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Marzok M, Almubarak AI, Kandeel M, El-Khodery S. Comparing the anti-nociceptive, sedative and clinicophysiological effects of epidural detomidine, detomidine-lidocaine and lidocaine in donkeys. Vet Rec 2023; 192:e2479. [PMID: 36544432 DOI: 10.1002/vetr.2479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 10/12/2022] [Accepted: 11/02/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Epidural analgesia using the alpha-2 agonist detomidine (DE), alone or in combination with lidocaine (LD), is frequently employed for standing surgical procedures in horses, but its use has not been evaluated in donkeys. METHODS In a randomised controlled prospective trial, 24 healthy adult donkeys were assigned to four groups (n = 6), each receiving 40 μg/kg of DE, 0.22 mg/kg of LD, combined DE and LD (DELD) or 0.9% sterile normal saline epidurally. After epidural injection of each treatment, the onset, degree and duration of sedation and anatomical extension of anti-nociception were observed. RESULTS DE and DELD treatments resulted in complete bilateral analgesia with loss of sensation in the tail, perineum, inguinal area, chest and the caudal aspect of the upper pelvic limb, and extended distally to the dorsal metatarsal area. DE and DELD resulted in a significantly (p < 0.05) longer duration of anti-nociception (110 ± 15.4 min and 141.6 ± 14.7 min, respectively) than LD (75.8 ± 4.9 min). The DELD duration of sedation was significantly (p < 0.05) longer than the DE duration (118.3 ± 19.4 min and 108.3 ± 7.5 min, respectively). LIMITATION The current study's main limitation is using only one dose of DE. CONCLUSION DE and DELD produced a very effective, safe and acceptable sedative and analgesic effect in the perineal and inguinal regions of donkeys.
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Affiliation(s)
- Mohamed Marzok
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
- Department of Surgery, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Adel I Almubarak
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Mahmoud Kandeel
- Department of Biomedical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
- Department of Pharmacology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Sabry El-Khodery
- Department of Internal Medicine, Infectious Diseases and Fish Diseases, Faculty of Veterinary Medicine, Mansoura University, Manosura, Egypt
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Song Y, Day CM, Afinjuomo F, Tan JQE, Page SW, Garg S. Advanced Strategies of Drug Delivery via Oral, Topical, and Parenteral Administration Routes: Where Do Equine Medications Stand? Pharmaceutics 2023; 15:pharmaceutics15010186. [PMID: 36678815 PMCID: PMC9861747 DOI: 10.3390/pharmaceutics15010186] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/23/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
While the global market for veterinary products has been expanding rapidly, there is still a lack of specialist knowledge of equine pharmaceutics. In many cases, the basic structure of the gastrointestinal tract (GIT) and integumentary system of the horse shares similarities with those of humans. Generally, the dosage form developed for humans can be repurposed to deliver equine medications; however, due to physiological variation, the therapeutic outcomes can be unpredictable. This is an area that requires more research, as there is a clear deficiency in literature precedence on drug delivery specifically for horses. Through a careful evaluation of equine anatomy and physiology, novel drug delivery systems (NDDSs) can be developed to adequately address many of the medical ailments of the horse. In addition to this, there are key considerations when delivering oral, topical, and parenteral drugs to horses, deriving from age and species variation. More importantly, NDDSs can enhance the duration of action of active drugs in animals, significantly improving owner compliance; and ultimately, enhancing the convenience of product administration. To address the knowledge gap in equine pharmaceutical formulations, this paper begins with a summary of the anatomy and physiology of the equine gastrointestinal, integumentary, and circulatory systems. A detailed discussion of potential dosage-form related issues affecting horses, and how they can be overcome by employing NDDSs is presented.
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Affiliation(s)
- Yunmei Song
- Centre for Pharmaceutical Innovation (CPI), Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Candace M. Day
- Centre for Pharmaceutical Innovation (CPI), Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Franklin Afinjuomo
- Centre for Pharmaceutical Innovation (CPI), Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
| | - Jin-Quan E. Tan
- SA Pharmacy, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, SA 5042, Australia
| | - Stephen W. Page
- Advanced Veterinary Therapeutics, Newtown, NSW 2042, Australia
| | - Sanjay Garg
- Centre for Pharmaceutical Innovation (CPI), Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia
- Correspondence: ; Tel.: +61-8-8302-1575
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Marzok M, Almubarak AI, Babiker H, Kandeel M, El-Hawari SF, El-khodery S. Comparative evaluation of sedative and anti-nociceptive effects of epidural romifidine, romifidine-lidocaine, and lidocaine in donkeys ( Equus asinus). Front Vet Sci 2022; 9:966715. [PMID: 36570502 PMCID: PMC9768802 DOI: 10.3389/fvets.2022.966715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 11/17/2022] [Indexed: 12/05/2022] Open
Abstract
Background Local and regional anesthetic procedures are valuable tools in veterinary practice. Caudal epidural administration of local anesthetic agents is widely reported for surgical interventions of the tail, anus, rectum, vulva, vagina, urethra, and bladder in the standing horse. Epidural analgesia is also obtained using various drugs such as alpha-2 adrenoceptor agonists, dissociative anesthetics, and opioids. The present study evaluates the anti-nociceptive and sedative effects of epidural administration of romifidine, a romifidine-lidocaine combination, and lidocaine alone in donkeys. Materials and methods In a randomized prospective study, twenty-four healthy adult donkeys were assigned to four groups (three experimental and one control; n = 6) received either 50 μg/kg of romifidine, 0.30 mg/kg of lidocaine, combined romifidine (50 μg/kg) and lidocaine (0.30 mg/kg) diluted in 0.9% sterile normal saline solution to a total injection volume of 12 ml, or an equivalent volume of sterile saline epidurally. After epidural injection of each treatment, the onset, degree, and duration of sedation and anatomical extension of anti-nociception were documented. Observations began immediately (time 0) pre-administration and at 5, 15, 30, 45, 60, and 30-min intervals subsequently until 210 min after drug injection. Time to onset of perineal analgesia was documented every minute after the epidural injection by evaluating the animal's response to pinpricks. Results Only romifidine and romifidine-lidocaine induced mild to moderate sedation. Romifidine, romifidine-lidocaine, and lidocaine induced complete bilateral caudal epidural analgesia with loss of sensation in the perineum, tail, inguinal region, caudal aspect of the upper hind limb, chest areas, and extended distally to the dorsal metatarsal area. Sedation lasted longer (p < 0.05) with romifidine (160 ± 15.4 min) than with romifidine-lidocaine (141.6 ± 13.2 min). Longer-lasting analgesia (p < 0.05) was obtained with romifidine (158.3 ± 9.8 min) and romifidine-lidocaine (165 ± 9.4 min) than with lidocaine (75.8 ± 8 min). Conclusions Epidural administration of a single dose of romifidine or a combination of romifidine-lidocaine produced mild to moderate sedation and complete anti-nociception in the perineal and inguinal regions of donkeys. The clinical usefulness of epidural romifidine or romifidine-lidocaine combinations to perform obstetric procedures in donkeys needs to be assessed.
