Evaluation of sedative and cardiorespiratory effects of romifidine and romifidine-butorphanol in cats

OBJECTIVE: To determine sedative and cardiorespiratory effects of romifidine alone and romifidine in combination with butorphanol and effects of preemptive atropine administration in cats sedated with romifidine-butorphanol. DESIGN: Randomized crossover study. ANIMALS: 6 healthy adult cats. PROCEDURES: Cats were given saline (0.9% NaCl) solution followed by romifidine alone (100 microg/kg [45.4 microg/lb], i.m.), saline solution followed by a combination of romifidine (40 microg/kg [18.1 microg/lb], i.m.) and butorphanol (0.2 mg/kg [0.09 mg/lb], i.m.), or atropine (0.04 mg/kg [0.02 mg/lb], s.c.) followed by romifidine (40 microg/kg, i.m.) and butorphanol (0.2 mg/kg, i.m.). Treatments were administered in random order, with > or = 1 week between treatments. Physiologic variables were determined before and after drug administration. Time to recumbency, duration of recumbency, time to recover from sedation, and subjective evaluation of sedation, muscle relaxation, and analgesia were assessed. RESULTS: Bradycardia developed in all cats that received saline solution and romifidine-butorphanol or romifidine alone. Preemptive administration of atropine prevented bradycardia for 50 minutes in cats given romifidine-butorphanol. Oxyhemoglobin saturation was significantly decreased 10 minutes after romifidine-butorphanol administration in atropine-treated cats. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that administration of romifidine alone or romifidine-butorphanol causes a significant decrease in heart rate and that preemptive administration of atropine in cats sedated with romifidine-butorphanol effectively prevents bradycardia for 50 minutes.     

Comparison of Intra-articular and Epidural Morphine for Analgesia Following Stifle Arthrotomy in Dogs

We prospectively studied 18 dogs that presented for exploratory stifle arthrotomy, with or without meniscectomy, and lateral extracapsular stabilization as a result of cranial cruciate ligament rupture. Dogs were premedicated with acepromazine, induced with thiopental, and maintained with halothane in oxygen. Preoperatively, dogs were assigned to one of three groups. Group 1 (n = 6) received intra-articular morphine (0.1 mg/kg diluted in 1 mL/10 kg body weight of saline) and epidural saline (1 mL/5 kg body weight saline plus the volume of saline representing 0.1 mg/kg of morphine). Group 2 (n = 6) received intra-articular saline (1 mL/10 kg body weight of saline plus the volume of saline representing 0.1 mg/kg of morphine) and epidural saline (1 mL/5 kg body weight saline plus the volume of saline representing 0.1 mg/kg of morphine). Group 3 (n = 6) received intra-articular saline (1 mL/10 kg body weight of saline plus the volume of saline representing 0.1 mg/kg of morphine) and epidural morphine (0.1 mg/kg of morphine diluted in 1 mL/5 kg body weight saline). The efficacy of each analgesia regimen was evaluated for 6 hours postoperatively with a pain score based on subjective and objective variables. Serum Cortisol and blood glucose concentrations were measured. Butorphanol was used to provide analgesia as needed based on a predetermined maximum pain score. Supplemental analgesics were required postoperatively every 2 to 3 hours for 6 hours in all dogs that did not initially receive analgesics (group 2). Pain scores were significantly lower in dogs administered morphine intra-articularly (group 1) and epidurally (group 3) at 30 minutes and 30, 120, and 360 minutes, respectively, compared with dogs that did not initially receive analgesics (group 2). One dog in group 1 and one dog in group 3 required supplemental analgesia with butorphanol. There was no difference between analgesia produced by intra-articular morphine compared with that of epidural morphine. Side effects after intra-articular or epidural morphine were not observed. Intra-articular administration of morphine can produce effective analgesia in dogs comparable with that produced by epidural administration of morphine.     

