveolar concentration (MAC) of isoflurane and analgesic and cardiorespiratory effects of lumbosacral epidural administration of 0.25 mg of butorphanol/kg of body weight in dogs.

Animals

16 healthy male dogs.

Procedure

Dogs were anesthetized with isoflurane alone. Eight dogs received butorphanol (group B) and the others an equal volume of isotonic saline solution (group S) administered by a catheter inserted in the lumbosacral epidural space. Isoflurane MAC was determined before and 30 minutes after the epidural injection, along with noxious stimulation to the fore- and hind limbs. Cardiorespiratory variables were recorded prior to and until 120 minutes after epidural administration. At that time, isoflurane anesthesia was ended, and nociception (toe pinch and pin-prick responses) was evaluated for 7 hours. Dogs were observed for 3 days to determine presence of neurologic side effects.

Results

For group-B dogs, isoflurane MAC decreased by 31 ± 8.6% after butorphanol was administered. Cutaneous insensitivity (to pin-prick nociceptive test) persisted for 3 hours after the end of isoflurane anesthesia in group-B dogs. No response was observed to toe pinch stimulation for 80 minutes after anesthesia.

Conclusions

Epidural administration of 0.25 mg of butorphanol/kg in dogs was safe; minimal cardiorespiratory and no neurologic side effects were observed, and analgesia and an isoflurane-sparing effect were apparent.

Clinical Relevance

The short duration of action of epidurally administered butorphanol limits its value for clinical practice. (Am J Vet Res 1996;57:1478-1482)

Free access
in American Journal of Veterinary Research

Abstract

Objectives

To evaluate the cardiovascular and respiratory effects of buprenorphine administered intravenously in clinically normal horses and horses with chronic obstructive pulmonary disease (COPD).

Animals

5 clinically normal horses and 5 horses with COPD that were in partial clinical remission (period A) or were having an acute attack of airway obstruction (period B).

Procedures

Pulmonary function testing, arterial blood gas analysis, and arterial blood pressure measurements were performed before and after a single intravenous bolus of buprenorphine (3 μg/kg of body weight). Respiratory rate (f), tidal volume (VT), expiratory-to-inspiratory time ratio (TE/TI), minute expiratory ventilation (VE), maximal change in transpulmonary pressure (ΔPL), dynamic compliance (Cdyn), and pulmonary resistance (RL) were calculated with a pulmonary function computer. Heart rate (HR) and systolic (SABP), diastolic (DABP), and mean arterial blood pressures (MABP) were measured.

Results

At baseline, COPD horses in period A had decreased Cdyn and increased f, VE, PL, and HR, whereas COPD horses in period B had decreased TE/TI and Cdyn, arterial blood pH, and Po2, and increased f, vE, ΔPL, and RL, compared with clinically normal horses. After drug administration, SABP, DABP, and MABP increased in all horses, f and VE increased in clinically normal horses, and Pao2 decreased within 60 minutes in horses with COPD.

Conclusion and Clinical Relevance

Buprenorphine can induce excitement in unsedated horses or horses that do not have signs of pain, but does not seem to induce severe respiratory depression or adverse cardiovascular effects in clinically normal horses or those with COPD. (Am J Vet Res 1998;59:1287–1291)

Free access
in American Journal of Veterinary Research

SUMMARY

Anesthesia of equids is associated with pulmonary dysfunction. Cardiovascular and respiratory effects of inhalation anesthetic agents and duration of anesthesia have been studied, using oxygen as the carrier gas. To our knowledge, the effects of inspired oxygen have not been determined. We studied the cardiovascular and respiratory effects of 2 inspired oxygen fractions (0.30 and > 0.85) in 5 laterally recumbent, halothane-anesthetized horses. Mean systemic arterial blood pressure, cardiac output, central venous pressure, pulmonary arterial pressure, arterial pH, and arterial base excess were similar in horses of the 2 groups during 4 hours of anesthesia at constant end-tidal halothane concentration. End-tidal partial pressure of CO2, arterial partial pressure of CO2 and O2, and alveolar-to-arterial O2 tension difference were greater in horses exposed to the higher oxygen concentration. On the basis of the data obtained, we suggest that greater hypoventilation and ventilation/perfusion mismatch occur when horses are breathing high-oxygen fraction. Arterial partial pressure of O2 was not different between the 2 groups of horses after they were disconnected from the anesthesia circuit and allowed to breathe room air. Horses recovered from anesthesia without complications.

