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Vet Anaesth Analg [journal]
- Pharmacokinetic profiles of the analgesic flupirtine in dogs after the administration of four pharmaceutical formulations. [JOURNAL ARTICLE]
- Vet Anaesth Analg 2014 Dec 11.
Flupirtine (FLU) is a non-opioid analgesic with no antipyretic or anti-inflammatory effects which is used in the treatment of pain in humans. There is a substantial body of evidence on the efficacy of FLU in humans but this is inadequate for the recommendation of its off-label use in veterinary clinical practice. The aim of this study was to evaluate the pharmacokinetic profiles of FLU after intravenous (IV), oral immediate release (POIR), oral prolonged release (POPR) and rectal (RC) administrations in healthy dogs.Four-treatment, single-dose, four-phase, unpaired, cross-over design (4 × 4 Latin-square).Six adult Labrador dogs.Animals in groups 1, 2 and 4 received a single dose of 5 mg kg(-1) FLU administered by IV, POIR and RC routes. Group 3 received a single dose of 200 mg subject(-1) via the POPR route. The wash-out periods were 1 week. Blood samples (1 mL) were collected at assigned times for 48 hours and plasma FLU concentrations were analysed by a validated HPLC method.Adverse effects including salivation, tremors and vomiting were noted in the IV group and resolved spontaneously within 10 minutes. These effects did not occur in the other groups. The FLU plasma concentrations were detectable in all of the treatment groups for 36 hours following administration. The pharmacokinetic profiles after extravascular administrations showed similar trends. The bioavailability values after POIR, POPR and RC were 41.93%, 36.78% and 29.43%, respectively. There were no significant differences in pharmacokinetic profiles between the POIR and POPR formulations. A 5 mg kg(-1) POIR dose or a 200 mg subject(-1) POPR dose gave plasma concentrations similar to those reported in humans after clinical dosing.This study provides pharmacokinetic data that can be used to design further studies to investigate FLU in dogs.
- Ultrasound-assisted periconal ocular blockade in rabbits. [JOURNAL ARTICLE]
- Vet Anaesth Analg 2014 Dec 1.
This study aimed to evaluate the benefit and specifically the feasibility of using ultrasound in ophthalmologic periconal block, and the occurrence of complications.Prospective experimental study.Ten healthy New Zealand White rabbits (6-8 months of age), weighing 2.0-3.5 kg.Rabbits were anesthetized by intramuscular injection of acepromazine (1 mg kg(-1) ), ketamine (30 mg kg(-1) ) and xylazine (3 mg kg(-1) ). Ultrasound-assisted periconal block with lidocaine was performed on 18 eyes. Intraocular pressure was measured by applanation tonometry whereas corneal sensitivity was assessed using an esthesiometer, before and after each periconal anesthesia.In all 18 eyes, it was possible to adequately visualize the needle shaft within the periconal space, as well as muscular cone, optic nerve and local anesthetic solution spread. Lidocaine 2% without epinephrine (0.79 ± 0.19 mL) was injected into the periconal space. There was no statistical difference between the intraocular pressure (mean ± SD) measured before (10.9 ± 2.9 mmHg) and after (11.9 ± 3.8 mmHg) the periconal anesthesia (p = 0.38). The effectiveness of the ultrasound-assisted technique was shown according to the values for corneal sensitivity, assessed before and after periconal anesthesia (p < 0.0001). Complications were not observed in this study.Eye ultrasonography allowed visualization of all anatomic structures necessary to perform a periconal block, as well as the needle insertion and anesthetic spread in real time. Further studies are required to prove the real potential of ultrasound for reducing the incidence of complications associated with ophthalmic blocks, especially when anatomic disorders of the eye could potentially increase the risk.Ultrasonography is a painless, noninvasive tool that may improve safety of ophthalmic regional blocks, potentially by reducing the prevalence of globe perforation or penetration of the optic nerve associated with the needle-based techniques.
- The effect of the stage of the ovarian cycle (anoestrus or dioestrus) and of pregnancy on the incidence of gastro-oesophageal reflux in dogs undergoing ovariohysterectomy. [JOURNAL ARTICLE]
- Vet Anaesth Analg 2014 Oct 28.