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Affiliation(s)
- Mohamed Marzok
- Department of Clinical Scienses, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia,Department of Surgery, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt,*Correspondence: Mohamed Marzok
| | - Adel I. Almubarak
- Department of Clinical Scienses, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Hussein Babiker
- Department of Clinical Scienses, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Mahmoud Kandeel
- Department of Biomedical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia,Department of Pharmacology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Sayed Fathi El-Hawari
- Department of Surgery, Faculty of Veterinary Medicine, Sohag University, Kafrelsheikh, Egypt
| | - Sabry El-khodery
- Department of Internal Medicine, Infectious Diseases and Fish Diseases, Faculty of Veterinary Medicine, Mansoura University, Manosura, Egypt
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Rønnow Kjærulff LN, Lindegaard C. A narrative review of caudal epidural anaesthesia and analgesia in horses. Part 1: Safety and efficacy of epidural drugs. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- L. N. Rønnow Kjærulff
- Department of Veterinary Clinical Sciences Faculty of Health Sciences University of Copenhagen Taastrup Denmark
| | - C. Lindegaard
- Department of Veterinary Clinical Sciences Faculty of Health Sciences University of Copenhagen Taastrup Denmark
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Marzok M, Almubarak AI, Abdel-Raheem SM, El-khodery S, Shawaf T, Kandeel M. Comparative Study of the Sedative and Anti-nociceptive Effects of Sacrococcygeal Epidural Administration of Romifidine, Lidocaine, and Romifidine/Lidocaine in the Dromedary Camel. Front Vet Sci 2022; 9:891581. [PMID: 35832332 PMCID: PMC9271924 DOI: 10.3389/fvets.2022.891581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022] Open
Abstract
In a randomized prospective study, comparative sedative and anti-nociceptive effects of epidural administration of romifidine (RO), lidocaine (LD), and a combination of romifidine-lidocaine (ROLD) in camel were evaluated. Eighteen healthy adult dromedary camels were assigned randomly to three treatment groups (n = 6), each receiving 50 μg/kg of RO, 0.30 mg/kg of LD, or a combination of both RO and LD. All treatments were expanded in 0.9% sterile normal saline solution to a final dose volume of 20 ml and administered directly into the sacrococcygeal space. After epidural injection of each treatment, the onset time, duration, anatomical extension of anti-nociception, and sedation were documented. Anti-nociception was tested at different areas using a pinprick test and artery forceps pinching at the perineum and inguinal area. RO and ROLD treatments resulted in mild to severe sedation and complete bilateral analgesia with loss of sensation in the tail, perineum, scrotum in males, vulva in females, the caudal aspect skin of the upper hind limb, and inguinal region (udder in females and the prepuce in males). The anatomic extent of anti-nociception reached the chest cranially and the footpad distally. Camels who received LD showed the shortest duration (P < 0.001) to the onset of perineal anti-nociception (3.67 ± 0.33 min) followed by those who received RO LD (4.00 ± 0.37 min) and RO (6.67 ± 0.33 min), respectively. RO and ROLD resulted in significantly (P < 0.001) longer periods of analgesia (158.33 ± 4.01 min and 165 ± 3.87 min, respectively) than LD (75.83 ± 3.27). An epidural RO and ROLD would appear to produce a very effective and acceptable anti-nociceptive effect in the perineal and inguinal regions of camels.
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Affiliation(s)
- Mohamed Marzok
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Hofuf, Saudi Arabia
- Department of Surgery, Faculty of Veterinary Medicine, Kafr El Sheikh University, Kafr El Sheikh, Egypt
- *Correspondence: Mohamed Marzok
| | - Adel I. Almubarak
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Hofuf, Saudi Arabia
| | - Sherief M. Abdel-Raheem
- Department of Public Health, College of Veterinary Medicine, King Faisal University, Al-Hofuf, Saudi Arabia
- Department of Animal Nutrition and Clinical Nutrition, Faculty of Veterinary Medicine, Assiut University, Assiut, Egypt
| | - Sabry El-khodery
- Department of Internal Medicine, Infectious Diseases and Fish Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | - Turke Shawaf
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Hofuf, Saudi Arabia
| | - Mahmoud Kandeel
- Department of Biomedical Sciences, College of Veterinary Medicine, King Faisal University, Al-Hofuf, Saudi Arabia
- Department of Pharmacology, Faculty of Veterinary Medicine, Kafr El Sheikh University, Kafr El Sheikh, Egypt
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Du R, Han R, Niu K, Xu J, Zhao Z, Lu G, Shang Y. The Multivariate Effect of Ketamine on PTSD: Systematic Review and Meta-Analysis. Front Psychiatry 2022; 13:813103. [PMID: 35356723 PMCID: PMC8959757 DOI: 10.3389/fpsyt.2022.813103] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a serious stress-related disorder caused by traumatic experiences. However, identifying a key therapy that can be used for PTSD treatment remains difficult. Ketamine, a well-known dissociative anesthetic, is considered safe to be used in anesthesia, pain management, and antidepressant actions since 1970. At present, it is still controversial whether PTSD can be treated with ketamine. The authors performed a meta-analysis to determine whether the use of perioperative ketamine lowers the incidence of PTSD. METHODS Cochrane Central Register of Controlled Trials, Embase, PubMed, and Web of Science were searched to examine the use of ketamine for the treatment of PTSD among soldiers with combating experience. Studies were included if they were randomized placebo-controlled, case-control, and cohort studies. The primary outcome was the incidence of PTSD in the later stage of the wounded or burn soldiers. The secondary outcome was the influence of ketamine on PTSD-scale scores for early and chronic PTSD, respectively. RESULTS Our search yielded a total of three studies (n = 503 patients) comparing the use of ketamine (n = 349) to control (n = 154). The available evidence showed no significant difference in the incidence of PTSD between combatant soldiers on the battlefield with or without ketamine treatment (risk ratio = 0.81, 95% CI, 0.63-1.04; P = 0.10). In 65 patients from three trials, ketamine was not only ineffective in treating early PTSD but also lead to exacerbation of the disease (risk ratio = 2.45, 95% CI, 1.33-3.58; P < 0.001). However, in 91 patients from the other three trials, ketamine is effective in treating chronic PTSD (risk ratio = -3.66, 95% CI, -7.05 to -0.27; P = 0.03). CONCLUSION Ketamine was not effective on lower the PTSD incidence for soldiers on the battlefield, nor on the PTSD-scale scores in early PTSD patients. However, it may improve the PTSD-scale scores for chronic conditions. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021255516, PROSPERO, identifier: CRD42021255516.