An evaluation of the analgesic effects of meloxicam in addition to epidural morphine/mepivacaine in dogs undergoing cranial cruciate ligament repair

The analgesic efficacy of an epidural morphine/mepivacaine combination alone versus epidural morphine/mepivacaine in combination with meloxicam administered prior to the onset of anesthesia was assessed in 20 dogs undergoing cranial cruciate ligament repair. Numerical and visual analog pain scores were performed prior to anesthesia and at 6, 8, 12, 16, and 24 hours after epidural administration by a trained observer, blinded to treatment. An analgesiometer was used to determine the amount of pressure required to produce an avoidance response at the incision site. Animals that received meloxicam demonstrated a trend toward decreased pain scores over all time periods. Visual analog pain scores tended to be lower in dogs receiving meloxicam across all time periods, with a significant interaction between time and visual analog score at 6 and 8 hours (P < 0.05). No dogs receiving meloxicam required rescue analgesia, while 3 of 10 dogs in the epidural only group required rescue analgesia. Administration of meloxicam in addition to epidural morphine plus mepivacaine conveys improved analgesia as compared with epidural alone. Postoperative analgesia is reliably maintained for 24 hours following administration.     

Analgesic, hemodynamic, and respiratory effects induced by caudal epidural administration of meperidine hydrochloride in mares.

OBJECTIVE: To determine the analgesic, hemodynamic, and respiratory effects induced by caudal epidural administration of meperidine hydrochloride in mares. ANIMALS: 7 healthy mares. Procedure: Each mare received meperidine (5%; 0.8 mg/kg of body weight) or saline (0.9% NaCl) solution via caudal epidural injection on 2 occasions. At least 2 weeks elapsed between treatments. Degree of analgesia in response to noxious electrical, thermal, and skin and muscle prick stimuli was determined before and for 5 hours after treatment. In addition, cardiovascular and respiratory variables were measured and degree of sedation (head position) and ataxia (pelvic limb position) evaluated. RESULTS: Caudal epidural administration of meperidine induced bilateral analgesia extending from the. coccygeal to S1 dermatomes in standing mares; degree of sedation and ataxia was minimal. Mean (+/- SD) onset of analgesia was 12 +/- 4 minutes after meperidine administration, and duration of analgesia ranged from 240 minutes to the entire 300-minute testing period. Heart and respiratory rates, rectal temperature, arterial blood pressures, Hct, PaO2, PaCO2, pHa, total solids and bicarbonate concentrations, and base excess were not significantly different from baseline values after caudal epidural administration of either meperidine or saline solution. CONCLUSIONS AND CLINICAL RELEVANCE: Caudal epidural administration of meperidine induced prolonged perineal analgesia in healthy mares. Degree of sedation and ataxia was minimal, and adverse cardiorespiratory effects were not detected. Meperidine may be a useful agent for induction of caudal epidural analgesia in mares undergoing prolonged diagnostic, obstetric, or surgical procedures in the anal and perineal regions.     

Sedation and Pain Management with Intravenous Romifidine−Butorphanol in Standing Horses

The objective of this study was to determine the sedation, analgesia, and clinical reactions induced by an intravenous combination of romifidine and butorphanol in horses. The study was conducted on six saddle horses weighing 382 to 513 kg (mean ± SD; 449 ± 54 kg) and aged 6 to 14 years. The horses each underwent three treatments: intravenous romifidine 0.1 mg/kg body weight (RM; mean dose, 4.5 mL); intravenous butorphanol 0.05 mg/kg body weight (BT; mean dose, 2.4 mL); and intravenous romifidine 0.1 mg/kg body weight plus butorphanol 0.05 mg/kg body weight (RMBT; mean dose, 7.0 mL). The order of treatments was randomized. Heart rate, arterial pressure, respiratory rate, rectal temperature, sedation, and analgesia were measured at two times before treatments, 15 minutes apart (times –15 and 0) and at 5, 10, 15, 30, 45, 60, 75, 90, 120, 150, and 180 minutes after drug administration. The onset of sedation was approximately 5 minutes after intravenous injection of RM and RMBT, whereas BT did not present this effect. The duration of complete sedation was approximately 60 minutes for RMBT and approximately 35 minutes for RM. The RMBT treatment provided 30 minutes and the RM treatment 20 minutes of complete analgesia. Heart rate decreased significantly (P < .05) from basal values in the RM and RMBT treatments. Only RM caused significant decreases (P < .05) in the respiratory rate. Arterial pressure did not change significantly (P > .05) in any treatment. Intravenous administration of a romifidine−butorphanol combination to horses resulted in longer duration of sedation and analgesia than administration of romifidine or butorphanol alone. These effects probably resulted from a synergistic effect of the two drugs.     