To investigate the potential association of increased blood progesterone (P4 ) concentrations and/or late pregnancy with the incidence of gastro-oesophageal reflux (GOR), in healthy bitches undergoing ovariohysterectomy under general anaesthesia during anoestrus or dioestrus or during the second half of pregnancy.Prospective observational study.Ninety-four healthy, female, dogs, aged 1-8 years presented for elective ovariohysterectomy.Non-pregnant animals were classified into group A (anoestrus) (n = 35) if blood P4 concentration was sufficiently low or group D (dioestrus) (n = 26) if blood P4 concentration was sufficiently high. All animals in the second half of pregnancy were classified into group P (n = 33). Acepromazine (0.05 mg kg(-1) ) was administered intramuscularly as preanaesthetic medication, and sodium thiopental (10 mg kg(-1) , with additional doses if needed) was administered intravenously (IV) for induction of anaesthesia. After endotracheal intubation, halothane (1.1-1.3% end-tidal concentration) in oxygen was used for maintenance of anaesthesia. Lower oesophageal pH was monitored continuously throughout surgery using a pH-measuring probe. Reflux was considered to have occurred whenever pH values of >7.5 (alkaline reflux) or <4 (acid reflux) were recorded. On completion of surgery, carprofen (4 mg kg(-1) ) was administered IV. Further administration of analgesics post-operatively was dictated by visual analogue scale pain scoring.Acid GOR was observed in five of 26 dogs in group D, six of 35 group A, and 12 of 33 group P (p = 0.152). The incidence of GOR in group P approached statistical significance and was higher than the incidence in the combined group A + D (one sided p = 0.044, two sided p = 0.077).In dogs undergoing ovariohysterectomy, GOR during anaesthesia occurs with a high incidence in dogs in the second half of pregnancy compared to non-pregnant animals during anoestrus or dioestrus.Measures could be taken in such cases to avoid the consequences of potential reflux.
- Pharmacokinetics and pharmacodynamics of propofol with or without 2% benzyl alcohol following a single induction dose administered intravenously in cats. [JOURNAL ARTICLE]
- Vet Anaesth Analg 2014 Oct 20.
To compare the pharmacokinetics and pharmacodynamics of propofol with or without 2% benzyl alcohol administered intravenously (IV) as a single induction dose in cats.Prospective experimental study.Six healthy adult cats, three female intact, three male castrated, weighing 4.8 ± 1.8 kg.Cats received 8 mg kg(-1) IV of propofol (P) or propofol with 2% benzyl alcohol (P28) using a randomized crossover design. Venous blood samples were collected at predetermined time points to 24 hours after drug administration to determine drug plasma concentrations. Physiologic and behavioral variables were also recorded. Propofol and benzyl alcohol concentrations were determined using high pressure liquid chromatography with fluorescence detection. Pharmacokinetic parameters were described using a 2-compartment model. Pharmacokinetic and pharmacodynamic parameters were analyzed using repeated measures anova (p < 0.05).Plasma concentrations of benzyl alcohol were below the lower limits of quantification (LLOQ) at all time points for two of the six cats (33%), and by 30 minutes for the remaining four cats. Propofol pharmacokinetics, with or without 2% benzyl alcohol, were characterized by rapid distribution, a long elimination phase, and a large volume of distribution. No differences were noted between treatments with the exception of clearance from the second compartment (CLD2), which was 23.6 and 38.8 mL kg(-1) minute(-1) in the P and P28 treatments, respectively. Physiologic and behavioral variables were not different between treatments with the exception of heart rate at 4 hours post administration.The addition of 2% benzyl alcohol as a preservative minimally altered the pharmacokinetics and pharmacodynamics of propofol 1% emulsion when administered as a single IV bolus in this group of cats. These data support the cautious use of propofol with 2% benzyl alcohol for induction of anesthesia in healthy cats.
- The volume effect of lidocaine on thoracic epidural anesthesia in conscious Beagle dogs. [JOURNAL ARTICLE]
- Vet Anaesth Analg 2014 Oct 20.