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Affiliation(s)
- Rui Du
- Institute for Biomedical Sciences of Pain, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Ruili Han
- Department of Anaesthesiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Kun Niu
- Department of Anaesthesiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Jiaqiao Xu
- Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Zihou Zhao
- Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Guofang Lu
- Department of Physiology and Pathophysiology, National Key Discipline of Cell Biology, Fourth Military Medical University, Xi'an, China.,State Key Laboratory of Cancer Biology and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China
| | - Yulong Shang
- State Key Laboratory of Cancer Biology and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China
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Rønnow Kjærulff LN, Dorch Lauritsen NJ, Thorn Ekstrøm C, Østergaard S, Olsen E, Hyldahl Laursen S, Lindegaard C. Caudal epidural co‐administration of methadone and morphine in horses: An evaluation of analgesic properties and effects on locomotor function, mentation and physical examination parameters. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- L. N. Rønnow Kjærulff
- Department of Veterinary Clinical Sciences Faculty of Health SciencesUniversity of Copenhagen TaastrupDenmark
| | - N. J. Dorch Lauritsen
- Department of Veterinary Clinical Sciences Faculty of Health SciencesUniversity of Copenhagen TaastrupDenmark
| | - C. Thorn Ekstrøm
- Biostatistics Department of Public Health University of Copenhagen Copenhagen Denmark
| | - S. Østergaard
- Department of Veterinary Clinical Sciences Faculty of Health SciencesUniversity of Copenhagen TaastrupDenmark
| | - E. Olsen
- Veterinary Teaching Hospital UDS Swedish Agricultural University Uppsala Sweden
| | | | - C. Lindegaard
- Department of Veterinary Clinical Sciences Faculty of Health SciencesUniversity of Copenhagen TaastrupDenmark
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Carrozzo MV, Ambros B. Collapse in a mare during standing sedation with a fatal outcome. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-000829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Barbara Ambros
- Small and large animal clinicsWestern College of Veterinary MedicineSaskatoonSaskatchewanCanada
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Bertonha C, Valadão C, Cruz M, Takeda M, Cholfe B. A influência da morfina ou tramadol pela via epidural no trânsito gastrintestinal de equinos. ARQ BRAS MED VET ZOO 2018. [DOI: 10.1590/1678-4162-10194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Os opioides são utilizados na medicina veterinária na analgesia dos animais, porém há restrição quanto ao uso desses fármacos em equinos, pois podem desencadear alterações gastrintestinais, mas a administração pela via epidural minimiza os efeitos adversos. Assim, oito equinos hígidos foram utilizados em três grupos experimentais, objetivando-se avaliar a influência no trânsito gastrintestinal da injeção epidural de morfina (0,2mg/kg), tramadol (1,0mg/kg) ou NaCl 0,9%. Para a avaliação do trânsito gastrintestinal, foi administrada a lignina purificada e enriquecida (Lipe®), pela via oral, a qual posteriormente foi analisada nas fezes. As fezes foram coletadas para investigação desse marcador, antes da epidural e em intervalos até totalizar 48 horas do início do experimento. Os dados foram submetidos à análise de variância (ANOVA) de uma via, com repetições múltiplas. As médias entre cada momento dos grupos e dos momentos dentro de cada grupo foram comparadas pelo teste de Student-Newman-Keuls (P≤0,05). A morfina ou o tramadol administrados pela via epidural não alteraram o tempo médio de retenção da fase líquida, a taxa de passagem e o tempo de trânsito do marcador utilizado. Diante de tais achados, conclui-se que a morfina ou o tramadol pela via epidural não alteram o trânsito gastrintestinal.
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Zanos P, Moaddel R, Morris PJ, Riggs LM, Highland JN, Georgiou P, Pereira EFR, Albuquerque EX, Thomas CJ, Zarate CA, Gould TD. Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms. Pharmacol Rev 2018; 70:621-660. [PMID: 29945898 PMCID: PMC6020109 DOI: 10.1124/pr.117.015198] [Citation(s) in RCA: 659] [Impact Index Per Article: 109.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Ketamine, a racemic mixture consisting of (S)- and (R)-ketamine, has been in clinical use since 1970. Although best characterized for its dissociative anesthetic properties, ketamine also exerts analgesic, anti-inflammatory, and antidepressant actions. We provide a comprehensive review of these therapeutic uses, emphasizing drug dose, route of administration, and the time course of these effects. Dissociative, psychotomimetic, cognitive, and peripheral side effects associated with short-term or prolonged exposure, as well as recreational ketamine use, are also discussed. We further describe ketamine's pharmacokinetics, including its rapid and extensive metabolism to norketamine, dehydronorketamine, hydroxyketamine, and hydroxynorketamine (HNK) metabolites. Whereas the anesthetic and analgesic properties of ketamine are generally attributed to direct ketamine-induced inhibition of N-methyl-D-aspartate receptors, other putative lower-affinity pharmacological targets of ketamine include, but are not limited to, γ-amynobutyric acid (GABA), dopamine, serotonin, sigma, opioid, and cholinergic receptors, as well as voltage-gated sodium and hyperpolarization-activated cyclic nucleotide-gated channels. We examine the evidence supporting the relevance of these targets of ketamine and its metabolites to the clinical effects of the drug. Ketamine metabolites may have broader clinical relevance than was previously considered, given that HNK metabolites have antidepressant efficacy in preclinical studies. Overall, pharmacological target deconvolution of ketamine and its metabolites will provide insight critical to the development of new pharmacotherapies that possess the desirable clinical effects of ketamine, but limit undesirable side effects.
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Affiliation(s)
- Panos Zanos
- Departments of Psychiatry (P.Z., L.M.R., J.N.H., P.G., T.D.G.), Pharmacology (E.F.R.P., E.X.A., T.D.G.), Anatomy and Neurobiology (T.D.G.), Epidemiology and Public Health, Division of Translational Toxicology (E.F.R.P., E.X.A.), Medicine (E.X.A.), and Program in Neuroscience (L.M.R.) and Toxicology (J.N.H.), University of Maryland School of Medicine, Baltimore, Maryland; Biomedical Research Center, National Institute on Aging, Intramural Research Program, National Institutes of Health, Baltimore, Maryland (R.M.); Division of Preclinical Innovation, National Center for Advancing Translational Sciences, Intramural Research Program, National Institutes of Health, Rockville, Maryland (P.J.M., C.J.T.); and Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Ruin Moaddel
- Departments of Psychiatry (P.Z., L.M.R., J.N.H., P.G., T.D.G.), Pharmacology (E.F.R.P., E.X.A., T.D.G.), Anatomy and Neurobiology (T.D.G.), Epidemiology and Public Health, Division of Translational Toxicology (E.F.R.P., E.X.A.), Medicine (E.X.A.), and Program in Neuroscience (L.M.R.) and Toxicology (J.N.H.), University of Maryland School of Medicine, Baltimore, Maryland; Biomedical Research Center, National Institute on Aging, Intramural Research Program, National Institutes of Health, Baltimore, Maryland (R.M.); Division of Preclinical Innovation, National Center for Advancing Translational Sciences, Intramural Research Program, National Institutes of Health, Rockville, Maryland (P.J.M., C.J.T.); and Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Patrick J Morris
- Departments of Psychiatry (P.Z., L.M.R., J.N.H., P.G., T.D.G.), Pharmacology (E.F.R.P., E.X.A., T.D.G.), Anatomy and Neurobiology (T.D.G.), Epidemiology and Public Health, Division of Translational Toxicology (E.F.R.P., E.X.A.), Medicine (E.X.A.), and Program in Neuroscience (L.M.R.) and Toxicology (J.N.H.), University of Maryland School of Medicine, Baltimore, Maryland; Biomedical Research Center, National Institute on Aging, Intramural Research Program, National Institutes of Health, Baltimore, Maryland (R.M.); Division of Preclinical Innovation, National Center for Advancing Translational Sciences, Intramural Research Program, National Institutes of Health, Rockville, Maryland (P.J.M., C.J.T.); and Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Lace M Riggs