Perineal analgesia and hemodynamic effects of the epidural administration of meperidine or hyperbaric bupivacaine in conscious horses

Epidural administration of bupivacaine and meperidine produces analgesia in several animal species and in humans. A prospective randomized study was conducted in 18 healthy horses to compare the effect of these 2 drugs administered by the epidural route. Animals were divided into 3 treatment groups of 6 animals each. All drugs were injected by the epidural route in all animals between the 1st and 2nd coccygeal vertebrae. Treatment 1 (BUP)--0.06 mg/kg of body weight of 0.5% hyperbaric bupivacaine; treatment 2 (MEP)--0.6 mg/kg of body weight of 5% meperidine; treatment 3 (SS)--0.9% saline solution (control group). Heart rate, arterial pressure, respiratory rate, rectal temperature, analgesia, sedation, and motor-blocking were determined before drug administration (baseline values); at 5, 10, 15, and 30 minutes after drug administration, and then at 30-minute intervals thereafter. Both hyperbaric bupivacaine and meperidine administered epidurally produced complete bilateral perineal analgesia in all horses. The onset of analgesia was 6, s = 2.6 minutes after injection of bupivacaine, as opposed to 9, s = 2 minutes after meperidine. The duration of analgesia was 240, s = 57 minutes for meperidine and 320, s = 30 minutes for bupivacaine. Heart and respiratory rates, arterial pressure, and rectal temperature did not change (P < 0.05) significantly from basal values after the epidural administration of bupivacaine, meperidine, or saline solution. To conclude, both bupivacaine and meperidine induced long-lasting perineal analgesia, with minimal cardiovascular effects. Analgesia was induced faster and lasted longer with bupivacaine.     

Comparison of morphine and butorphanol as pre-anaesthetic agents in combination with romifidine for field castration in ponies

OBJECTIVE: The aim of this study was to compare two different alpha2 agonist-opioid combinations in ponies undergoing field castration. STUDY DESIGN: Prospective double-blind randomized clinical trial. ANIMAL POPULATION: Fifty-four ponies undergoing field castration. MATERIALS AND METHODS: The ponies were randomly allocated to receive one of three different pre-anaesthetic medications [intravenous (IV) romifidine 100 microg kg(-1) and butorphanol 50 micro kg(-1); romifidine 100 microg kg(-1) and morphine 0.1 mg kg(-1) IV, or romifidine 100 microg kg(-1) and saline IV] before induction of anaesthesia with ketamine 2.2 mg kg(-1) IV. Further doses of romifidine (25 microg kg(-1)) and ketamine (0.5 mg kg(-1)) were given when required to maintain anaesthesia. Quality of sedation, induction of anaesthesia, maintenance of anaesthesia, recovery, and surgical condition were assessed using a visual analogue scale scoring system and compared. The effects of the different drug combinations on heart and respiratory rate were evaluated and the recovery time was recorded. RESULTS: Anaesthesia was considered adequate for surgery in all ponies. No anaesthetic complications were observed. Quality of sedation was significantly better in the butorphanol group compared with the control group (p = 0.0428). Overall quality of anaesthesia was better in the butorphanol group compared with morphine (p = 0.0157) and control (p < 0.05) groups. Quality of induction of anaesthesia and recovery were not significantly different between groups, nor were the surgical conditions, recovery time and the number of repeated anaesthetic doses required during the procedure. Muscle twitches were observed in both the control and morphine groups. Maintenance of anaesthesia was judged to be smoother in the butorphanol group compared with the morphine and control groups (p = 0.006). Heart rate decreased significantly (p < 0.01) in all groups after administration of sedatives but did not differ significantly between groups at any time point. CONCLUSION: The combination of butorphanol and romifidine was found to provide better sedation compared with the other drug combinations. CLINICAL RELEVANCE: The combination of butorphanol and romifidine provided better sedation, but morphine was found to be a suitable alternative to butorphanol. Use of morphine and butorphanol in combination with alpha2 agonists should be further investigated to assess their analgesic effects.     