Free access
in American Journal of Veterinary Research

Abstract

Objective—To determine prevalence of adverse effects associated with epidural administration of morphine with or without bupivacaine in dogs and cats undergoing surgery and evaluate effects of epidural administration of morphine on postoperative pain severity.

Design—Retrospective study.

Animals—242 dogs and 23 cats.

Procedure—Morphine with or without bupivacaine was administered prior to surgery with a Tuohy needle, spinal needle, or epidural catheter. In 18 dogs that underwent surgery twice, results of preemptive epidural administration of morphine with or without bupivacaine were compared with results of systemic administration of oxymorphone and ketoprofen.

Results—The delivered fraction of isoflurane was significantly lower in animals given morphine and bupivacaine than in animals given morphine alone. Analgesia was of significantly longer duration in dogs given morphine and bupivacaine than in dogs given morphine alone. During anesthesia, mild respiratory and cardiovascular depression was reported. Seven dogs and 2 cats had urine retention, and 2 dogs developed pruritus. Six dogs vomited when a second dose of morphine was given epidurally the day after surgery. Eight of 72 dogs had delayed hair growth. In 18 dogs that underwent surgery twice, the delivered fraction of isoflurane was significantly lower and the duration of analgesia was significantly longer when morphine with or without bupivacaine was given epidurally than when oxymorphone and ketoprofen were given.

Conclusions and Clinical Relevance—Results suggest that preemptive epidural administration of morphine with or without bupivacaine is a safe and effective method of inducing long-lasting analgesia in dogs and cats and is superior to standard management of postoperative pain with repeated injection of oxymorphone and ketoprofen. (J Am Vet Med Assoc 2002;221:666–672)

Full access
in Journal of the American Veterinary Medical Association

Objective—

To compare analgesic effects of ketoprofen, oxymorphone hydrochloride, and butorphanol when used to control postoperative pain associated with elective orthopedic surgery in dogs.

Design—

Prospective randomized clinical trial.

Animals—

70 dogs undergoing orthopedic surgery on a hind limb.

Procedure—

Dogs were randomly assigned to 1 of 4 postoperative analgesic treatment groups: ketoprofen alone, oxymorphone alone, butorphanol alone, or ketoprofen-oxymorphone. Drugs were given IM at the end of anesthesia. Pain score, sedation score, arterial blood pressures, arterial blood gas partial pressures, and plasma Cortisol concentration were measured for 12 hours after surgery. If the pain score was ≥ 9, supplemental oxymorphone was administered IM.

Results—

The proportion of dogs that did not require supplemental treatment with oxymorphone was significantly higher for the ketoprofen alone and ketoprofen-oxymorphone groups than for the oxymorphone alone group. During the first hour after surgery, pain score was lower for oxymorphone alone and ketoprofen-oxymorphone groups than for ketoprofen or butorphanol alone groups. Significant differences were not detected among groups in regard to pain score 2 and 3 hours after surgery or in regard to arterial blood pressures at any time. From 4 to 12 hours after surgery, pain score was significantly lower for the ketoprofen alone group than for other groups. Plasma Cortisol concentration was significantly higher for the oxymorphone alone group 6 and 8 hours after surgery, compared with other groups.

Clinical Implications—

Except during the first hour after surgery, dogs given ketoprofen alone after elective orthopedic surgery had a greater level of, and longer-lasting, analgesia than did dogs given oxymorphone or butorphanol alone. (J Am Vet Med Assoc 1997;211:438–444)

Free access
in Journal of the American Veterinary Medical Association