- Departments of Psychiatry (P.Z., L.M.R., J.N.H., P.G., T.D.G.), Pharmacology (E.F.R.P., E.X.A., T.D.G.), Anatomy and Neurobiology (T.D.G.), Epidemiology and Public Health, Division of Translational Toxicology (E.F.R.P., E.X.A.), Medicine (E.X.A.), and Program in Neuroscience (L.M.R.) and Toxicology (J.N.H.), University of Maryland School of Medicine, Baltimore, Maryland; Biomedical Research Center, National Institute on Aging, Intramural Research Program, National Institutes of Health, Baltimore, Maryland (R.M.); Division of Preclinical Innovation, National Center for Advancing Translational Sciences, Intramural Research Program, National Institutes of Health, Rockville, Maryland (P.J.M., C.J.T.); and Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Jaclyn N Highland
- Departments of Psychiatry (P.Z., L.M.R., J.N.H., P.G., T.D.G.), Pharmacology (E.F.R.P., E.X.A., T.D.G.), Anatomy and Neurobiology (T.D.G.), Epidemiology and Public Health, Division of Translational Toxicology (E.F.R.P., E.X.A.), Medicine (E.X.A.), and Program in Neuroscience (L.M.R.) and Toxicology (J.N.H.), University of Maryland School of Medicine, Baltimore, Maryland; Biomedical Research Center, National Institute on Aging, Intramural Research Program, National Institutes of Health, Baltimore, Maryland (R.M.); Division of Preclinical Innovation, National Center for Advancing Translational Sciences, Intramural Research Program, National Institutes of Health, Rockville, Maryland (P.J.M., C.J.T.); and Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Polymnia Georgiou
- Departments of Psychiatry (P.Z., L.M.R., J.N.H., P.G., T.D.G.), Pharmacology (E.F.R.P., E.X.A., T.D.G.), Anatomy and Neurobiology (T.D.G.), Epidemiology and Public Health, Division of Translational Toxicology (E.F.R.P., E.X.A.), Medicine (E.X.A.), and Program in Neuroscience (L.M.R.) and Toxicology (J.N.H.), University of Maryland School of Medicine, Baltimore, Maryland; Biomedical Research Center, National Institute on Aging, Intramural Research Program, National Institutes of Health, Baltimore, Maryland (R.M.); Division of Preclinical Innovation, National Center for Advancing Translational Sciences, Intramural Research Program, National Institutes of Health, Rockville, Maryland (P.J.M., C.J.T.); and Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Edna F R Pereira
- Departments of Psychiatry (P.Z., L.M.R., J.N.H., P.G., T.D.G.), Pharmacology (E.F.R.P., E.X.A., T.D.G.), Anatomy and Neurobiology (T.D.G.), Epidemiology and Public Health, Division of Translational Toxicology (E.F.R.P., E.X.A.), Medicine (E.X.A.), and Program in Neuroscience (L.M.R.) and Toxicology (J.N.H.), University of Maryland School of Medicine, Baltimore, Maryland; Biomedical Research Center, National Institute on Aging, Intramural Research Program, National Institutes of Health, Baltimore, Maryland (R.M.); Division of Preclinical Innovation, National Center for Advancing Translational Sciences, Intramural Research Program, National Institutes of Health, Rockville, Maryland (P.J.M., C.J.T.); and Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Edson X Albuquerque
- Departments of Psychiatry (P.Z., L.M.R., J.N.H., P.G., T.D.G.), Pharmacology (E.F.R.P., E.X.A., T.D.G.), Anatomy and Neurobiology (T.D.G.), Epidemiology and Public Health, Division of Translational Toxicology (E.F.R.P., E.X.A.), Medicine (E.X.A.), and Program in Neuroscience (L.M.R.) and Toxicology (J.N.H.), University of Maryland School of Medicine, Baltimore, Maryland; Biomedical Research Center, National Institute on Aging, Intramural Research Program, National Institutes of Health, Baltimore, Maryland (R.M.); Division of Preclinical Innovation, National Center for Advancing Translational Sciences, Intramural Research Program, National Institutes of Health, Rockville, Maryland (P.J.M., C.J.T.); and Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Craig J Thomas
- Departments of Psychiatry (P.Z., L.M.R., J.N.H., P.G., T.D.G.), Pharmacology (E.F.R.P., E.X.A., T.D.G.), Anatomy and Neurobiology (T.D.G.), Epidemiology and Public Health, Division of Translational Toxicology (E.F.R.P., E.X.A.), Medicine (E.X.A.), and Program in Neuroscience (L.M.R.) and Toxicology (J.N.H.), University of Maryland School of Medicine, Baltimore, Maryland; Biomedical Research Center, National Institute on Aging, Intramural Research Program, National Institutes of Health, Baltimore, Maryland (R.M.); Division of Preclinical Innovation, National Center for Advancing Translational Sciences, Intramural Research Program, National Institutes of Health, Rockville, Maryland (P.J.M., C.J.T.); and Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Carlos A Zarate
- Departments of Psychiatry (P.Z., L.M.R., J.N.H., P.G., T.D.G.), Pharmacology (E.F.R.P., E.X.A., T.D.G.), Anatomy and Neurobiology (T.D.G.), Epidemiology and Public Health, Division of Translational Toxicology (E.F.R.P., E.X.A.), Medicine (E.X.A.), and Program in Neuroscience (L.M.R.) and Toxicology (J.N.H.), University of Maryland School of Medicine, Baltimore, Maryland; Biomedical Research Center, National Institute on Aging, Intramural Research Program, National Institutes of Health, Baltimore, Maryland (R.M.); Division of Preclinical Innovation, National Center for Advancing Translational Sciences, Intramural Research Program, National Institutes of Health, Rockville, Maryland (P.J.M., C.J.T.); and Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
| | - Todd D Gould
- Departments of Psychiatry (P.Z., L.M.R., J.N.H., P.G., T.D.G.), Pharmacology (E.F.R.P., E.X.A., T.D.G.), Anatomy and Neurobiology (T.D.G.), Epidemiology and Public Health, Division of Translational Toxicology (E.F.R.P., E.X.A.), Medicine (E.X.A.), and Program in Neuroscience (L.M.R.) and Toxicology (J.N.H.), University of Maryland School of Medicine, Baltimore, Maryland; Biomedical Research Center, National Institute on Aging, Intramural Research Program, National Institutes of Health, Baltimore, Maryland (R.M.); Division of Preclinical Innovation, National Center for Advancing Translational Sciences, Intramural Research Program, National Institutes of Health, Rockville, Maryland (P.J.M., C.J.T.); and Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (C.A.Z.)
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Sampaio BF, DeRossi R, Menezes PH, Escobar LL, Milan B. Effects of a Caudal Epidural Anesthesia Using Midazolam With or Without Lidocaine to Perform an Endometrial Biopsy in Mares. J Equine Vet Sci 2017. [DOI: 10.1016/j.jevs.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rédua MA, Valadão CA, Duque JC, Balestrero LT. The pre-emptive effect of epidural ketamine on wound sensitivity in horses tested by using von Frey filaments. Vet Anaesth Analg 2016; 29:200-206. [PMID: 28404363 DOI: 10.1046/j.1467-2995.2002.00083.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2001] [Accepted: 01/04/2002] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the pre-emptive analgesic effect of pre-incisional epidural ketamine. STUDY DESIGN A blinded, randomized experimental study. ANIMALS Sixteen mixed breed mares, 7.6 ± 2.8 years old, weighing 352 ± 32 kg. METHODS In a pilot study, an incision was made on one lateral thigh using a lidocaine block and no further analgesics, and it was verified that the nociceptive threshold was lower on the incised side than nonincised side (p ≤ 0.05), and that von Frey filaments evoked a pain response. The 16 animals were divided into group A (ketamine, n = 9) and B (saline, n = 7). An epidural catheter was inserted 24 hours before the trials. The thigh was shaved bilaterally, and the right side was blocked (incised side) using lidocaine. Twenty-five minutes later, ketamine (A) or saline (B) was administered epidurally. Five minutes later, a 10-cm skin incision was made on the right side, and then sutured. Nociceptive threshold was determined with von Frey filaments at 1, 3, and 5 cm around the incision at 15-minute intervals for 2 hours, then at 4, 6, and 8 hours. Behavioral alterations, heart and respiratory rates were recorded. Nociceptive thresholds from these points were averaged to obtain mean values at each time, converted to a logarithmic scale, and submitted to a nonparametric analysis (Mann-Whitney and one-way repeated measures anova test, p ≤ 0.05). RESULTS After 8 hours, the global range score revealed reduced hyperalgesia (p < 0.01) around the incision in 92% (4.65-4.27) of evaluated intervals in group A (ketamine). There were no significant changes in behavior, heart and respiratory rates. CONCLUSIONS It was concluded that pre-emptive epidural ketamine reduced post-incisional pain in the horse, and that von Frey filaments were able to quantify cutaneous sensitivity after tissue damage. CLINICAL RELEVANCE Epidural ketamine injection can reduce post-incisional sensitivity in the horse.