Laparoscopic ovariectomy using the endo-GIA stapling device and endo-catch pouches and evaluation of analgesic efficacy of epidural morphine sulfate in 10 mares

OBJECTIVE: To evaluate use of ENDO-GIA staples and ENDO-Catch pouches for ovariectomy in mares and to evaluate the efficacy of epidural morphine analgesia. STUDY DESIGN: Randomized clinical trial. ANIMALS: Mares (n = 10) with normal ovaries. METHODS: An Endo-GIA II stapler (United States Surgical Corp., Norwalk, CT) was used to amputate the ovaries bilaterally, in standing mares, and Endo-Catch II pouches (United States Surgical Corp.) were used for retrieval. Epidural morphine was used in 5 mares, and procedure duration, volume of lidocaine required to desensitize the ovarian pedicle, and sedation were compared with horses not administered epidural morphine. RESULTS: Use of the Endo-GIA II stapling device was an easy and an efficient method of ovariectomy, which was facilitated by use of epidural morphine. For the epidural group, the mean (+/-SD) surgical time was 69.2 +/- 10.2 minutes compared with 124.4 +/- 21.2 minutes for mares not administered morphine. Less systemic sedation was required for mares administered epidural morphine. CONCLUSIONS: Minimal ovarian manipulation was required to apply the stapler, hemorrhage was slight, and none of the mares had complications. Epidural morphine provided effective analgesia, improving patient comfort, and reduced the sedation needed to perform ovariectomy. CLINICAL RELEVANCE: Endo-GIA II staples are an efficient method for ovariectomy in normal mares. Epidural morphine should be considered to facilitate ovariectomy because less sedation and local anesthetic administration is required.     

Comparison of lidocaine, xylazine, and lidocaine−xylazine for caudal epidural analgesia in cattle

Objective To directly compare the time to onset and duration of analgesia produced by a lidocaine/xylazine combination with that produced by lidocaine and xylazine administered alone in the caudal epidural space of dairy cattle. Design Prospective randomized experimental study. Animals Nine adult (> 4 years of age) dairy cows (520–613 kg). Methods Caudal epidural analgesia was produced in all cows with 2% lidocaine (0.22 mg kg^?1; 5.5 mL 500 kg^?1), 10% xylazine (0.05 mg kg^?1 diluted to 5.5 mL 500 kg^?1 with sterile water), and 2% lidocaine/10% xylazine (0.22 mg kg^?1/0.05 mg kg^?1; total volume of 5.7 mL 500 kg^?1), at no earlier than weekly intervals in a Latin square design. Time to onset, duration and cranial spread of analgesia were recorded, as were degree of sedation, ataxia and ptyalism. Results No significant difference (p > 0.05) was noted for time (mean ± SEM) of onset of analgesia between lidocaine (4.8 ± 1.0 minutes) and the lidocaine/xylazine combination (5.1 ± 0.9 minutes) but onset of analgesia following xylazine was significantly longer (11.7 ± 1.0 minutes) than either of the other two treatments. Lidocaine/xylazine (302.8 ± 11.0 minutes) produced analgesia of significantly longer duration than that of xylazine (252.9 ± 18.9 minutes) and both the lidocaine/xylazine combination and xylazine alone produced analgesia of significantly longer duration than that produced by lidocaine (81.8 ± 11.8 minutes). In all cattle, xylazine, administered either alone or with lidocaine, induced mild to moderate sedation and ataxia and cutaneous analgesia from the coccyx to T13. Mild ataxia was also present in those cattle receiving lidocaine alone. Conclusion The combination of xylazine and lidocaine produces analgesia of quicker onset and longer duration than xylazine administered alone and of longer duration than lidocaine administered alone. Clinical relevance Utilizing this combination, long‐duration obstetrical and surgical procedures could commence relatively soon after epidural injection and could be completed without re‐administration of anesthetic agents.     