To evaluate the volume effect of local anesthetic solution on thoracic epidural analgesia in dogs.Prospective, experimental trial.Five healthy adult Beagle dogs weighing 9.7 ± 1.3 kg.A catheter was inserted into the seventh thoracic epidural space using a lumbosacral approach, and secured with suture under total intravenous (IV) anesthesia with propofol. Each dog was administered four volume treatments (0.05, 0.10, 0.15 and 0.20 mL kg(-1) ) of 2% lidocaine via the catheter at 12 hour intervals. In every treatment, dogs were re-anesthetized with propofol (6 mg kg(-1) , IV) and isoflurane, and received iohexol at each volume to visualize the epidural distribution (ED) through computed tomography. Three hours after epidurography, when dogs had recovered from anesthesia, the appropriate volume of lidocaine was injected through the catheter, and sensory blockade (SB) in dermatomes was evaluated by pinching with a mosquito forceps. Results were presented as median (range), and the volume effect on ED and SB was analyzed with one-way Kruskal-Wallis anova.In proportion to volumes (0.05, 0.10, 0.15 and 0.20 mL kg(-1) ), there were significant increases in the extent of ED from 7.4 (5.5-9.0) to 10.4 (8.0-12.0), 13.2 (12.5-13.0), and 15.2 (13.0-18.0) vertebrae, respectively, p < 0.001, and in SB from 2.7 (1.0-5.0) to 6.8 (4.5-10.5), 9.9 (6.5-13.0), and 13.1 (11.0-15.0) dermatomes, respectively, p < 0.001. Unilateral ED and SB were observed in all treatments with various grades, and this distribution was more frequent in the low volume treatments. In the high volume treatments, temporary complications including Horner's syndrome, ataxia, paraplegia, depression, stupor, and intermittent cough occurred often.The increase in volume of local anesthetic solution improved SB by resulting in more consistent bilateral dermatome blockade as well as an extended blockade. However, caution should be exerted, as higher volume injections of lidocaine caused side effects in all dogs.
- Comparison of the effects of propofol or alfaxalone for anaesthesia induction and maintenance on respiration in cats. [JOURNAL ARTICLE]
- Vet Anaesth Analg 2014 Oct 13.
To compare the effects of propofol and alfaxalone on respiration in cats.Randomized, 'blinded', prospective clinical trial.Twenty cats undergoing ovariohysterectomy.After premedication with medetomidine 0.01 mg kg(-1) intramuscularly and meloxicam 0.3 mg kg(-1) subcutaneously, the cats were assigned randomly into two groups: group A (n = 10) were administered alfaxalone 5 mg kg(-1) minute(-1) followed by 10 mg kg(-1) hour(-1) intravenously (IV) and group P (n = 10) were administered propofol 6 mg kg(-1 ) minute(-1) followed by 12 mg kg(-1) hour(-1) IV for induction and maintenance of anaesthesia, respectively. After endotracheal intubation, the tube was connected to a non-rebreathing system delivering 100% oxygen. The anaesthetic maintenance drug rate was adjusted (± 0.5 mg kg(-1) hour(-1) ) every 5 minutes according to a scoring sheet based on physiologic variables and clinical signs. If apnoea > 30 seconds, end-tidal carbon dioxide (Pe'CO2 ) > 7.3 kPa (55 mmHg) or arterial haemoglobin oxygen saturation (SpO2 ) < 90% occurred, manual ventilation was provided. Methadone was administered postoperatively. Data were analyzed using independent-samples t-tests, Fisher's exact test, linear mixed-effects models and binomial test.Manual ventilation was required in two and eight of the cats in group A and P, respectively (p = 0.02). Two cats in both groups showed apnoea. Pe'CO2 > 7.3 kPa was recorded in zero versus four and SpO2 < 90% in zero versus six cats in groups A and P respectively. Induction and maintenance dose rates (mean ± SD) were 11.6 ± 0.3 mg kg(-1) and 10.7 ± 0.8 mg kg(-1) hour(-1) for alfaxalone and 11.7 ± 2.7 mg kg(-1) and 12.4 ± 0.5 mg kg(-1) hour(-1) for propofol.Alfaxalone had less adverse influence on respiration than propofol in cats premedicated with medetomidine. Alfaxalone might be better than propofol for induction and maintenance of anaesthesia when artificial ventilation cannot be provided.