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Affiliation(s)
- Márcia A Rédua
- Departamento de Clínica e Cirurgia, Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista, Jaboticabal, Brazil
| | - Carlos Aa Valadão
- Departamento de Clínica e Cirurgia, Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista, Jaboticabal, Brazil.
| | - Juan C Duque
- Departamento de Clínica e Cirurgia, Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista, Jaboticabal, Brazil
| | - Lúcia T Balestrero
- Departamento de Clínica e Cirurgia, Faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista, Jaboticabal, Brazil
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Daradka M, Ibtihal K. Ovariectomy in Jenny using subarachnoid propofol administration. Vet Surg 2014; 43:569-73. [PMID: 24909598 DOI: 10.1111/j.1532-950x.2014.12225.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Accepted: 04/01/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the effects of subarachnoid propofol administration (SPA) on analgesia, sedation, ataxia, cardiopulmonary, blood gas variables, and its application in ovariectomy in Jennies. STUDY DESIGN Prospective, randomized, clinical trial. ANIMALS Adult Jennies (n = 20; 100-120 kg; 5-7 years old). METHODS In study 1, 5 Jennies had SPA (n = 5; group 1) through Tuohy catheter, and another 5 control Jennies had normal saline subarachnoid administration (n = 5; group 2). In study 2, 10 Jennies had SPA and ovariectomy (n = 10; group 3). In groups 1 and 3 analgesia, sedation and ataxia scores, cardiopulmonary and blood gas variables were recorded at different intervals before and after PSA. In group 2, only cardiopulmonary and blood gas variables were recorded. RESULTS SPA produced pronounced analgesia, mild sedation and minimal ataxia. Heart rate (HR), respiratory rate (RR), pulse rate (PR), rectal temperature (RT), arterial blood pH, PaO2 , and PaCO2 were not significantly different from base line values after subarachnoid administration of either propofol or normal saline. CONCLUSION SPA was found to be useful, efficient and feasible procedure for ovariectomy through standing flank laparotomy in Jennies.
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Affiliation(s)
- Mousa Daradka
- Faculty of Veterinary Medicine, Department of Veterinary Clinical Sciences, Jordan University of Science and Technology, Irbid, Jordan
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Sanchez LC, Robertson SA. Pain control in horses: What do we really know? Equine Vet J 2014; 46:517-23. [DOI: 10.1111/evj.12265] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 03/07/2014] [Indexed: 01/15/2023]
Affiliation(s)
- L. C. Sanchez
- Department of Large Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville USA
| | - S. A. Robertson
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; Michigan State University; East Lansing USA
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Gozalo-Marcilla M, Gasthuys F, Schauvliege S. Partial intravenous anaesthesia in the horse: a review of intravenous agents used to supplement equine inhalation anaesthesia. Part 1: lidocaine and ketamine. Vet Anaesth Analg 2014; 41:335-45. [PMID: 24815750 DOI: 10.1111/vaa.12179] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 09/13/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To review the literature with regard to the use of different intravenous agents as supplements to inhalational anaesthesia in horses. These drugs include lidocaine, ketamine, opioids and α2 -agonists. The Part 1 of this review will focus in the use of lidocaine and ketamine. DATABASES USED Pubmed & Web of Science. Search terms: horse, inhalant anaesthesia, balanced anaesthesia, partial intravenous anaesthesia, lidocaine, ketamine. CONCLUSIONS Different drugs and their combinations can be administered systemically in anaesthetized horses, with the aim of reducing the amount of the volatile agent whilst improving the recovery qualities and providing a multimodal analgesic approach. However, full studies as to whether these techniques improve cardiopulmonary status are not always available and potential disadvantages should also be considered.
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Affiliation(s)
- Miguel Gozalo-Marcilla
- Department of Surgery and Anaesthesia of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Azari O, Molaei MM, Ehsani AH. Caudal epidural analgesia using lidocaine alone or in combination with ketamine in dromedary camels Camelus dromedarius. J S Afr Vet Assoc 2014; 85:e1-e4. [PMID: 24830566 DOI: 10.4102/jsava.v85i1.1002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 05/23/2013] [Accepted: 06/10/2013] [Indexed: 11/01/2022] Open
Abstract
This study was performed to investigate the analgesic effect of lidocaine and a combination of lidocaine and ketamine following epidural administration in dromedary camels. Ten 12-18-month-old camels were randomly divided into two equal groups. In group L, the animals received 2% lidocaine (0.22 mg/kg) and in group LK the animals received a mixture of 10% ketamine (1 mg/kg) and 2% lidocaine (0.22 mg/kg) administered into the first intercoccygeal (Co1-Co2) epidural space while standing. Onset time and duration of caudal analgesia, sedation level and ataxia were recorded after drug administration. Data were analysed by U Mann-Whitney tests and significance was taken as p < 0.05. The results showed that epidural lidocaine and co-administration of lidocaine and ketamine produced complete analgesia in the tail, anus and perineum. Epidural administration of the lidocaine-ketamine mixture resulted in mild to moderate sedation, whilst the animals that received epidural lidocaine alone were alert and nervous during the study. Ataxia was observed in all test subjects and was slightly more severe in camels that received the lidocaine-ketamine mixture. It was concluded that epidural administration of lidocaine plus ketamine resulted in longer caudal analgesia in standing conscious dromedary camels compared with the effect of administering lidocaine alone.
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Affiliation(s)
- Omid Azari
- Department of Clinical Sciences, Shahid Bahonar University of Kerman.