Comparison of sedative effects of romifidine following intravenous, intramuscular, and sublingual administration to horses.

OBJECTIVE: To compare sedative effects of romifidine following IV, IM, or sublingual (SL) administration in horses. ANIMALS: 30 horses that required sedation for routine tooth rasping. PROCEDURE: Horses (n = 10/group) were given romifidine (120 microg/kg) IV, IM, or SL. Heart rate, respiratory rate, head height, distance between the ear tips, thickness of the upper lip, response to auditory stimulation, response to tactile stimulation, and degree of ataxia were recorded every 15 minutes for 180 minutes. Tooth rasping was performed 60 minutes after administration of romifidine, and overall adequacy of sedation was assessed. RESULTS: IV and IM administration of romifidine induced significant sedation, but SL administration did not induce significant sedative effects. Scores for overall adequacy of sedation after IV and IM sedation were not significantly different from each other but were significantly different from scores for horses given romifidine SL. Sedative and other effects varied among groups during the first 60 minutes after drug administration; thereafter, effects of IV and IM administration were similar. CONCLUSIONS AND CLINICAL RELEVANCE: Onset of action was fastest and degree of sedation was greater after IV, compared with IM, administration of romifidine, but duration of action was longer after IM administration. Sublingual administration did not result in clinically important sedative effects.     

Sedative, analgesic and cardiorespiratory effects of romifidine in cats

OBJECTIVE: To evaluate the sedative, analgesic, and cardiorespiratory effects of intramascular (IM) romifidine in cats. STUDY DESIGN: Prospective, randomized experimental trial. ANIMALS: Ten healthy adult cats. METHODS: Romifidine (100, 200, and 400 microg kg(-1)) or xylazine (1 mg kg(-1)) was given IM in a cross-over study design. Heart rate (HR), respiratory rate (RR), rectal temperature (RT), hemoglobin saturation, oscillometric arterial pressure, and scores for sedation, muscle relaxation, position, auditory response, and analgesia were determined before and after drug administration. Time to recumbency, duration of recumbency, and time to recover from sedation were determined. Subjective evaluation and cardiorespiratory variables were recorded before and at regular intervals for 60 minutes after drug administration. RESULTS: Bradycardia developed in all cats that were given romifidine or xylazine. No other significant differences in physiologic parameters were observed from baseline values or between treatments. Increasing the dose of romifidine did not result in increased sedation or muscle relaxation. Cats given xylazine showed higher sedation and muscle relaxation scores over time. Analgesia scores were significantly higher after administration of romifidine (400 microg kg(-1)) and xylazine (1 mg kg(-1)) than after romifidine at 100 or 200 microg kg(-1). Duration of lateral recumbency was not significantly different between treatments; however, cats took longer to recover after administration of 400 micro g kg(-1) romifidine. CONCLUSIONS AND CLINICAL RELEVANCE: Bradycardia is the most important adverse effect after IM administration of romifidine at doses ranging from 100 to 400 microg kg(-1) or 1 mg kg(-1) of xylazine in cats. The sedative effects of romifidine at 200 microg kg(-1) are comparable to those of 1 mg kg(-1) of xylazine, although muscle relaxation and analgesia were significantly less with romifidine than with xylazine.     