- Comparison of midazolam and diazepam as co-induction agents with ketamine for anaesthesia in sedated ponies undergoing field castration. [JOURNAL ARTICLE]
- Vet Anaesth Analg 2014 Oct 13.
To compare intravenous (IV) midazolam and diazepam administered with ketamine for induction of anaesthesia in ponies, already sedated with detomidine, undergoing field castration.Prospective, randomised, 'blinded', clinical study.Twenty Welsh pony yearlings.After IV injection of detomidine (20 μg kg(-1) ) and phenylbutazone (4.4 mg kg(-1) ) ponies were allocated to receive either IV midazolam (group M) or diazepam (group D) (both 0.06 mg kg(-1) ) with ketamine (2.2 mg kg(-1) ) for induction of anaesthesia. Using simple descriptive scales, quality of sedation, induction, endotracheal intubation, surgical conditions and recovery were scored by observers blinded to treatment. Time from sedation to induction of anaesthesia, IV injection to lateral recumbency, induction to start of surgery, induction to first head lift and to standing, and total surgical time were measured. Cardiorespiratory function was assessed every 5 minutes. Time, number and total quantity of additional IV ketamine as well as any adverse effects were documented. Data were tested for normality and analysed using two-way anova with Bonferroni post hoc tests, unpaired t-tests and Mann-Whitney U tests as appropriate. Significance was set at p < 0.05.There were no significant group differences in any of the measured variables except bodyweight (mean ± SD: group M 163 ± 12 kg; group D 150 ± 7 kg; p = 0.01). One pony in group M required ketamine 15 minutes after induction of anaesthesia. Surgical conditions were good in all cases; time from induction to standing was 50 ± 11 minutes in group M and 48 ± 12 minutes in group D. There were no adverse effects. Recoveries were uneventful with minimal ataxia.Midazolam and diazepam at 0.06 mg kg(-1) can be used interchangeably in combination with ketamine for IV induction of short term anaesthesia in ponies.
- Opioid-induced adverse effects in a Holstein calf. [LETTER]
- Vet Anaesth Analg 2014 Oct 13.
- Comparison of epidural versus intrathecal anaesthesia in dogs undergoing pelvic limb orthopaedic surgery. [JOURNAL ARTICLE]
- Vet Anaesth Analg 2014 Oct 7.
To compare the procedural failure rate (PFR), intraoperative rescue analgesia (iRA) probability and postoperative duration of motor block after epidural and intrathecal anaesthesia in dogs undergoing pelvic limb orthopaedic surgery.Prospective, randomized clinical trial.Ninety-two client-owned dogs.Dogs were assigned randomly to receive either lumbosacral epidural anaesthesia (EA) (bupivacaine 0.5% and morphine 1%) or intrathecal anaesthesia with the same drugs in a hyperbaric solution (HIA). Inaccurate positioning of the needle, assessed by radiographic imaging, and lack of cerebral spinal fluid outflow were considered procedural failures (PFs) of EA and HIA, respectively. Fentanyl (1 μg kg(-1) IV) was provided for intraoperative rescue analgesia, when either the heart rate or the mean arterial pressure increased by 30% above the pre-stimulation value. Its use was recorded as a sign of intraoperative analgesic failure. The motor block resolution was evaluated postoperatively. Variables were compared using Fisher's exact test, the Mann-Whitney U test and the Kaplan-Meier 'survival' analysis as relevant.The PFRs in the EA and HIA groups were 15/47 (32%) and 3/45 (7%), respectively (p = 0.003). Differences in iRA were analysed in 26 and 30 subjects in the EA and HIA groups respectively, using Kaplan-Meier survival analysis. The iRA probability within the first 80 minutes of needle injection (NI) was higher in the EA group (p = 0.045). The incidence of dogs walking within 3 hours of NI was significantly higher in the HIA group (8/20, 40%) than in the EA group (0/17) (p = 0.004).HIA was found to have lower PF, lower intraoperative analgesic failure and faster motor block resolution. In this study HIA was shown to provide some advantages over EA in dogs undergoing commonly performed pelvic limb orthopaedic surgery in a day-hospital regime.