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Derossi R, Módolo TJC, Maciel FB, Pagliosa RC. Efficacy of epidural lidocaine combined with tramadol or neostigmine on perineal analgesia in the horse. Equine Vet J 2012; 45:497-502. [DOI: 10.1111/j.2042-3306.2012.00654.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 08/19/2012] [Indexed: 11/26/2022]
Affiliation(s)
- R. Derossi
- Department of Veterinary Medicine; Surgery and Anaesthesiology; Faculty of Veterinary Medicine and Animal Science; Federal University of Mato Grosso do Sul; Campo Grande; Brazil
| | - T. J. C. Módolo
- Department of Veterinary Medicine; Federal University of Mato Grosso do Sul; Campo Grande; Brazil
| | - F. B. Maciel
- Department of Veterinary Medicine; Federal University of Mato Grosso do Sul; Campo Grande; Brazil
| | - R. C. Pagliosa
- Department of Veterinary Medicine; Federal University of Mato Grosso do Sul; Campo Grande; Brazil
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DeRossi R, Maciel FB, Módolo TJC, Pagliosa RC. Efficacy of concurrent epidural administration of neostigmine and lidocaine for perineal analgesia in geldings. Am J Vet Res 2012; 73:1356-62. [DOI: 10.2460/ajvr.73.9.1356] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Azari O, Molaei MM, Emadi L, Sakhaee E, Esmaeili M. Epidural ketamine in the dromedary camel. Vet Anaesth Analg 2012; 39:291-5. [DOI: 10.1111/j.1467-2995.2012.00708.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Comparison of Analgesic Effects of Caudal Epidural 0.25% Bupivacaine with Bupivacaine Plus Morphine or Bupivacaine Plus Ketamine for Analgesia in Conscious Horses. J Equine Vet Sci 2012. [DOI: 10.1016/j.jevs.2011.08.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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DeRossi R, Pompermeyer CTD, Silva-Neto AB, Barros ALCD, Jardim PHDA, Frazílio FO. Lumbosacral epidural magnesium prolongs ketamine analgesia in conscious sheep. Acta Cir Bras 2012; 27:137-43. [DOI: 10.1590/s0102-86502012000200007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 12/14/2011] [Indexed: 11/22/2022] Open
Abstract
PURPOSE: To determine the analgesic, motor, sedation and systemic effects of lumbosacral epidural magnesium sulphate added to ketamine in the sheep. METHODS: Six healthy adult male mixed-breed sheep; weighing 43 ± 5 kg and aged 20-36 months. Each sheep underwent three treatments, at least 2 weeks apart, via epidural injection: (1) ketamine (KE; 2.5 mg/kg), (2) magnesium sulphate (MG; 100 mg), and (3) KE + MG (KEMG; 2.5 mg/kg + 100 mg, respectively). Epidural injections were administered through the lumbosacral space. Analgesia, motor block, sedation, cardiovascular effects, respiratory rate, skin temperature, and rectal temperature were evaluated before (baseline) and after drug administration as needed. RESULTS: The duration of analgesia with the lumbosacral epidural KEMG combination was 115 ± 17 min (mean ± SD), that is, more than twice that obtained with KE (41 ± 7 min) or MG (29 ± 5 min) alone. KE and KEMG used in this experiment induced severe ataxia. The heart rate and arterial blood pressures changes were no statistical difference in these clinically health sheep. CONCLUSION: The dose of magnesium sulphate to lumbosacral epidural ketamine in sheep is feasible, and can be used in procedures analgesics in sheep.
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Benredouane K, Ringer SK, Fourel I, Lepage OM, Portier KG, Bettschart-Wolfensberger R. Comparison of xylazine-butorphanol and xylazine-morphine-ketamine infusions in horses undergoing a standing surgery. Vet Rec 2011; 169:364. [PMID: 21896566 DOI: 10.1136/vr.d5333] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- K Benredouane
- Equine Department, Anaesthesiology, VetAgro Sup (Veterinary Campus of Lyon), 69280 Marcy l'Etoile, France.
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DeRossi R, Verde-Selva AB, Bertoni RA, Ruzzon RHS, Silva-Neto AB. Lignocaine versus bupivacaine for flank anaesthesia using multiport catheters via a caudal epidural approach in cattle. Aust Vet J 2010; 88:362-7. [PMID: 20726973 DOI: 10.1111/j.1751-0813.2010.00608.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the anaesthetic and systemic effects of dorsolumbar epidural anaesthesia using non-stylet multiport catheters via the caudal approach to administer hypertonic 5% lignocaine (HL) or hypertonic 0.5% bupivacaine (HB) to the flank in standing cattle. MATERIALS AND METHODS Six healthy adult cattle weighing 310-455 kg received 0.2 mg/kg HL or 0.025 mg/kg of HB; control animals received 0.9% saline solution. All drugs were injected into the dorsolumbar epidural space via a caudal approach through a non-stylet multiport catheter. Each animal received each treatment at random. Evaluations of anaesthesia, ataxia, heart rate, arterial pressures, respiratory rate and rectal temperature were obtained at 0 (basal), 5, 10, 15, 30, 45, 60, 75, and 90 min after epidural injection and then at 30-min intervals until loss of anaesthesia. All animals received a standard noxious stimulus and a 4-point scale was used to score the response. A second scale was used to score ataxia. RESULTS The duration of anaesthesia in the upper and lower flanks in cattle was 68 +/- 12 and 110 +/- 15 min (mean +/- SD) after dorsolumbar epidural HL or HB, respectively. Both hypertonic local anaesthetics produced a mild ataxia. The systemic changes were within acceptable limits in these clinically healthy cattle. CONCLUSION In standing cattle the dorsolumbar epidural injection of hypertonic lignocaine provided faster onset of anaesthesia and fewer cardiovascular effects, but had a shorter duration of anaesthesia than hypertonic bupivacaine.
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Affiliation(s)
- R DeRossi
- Department of Veterinary Medicine - Surgery and Anesthesiology, Faculty of Veterinary Medicine and Animal Science, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil.
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DeRossi R, Bertoni RA, Ruzzon RH, Verde-Selva AB, Frazílio FO. Segmental dorsolumbar epidural analgesia via the caudal approach using multiple port catheters with ketamine or lidocaine or in combination in cattle. Vet Anaesth Analg 2010; 37:451-9. [PMID: 20712612 DOI: 10.1111/j.1467-2995.2010.00559.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the analgesic and systemic effects of epidural administration of ketamine, lidocaine or a combination of ketamine/lidocaine in standing cattle. STUDY DESIGN Prospective, randomized, experimental trial. ANIMALS Six healthy male cattle weighing between 335 and 373 kg. METHODS The animals received 0.5 mg kg(-1) of ketamine (K), 0.2 mg kg(-1) of 2% lidocaine (L) or 0.25 mg kg(-1) ketamine plus 0.1 mg kg(-1) lidocaine (KL). All the drugs were injected into the dorsolumbar epidural space via a caudal approach through a non-styletted multiple-port catheter. Each animal received each treatment at random. Evaluations of analgesia, sedation, ataxia, heart rate, arterial pressure, respiratory rate, skin temperature and rectal temperature were obtained at 0 (basal), 5, 10, 15, 30, 45, 60, 75, 90 minutes after epidural injection, and then at 30-minute intervals until loss of analgesia occurred. Skin temperature was taken at these intervals up to 60 minutes. All the animals received a standard noxious stimulus; a 4-point scale was used to score the response. A second scale was used to score ataxia and a third for sedation. RESULTS The duration of analgesia in the upper and lower flanks in cattle was 140 +/- 15, 50 +/- 14 and 80 +/- 22 minutes (mean +/- SD) after dorsolumbar epidural KL, K or L, respectively. The cardiovascular changes were within acceptable limits in these clinically healthy cattle. CONCLUSIONS Dorsolumbar epidural administration of KL to cattle resulted in longer duration of analgesia of the upper and lower flanks in standing conscious cattle, than the administration of K or L alone. CLINICAL RELEVANCE Further research is necessary to determine whether this combination using this technique provides sufficient analgesia for flank surgery in standing cattle.
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Affiliation(s)
- Rafael DeRossi
- Department of Veterinary Medicine-Surgery and Anesthesiology, Faculty of Veterinary Medicine and Animal Science, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil.