Caudal epidural analgesia induced by xylazine administration in cows

Xylazine (0.05 mg/kg of body weight diluted to a 5-ml volume, using 0.9% NaCl) or 5 ml of 0.9% NaCl was administered epidurally into the first caudal intervertebral space (Co1-Co2) in 8 cows (mean +/- SD body weight, 583 +/- 150 kg). Cows were observed for responses to deep needle pricking of the caudal dermatomes (S3 to Co), sedation, and ataxia. Heart rate, respiratory rate, body temperature, rate of ruminal contractions, coccygeal arterial blood pressure, pHa, blood gas tension (PaO2, PaCO2), base excess, total solids concentration, and PCV were determined before and after xylazine administration. Epidurally administered xylazine induced sedation and selective (S3 to Co) analgesia for at least 2 hours. Mild ataxia of hind limbs was observed in 6 cows, but all cows remained standing. Heart rate, respiratory rate, rate of ruminal contractions, arterial blood pressure, PaO2, PCV, and total solids concentration were significantly (P less than 0.05) decreased, and PaCO2, base excess, and bicarbonate concentration were significantly (P less than 0.05) increased after xylazine administration. Epidurally administered 0.9% NaCl did not alter sensory perception to needle pricking and did not affect any of the physiologic variables determined. Although epidural administration of xylazine induced analgesia and sedation in healthy cows, it should be avoided for epidural analgesia in cattle with heart disease, lung disease, and/or gastrointestinal disease because of its potent cardiopulmonary and ruminal depressant effects.     

Efficacy of an Epidural Combination of Morphine and Detomidine in Alleviating Experimentally Induced Hindlimb Lameness in Horses

Amphotericin B-induced synovitis of the left tarsocrural joint was used to create a grade 3 of 4 lameness in 11 horses. Caudal epidural catheters were placed and advanced to the lumbosacral region. Baseline heart and respiratory rates were recorded and horses were videotaped at a walk and trot. Morphine sulphate (0.2 mg/kg) and detomidine hydrochloride (30 μg/kg) were administered to treated horses (n = 8) through the epidural catheter; an equivalent volume of physiologic saline solution was administered to control horses (n = 3) through the catheter. At hourly intervals after epidural injection for a total of 6 hours, heart and respiratory rates were recorded, and horses were videotaped walking and trotting. At the end of the observation period, video recordings were scrambled onto a master videotape. Lamenesses were scored by three investigators unaware of group assignment or treatment time. Lameness scores, heart rates, and respiratory rates were compared between groups using repeated measures analysis of variance. There was a significant decrease in lameness score after treatment with epidural morphine and detomidine ( P =.0003); average lameness scores of treated horses were less than grade 1 at each hourly observation for 6 hours after drug administration. Early in the observation period, heart rates significantly increased in control horses and decreased in treated horses ( P =.03). A similar trend occurred for respiratory rates ( P =.07). Results of this study demonstrate that epidural administration of a combination of morphine and detomidine is capable of providing profound hindlimb analgesia in horses.     

Comparison of analgesic efficacy of preoperative or postoperative carprofen with or without preincisional mepivacaine epidural anesthesia in canine pelvic or femoral fracture repair