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DeRossi R, Ruzzon RHS, Verde-Selva AB, Bertoni RA. 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; 71:17-23. [PMID: 20043776 DOI: 10.2460/ajvr.71.1.17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate use of nonstyletted multiple-port catheters for epidural administration of ketamine hydrochloride via the caudal approach to induce analgesia of the paralumbar fossa (flank) in cattle. ANIMALS 6 healthy bulls. PROCEDURES 1 week before experiments began, a multiple-port catheter was inserted by use of a Tuohy needle in all cattle via the caudal approach (between the first and second coccygeal vertebrae); the tip was threaded approximately 48 cm cranial into the dorsolumbar region. Each bull was administered ketamine (0.3, 0.5, or 0.7 mg/kg) at time 0. Heart rate, blood pressures, respiratory rate, rectal temperature, analgesia, sedation, and ataxia were determined before treatment (baseline [time 0]); at 5, 10, 15, 30, 45, 60, 75, and 90 minutes; and every 30 minutes thereafter until end of analgesia. RESULTS All multiple-port catheters were threaded with negligible resistance into the dorsolumbar region in all bulls. All doses of ketamine were effective for inducing analgesia of the flank region of bulls in a standing position. Total analgesia time was dose dependent (35, 50, and 80 minutes for 0.3, 0.5, and 0.7 mg/kg, respectively). All doses of ketamine induced mild or moderate ataxia. Heart rate changes were within acceptable limits. CONCLUSIONS AND CLINICAL RELEVANCE Segmental dorsolumbar epidural analgesia with ketamine administered via multiple-port catheters by use of the caudal approach in cattle was feasible, and the cattle remained standing with minimal adverse effects. Further studies are necessary to determine whether this technique provides optimal conditions to allow surgery in standing cattle.
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Affiliation(s)
- Rafael DeRossi
- Department of Veterinary Medicine-Surgery and Anesthesiology, Faculty of Veterinary Medicine and Animal Science, Federal University of Mato Grosso do Sul, Campo Grande, 79070-900, MS, Brazil.
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Iff I, Mosing M, Lechner T, Moens Y. The use of an acoustic device to identify the extradural space in standing horses. Vet Anaesth Analg 2010; 37:57-62. [DOI: 10.1111/j.1467-2995.2009.00491.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Endotoxemia is a major cause of morbidity and mortality in horses affected by colic. This article briefly reviews the pathogenesis of endotoxemia in horses with colic, reviews current established treatments, and describes new advances in the treatment of endotoxemia.
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Affiliation(s)
- Gal Kelmer
- Large Animal Department, Koret Veterinary Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel.
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Sub-arachnoid ketamine administration combined with or without misoprostol/oxytocin to facilitate cervical dilation in ewes: A case study. Small Rumin Res 2009. [DOI: 10.1016/j.smallrumres.2009.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Iff I, Mosing M, Moens Y. Pressure profile in the caudal extradural space of standing horses before and after extradural drug administration. Vet J 2008; 180:112-5. [PMID: 18406643 DOI: 10.1016/j.tvjl.2007.10.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2007] [Revised: 10/24/2007] [Accepted: 10/29/2007] [Indexed: 11/29/2022]
Abstract
The objectives of this study were to measure the pressure in the caudal extradural space of standing horses and to evaluate the usefulness of pressure waves to identify correct needle placement. Caudal extradural pressure was measured in 12 healthy horses. The pressure and any extradural pressure waves were recorded for 3min after puncture, for 1min after testing for lack of resistance (LOR), and for 10min after lidocaine injection. Successful extradural drug administration was confirmed in all horses. The median extradural pressure findings after puncture, after LOR, immediately after injection and 10min after needle placement were -1.60kPa (range -2.27 to 1.33kPa), -0.67kPa (-2.27 to 5.73kPa), 5.00kPa (0.93 to 9.87kPa) and 0.13kPa (-0.67 to 4.53kPa), respectively. Extradural pressure waves were not always present. Extradural space pressure was sub-atmospheric in most horses and extradural injection significantly increased this pressure for up to 10min. Extradural pressure waves had limited usefulness in the confirmation of the correct placement of the needle.
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Affiliation(s)
- Isabelle Iff
- Clinic for Anaesthesiology and Perioperative Intensive Care, Clinical Department of Small Animals and Horses, Veterinary University, Vienna, Austria.
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Dória RGS, Valadão CAA, Duque JC, Farias A, Almeida RM, Netto AC. Comparative study of epidural xylazine or clonidine in horses. Vet Anaesth Analg 2008; 35:166-72. [DOI: 10.1111/j.1467-2995.2007.00357.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kinjavdekar P, Singh GR, Aithal HP, Pawde AM. Clinicophysiological Effects of Spinally Administered Ketamine and Its Combination with Xylazine and Medetomidine in Healthy Goats. Vet Res Commun 2007; 31:847-61. [PMID: 17294260 DOI: 10.1007/s11259-007-0049-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2006] [Indexed: 11/26/2022]
Abstract
The study was conducted in 9 healthy adult goats of either sex, weighing 15-20 kg, to evaluate and compare the clinicophysiological effects of spinally administered ketamine alone and in combination with xylazine and medetomidine. Nine trials each of the three treatments were conducted randomly by injecting ketamine (2.5 mg/kg) (n = 9), ketamine and xylazine (2.5 mg/kg and 0.05 mg/kg) (n = 9) and ketamine and medetomidine (2.5 mg/kg and 10 microg/kg) (n = 9). The drugs were administered at the lumbosacral subarachnoid space under strict aseptic conditions. The treatments were evaluated on the basis of clinicophysiological, haematological, biochemical and haemodynamic observations. Ketamine produced mild to moderate analgesia of the hindquarters. Its combination with either xylazine or medetomidine produced complete analgesia of the hindquarters for 45-60 min. Ataxia was moderate in the ketamine group, whereas animals attained sternal recumbency in the combination groups. A moderate degree of sedation was recorded in the combination groups. Heart rate and respiratory rate depression in the combination groups and heart rate and respiratory rate stimulation in ketamine group were recorded. Haematological parameters decreased in all the groups. Increase in serum glucose, creatinine and urea nitrogen was recorded in all the groups. Serum electrolytes did not show any significant change. The results showed that the combination of ketamine with xylazine or medetomidine at these dose rates produced a comparable degrees of analgesia of hindquarters with transient and minimal cardiopulmonary side effects.
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Affiliation(s)
- P Kinjavdekar
- Division of Surgery, Indian Veterinary Research Institute, Izatnagar, UP, India.