Objective— To compare analgesic efficacy of preoperative versus postoperative administration of carprofen and to determine, if preincisional mepivacaine epidural anesthesia improves postoperative analgesia in dogs treated with carprofen. Study Design— Blind, randomized clinical study. Animals— Dogs with femoral (n=18) or pelvic (27) fractures. Methods— Dogs were grouped by restricted randomization into 4 groups: group 1=carprofen (4 mg/kg subcutaneously) immediately before induction of anesthesia, no epidural anesthesia; group 2=carprofen immediately after extubation, no epidural anesthesia; group 3=carprofen immediately before induction, mepivacaine epidural block 15 minutes before surgical incision; and group 4=mepivacaine epidural block 15 minutes before surgical incision, carprofen after extubation. All dogs were administered carprofen (4 mg/kg, subcutaneously, once daily) for 4 days after surgery. Physiologic variables, nociceptive threshold, lameness score, pain, and sedation (numerical rating scale [NRS], visual analog scale [VAS]), plasma glucose and cortisol concentration, renal function, and hemostatic variables were measured preoperatively and at various times after surgery. Dogs with VAS pain scores >30 were administered rescue analgesia. Results— Group 3 and 4 dogs had significantly lower pain scores and amount of rescue analgesia compared with groups 1 and 2. VAS and NRS pain scores were not significantly different among groups 1 and 2 or among groups 3 and 4. There was no treatment effect on renal function and hemostatic variables. Conclusions— Preoperative carprofen combined with mepivacaine epidural anesthesia had superior postoperative analgesia compared with preoperative carprofen alone. When preoperative epidural anesthesia was performed, preoperative administration of carprofen did not improve postoperative analgesia compared with postoperative administration of carprofen. Clinical Relevance— Preoperative administration of systemic opioid agonists in combination with regional anesthesia and postoperative administration of carprofen provides safe and effective pain relieve in canine fracture repair.     

Analgesic effects of epidurally administered levogyral ketamine alone or in combination with morphine on intraoperative and postoperative pain in dogs undergoing ovariohysterectomy

OBJECTIVE: To evaluate the analgesic and adverse effects of epidurally administered levogyral (S[+]) ketamine alone or in combination with morphine on intraoperative and postoperative pain in dogs undergoing ovariohysterectomy. ANIMALS: 30 dogs scheduled for ovariohysterectomy. PROCEDURE: Dogs were randomly allocated to 1 of 3 groups. Dogs in group 1 received S(+) ketamine (1 mg/kg), dogs in group 2 received S(+) ketamine (0.5 mg/kg) and morphine (0.05 mg/kg), and dogs in group 3 received S(+) ketamine (1 mg/kg) and morphine (0.025 mg/kg). The skin was incised 15 minutes after epidural administration of analgesics. Heart rate (HR), respiratory rate (RR), systolic blood pressure (SBP), oxygen saturation as measured by pulse oximetry, and arterial blood gases were obtained before anesthesia, 15 minutes after epidural administration of analgesics, 15 and 30 minutes after initiation of surgery, and at the end of surgery. During the intraoperative period, an increase of > or =20% in baseline values for HR, RR, and SBP was considered a sign of intraoperative pain. Signs of pain and adverse effects were assessed at 2, 4, and 8 hours postoperatively. RESULTS: There were no significant differences in intraoperative or postoperative measurements among the 3 groups. No dogs had intraoperative signs of pain. Mean postoperative pain assessment scores were <3.5 in all 3 groups. Salivation was the most frequent adverse effect in dogs in groups 1 and 3, and sedation occurred more frequently in dogs in groups 2 and 3. CONCLUSIONS AND CLINICAL RELEVANCE: All 3 analgesic regimens provided good respiratory and cardiovascular stability intraoperatively and adequate postoperative analgesia with minimal adverse effects.     

Caudal epidural analgesia in cattle using xylazine.

Each of 25 mature Holstein cows were given a single 5 mL epidural injection of one of four different concentrations of xylazine or saline. The onset, magnitude and duration of caudal epidural analgesia was quantitated with the use of a low voltage DC current applied to the perineal area. The dose that produced the longest duration of analgesia and produced the least ataxia or sedation was approximately 0.05 mg/kg (25 mg in 5 mL diluent). The analgesia produced by this xylazine dose was compared to a standard dose of epidural lidocaine (100 mg/5 mL) by the same method. To investigate the role of systemic absorption in the production of epidural analgesia, the previously utilized epidural xylazine dosage was given intramuscularly to four adult cows. Analgesia was quantitated as before and the results compared with epidural xylazine. Epidural xylazine produced a significantly greater duration of analgesia, as measured by this model, than did epidural lidocaine. Xylazine, given epidurally, produced greater perineal analgesia than did xylazine given intramuscularly.     

Comparison of Analgesic Effects of Caudal Epidural 0.25% Bupivacaine with Bupivacaine Plus Morphine or Bupivacaine Plus Ketamine for Analgesia in Conscious Horses

The aim of this study was to compare the effects of caudal epidural bupivacaine alone (BP), bupivacaine plus morphine (BPMP), and bupivacaine plus ketamine (BPKE) for perineal analgesia in horses. Each of the six saddle horses received a caudal epidural catheter and underwent 3 treatments: BP, 0.25% (0.04 mg/kg) bupivacaine hydrochloride without epinephrine; BPMP, 0.02 mg/kg of bupivacaine combined with 0.1 mg/kg of morphine-preservative free; and BPKE, 0.02 mg/kg of bupivacaine combined with 0.5 mg/kg of ketamine. The order of treatments was randomized. The cardiovascular system, respiratory rate, quality of analgesia, sedation, and motor blockade were assessed before drug administration (baseline), at 5, 10, 15, and 30 minutes, and every 30 minutes thereafter until loss of analgesia. The median time to onset of analgesia was 5 minutes after BP treatment, faster than after BPKE or BPMP treatments, which were 10 minutes and 15 minutes, respectively (P < .05). The BPMP treatment produced analgesia (315 minutes) for a longer duration than BP treatment (210 minutes) or BPKE treatment (240 minutes), in the regions of the tail, perineum, and upper hind limb in horses. All treatments presented mild sedation or motor blockade. There were minimal effects on the cardiovascular system and respiratory rate. BPMP may be preferable to a high dose of BP or BPKE. Caudal epidural BPMP can be an appropriate choice for regional perineal analgesia in horses.     

Comparison of cervical epidural morphine with intravenous morphine administration on antinociception in adult horses using thermal threshold testing

ObjectiveTo compare the antinociceptive effects of morphine administered via cervical epidural catheter to intravenously administered morphine using a thermal threshold (TT) testing model in healthy adult horses.Study designProspective, randomized, blinded experimental study.AnimalsA total of six university-owned adult horses.MethodsHorses were instrumented with a cervical (C1–C2) epidural catheter and TT testing device with probes at withers and thoracic limb coronary bands. All horses underwent three TT testing cycles including cervical epidural morphine administration (treatment EpiM; 0.1 mg kg^–1), systemic morphine administration (treatment SystM; 0.1 mg kg^–1) and no morphine administration (treatment Control). Baseline TT was established prior to treatments, and TT was tested at 15, 30, 60, 90, 120, 150, 180, 240, 300, 360, 420, 480, 600 and 720 minutes following treatment. Horses underwent a 5 day washout period between treatments and the order of treatment was randomized. Differences between treatments were analyzed with repeated measures anova.ResultsSystemic and epidural morphine administration resulted in significantly higher TT values compared with baseline and control treatment. The duration of effect was significantly longer in treatment EpiM (10–12 hours) than in treatment SystM (1.5–2.0 hours). Horses in treatment EpiM had significantly higher TT values at time points 180–600 minutes (withers) and 300–600 minutes (coronary band) than horses in treatment SystM.Conclusions and clinical relevanceCervical epidural administration of morphine provided antinociceptive effects as measured by increased TT for 10–12 hours compared with 1.5–2.0 hours for intravenously administered morphine. No complications or adverse effects were noticed following epidural placement of a C1–C2 catheter and administration of morphine. The use of a cervical epidural catheter can be considered for analgesia administration in treatment of thoracic limb and cervical pain in the horse.     

Evaluation of epidural administration of morphine or morphine and bupivacaine for postoperative analgesia after premedication with an opioid analgesic and orthopedic surgery in dogs

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.