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Singh P, Pratap K, Kinjavdekar P, Aithal HP, Singh GR, Pathak R. Xylazine, Ketamine and their Combination for Lumbar Epidural Analgesia in Water Buffalo Calves (Bubalus bubalis). ACTA ACUST UNITED AC 2006; 53:423-31. [PMID: 16970633 DOI: 10.1111/j.1439-0442.2006.00849.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The study was conducted to evaluate the effects of xylazine individually (0.05 mg/kg), ketamine individually (2.5 mg/kg), and a combination of xylazine and ketamine (0.05 mg/kg and 2.5 mg/kg) after lumbar epidural administration in water buffalo calves. Fifteen non-descript, male water buffalo calves of 6-8 months of age weighing between 55 and 75 kg were randomly placed in three groups (groups A, B and C). The agents were administered at the first lumbar epidural space. Clinico-physiological parameters, such as analgesia, ataxia, sedation, salivation, heart rate, respiratory rate and rectal temperature were studied. Other haematological and biochemical parameters monitored were haemoglobin, packed cell volume, total leukocyte count, plasma glucose, cortisol, protein albumin, globulin, blood urea nitrogen (BUN), creatinine, alanineamino transferase (ALT), sodium, potassium and chloride. The onset of analgesia (mean +/- SEM) was faster in group C (3.2 +/- 0.20 min) compared with that of group B (4.6 +/- 0.22 min) and group A (34.0 +/- 1.86 min). Analgesia of the thorax, flank, inguinal region, hind limbs, perineum and tail was complete in group C, but mild to moderate in groups A and B. Ataxia was severe in group C and mild in groups A and B. Mild to deep sedation was produced by groups A and C animals. Group B animals failed to produce sedation. Longer duration and greater depth of analgesia was produced in animals of group C. Heart rate, respiratory rate and rectal temperature decreased in groups A and C. The haematological parameters decreased in all the groups. The biochemical parameters like glucose, cortisol, BUN, creatinine, and ALT increased in all the animals. However, total proteins and albumin decreased in the three groups. The plasma electrolytes sodium, potassium and chloride did not show any significant change. The results of this study indicated a possible synergistic analgesic interaction between epidurally administered xylazine and ketamine, without causing any marked systemic effects in water buffalo calves.
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Affiliation(s)
- P Singh
- Division of Surgery, Indian Veterinary Research Institute, Izatnagar-243122, Uttar Pradesh, India
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Fielding CL, Brumbaugh GW, Matthews NS, Peck KE, Roussel AJ. Pharmacokinetics and clinical effects of a subanesthetic continuous rate infusion of ketamine in awake horses. Am J Vet Res 2006; 67:1484-90. [PMID: 16948590 DOI: 10.2460/ajvr.67.9.1484] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the pharmacokinetics and clinical effects of a subanesthetic, continuous rate infusion of ketamine administered to healthy awake horses. ANIMALS 8 adult horses. PROCEDURES Ketamine hydrochloride was administered to 2 horses, in a pilot study, at rates ranging from 0.4 to 1.6 mg/kg/h for 6 hours to determine an appropriate dose that did not cause adverse effects. Ketamine was then administered to 6 horses for a total of 12 hours (3 horses at 0.4 mg/kg/h for 6 hours followed by 0.8 mg/kg/h for 6 hours and 3 horses at 0.8 mg/kg/h for 6 hours followed by 0.4 mg/kg/h for 6 hours). Concentration of ketamine in plasma, heart rate, respiratory rate, blood pressure, physical activity, and analgesia were measured prior to, during, and following infusion. Analgesic testing was performed with a modified hoof tester applied at a measured force to the withers and radius. RESULTS No signs of excitement and no significant changes in the measured physiologic variables during infusion rates of 0.4 and 0.8 mg of ketamine/kg/h were found. At 6 hours following infusions, heart rate and mean arterial pressure were decreased, compared with preinfusion measurements. An analgesic effect could not be demonstrated during or after infusion. Pharmacokinetic variables for 0.4 and 0.8 mg/kg/h infusions were not significantly different. CONCLUSIONS AND CLINICAL RELEVANCE Ketamine can be administered to awake horses at 0.4 or 0.8 mg/kg/h without adverse behavioral effects. The observed pharmacokinetic values are different than those reported for single-dose IV bolus administration of this drug.
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Affiliation(s)
- C Langdon Fielding
- Department of Large Animal Medicine and Surgery, College of Veterinary Medicine and Biomedical Sciences, Texas A and M University, College Station, TX 77843-4474, USA
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Guedes AGP, Pluhar GE, Daubs BM, Rudé EP. Effects of preoperative epidural administration of racemic ketamine for analgesia in sheep undergoing surgery. Am J Vet Res 2006; 67:222-9. [PMID: 16454625 DOI: 10.2460/ajvr.67.2.222] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the effects of preoperative epidural administration of racemic ketamine to provide analgesia in sheep undergoing experimental hind limb orthopedic surgery. ANIMALS 12 adult sheep (weight range, 51.4 to 67.2 kg). PROCEDURE Sheep were anesthetized with guaifenesin, thiopental, and isoflurane; after induction of anesthesia, sheep received a lumbosacral epidural injection of ketamine (1 mg/kg; n = 6) or saline (0.9% NaCl) solution (1 mL/7 kg; 6 [control group]). Respiratory and cardiovascular variables were recorded before and at intervals during and for 6 hours after anesthesia. During that 6-hour postoperative period, analgesia was evaluated subjectively with a numeric ranking scale that included assessments of comfort, posture, movement, and response to wound palpation; buprenorphine was administered when a score > 3 (maximum score, 10) was achieved. Rectal temperature, heart and respiratory rates, and lameness were evaluated daily for 2 weeks after surgery. RESULTS At all evaluations, cardiovascular and respiratory variables were comparable between the 2 groups. Compared with control sheep, time to first administration of rescue analgesic was significantly longer and total dose of buprenorphine administered during the 6- hour postoperative period was significantly decreased for ketamine-treated sheep. During the second week following surgery, ketamine-treated sheep had significantly less lameness than control sheep. CONCLUSIONS AND CLINICAL RELEVANCE In sheep undergoing hind limb surgery, preoperative epidural administration of ketamine appears to provide analgesia in the immediate postoperative period and has residual analgesic effects, which may contribute to more rapid return of normal function in surgically treated limbs.
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Affiliation(s)
- Alonso G P Guedes
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108-1016, USA
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Derossi R, Miguel GLS, Frazílio FO, Nunes DB, Kassab TA. L-Bupivacaine 0.5% vs. racemic 0.5% bupivacaine for caudal epidural analgesia in horses. J Vet Pharmacol Ther 2005; 28:293-7. [PMID: 15953203 DOI: 10.1111/j.1365-2885.2005.00652.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Bupivacaine is available as a racemic mixture of its enantiomers, d-bupivacaine and l-bupivacaine (LB). The aim of this randomized, double-blind study was to investigate the clinical efficacy and safety of S(-)-bupivacaine compared with standard racemic bupivacaine (RB) in horses under caudal epidural analgesia. Two treatments were administered to each horse, with a 2-week interval between subsequent treatments. Treatment 1 consisted of 0.5% LB at a dose of 0.06 mg/kg of body weight, and treatment 2 consisted of 0.5% RB at a dose of 0.06 mg/kg of body weight. Epidural injections were given in all animals between the first and second coccygeal vertebra. Heart rate (HR), arterial pressures, respiratory rate (RR), rectal temperature (RT), analgesia, and motor blocking were determined before drug administration (basal) and 5, 10, 15 and 30 min after drug administration, and at 30 min intervals thereafter. There were no significant differences between the two treatments in the quality of sensory and motor block. The duration of analgesia was 320 +/- 30 min (mean +/- SD) for RB and 360 +/- 42 min for LB. HRs and RRs, arterial pressures and RT did not change (P < 0.05) significantly from basal values after epidural administration of LB or RB. This study supports that 0.5% LB is an effective alternative to RB in caudal epidural analgesia in conscious, standing horses. The use of LB vs. RB warrants further investigation, particularly for long-lasting surgery in the perineal region.
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Affiliation(s)
- R Derossi
- Department of Veterinary Medicine - Surgery and Anesthesiology, Faculty of Veterinary Medicine, Federal University of Mato Grosso do Sul State, Brazil.
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DeRossi R, Junqueira A, Lopes R, Beretta M. Use of ketamine or lidocaine or in combination for subarachnoid analgesia in goats. Small Rumin Res 2005. [DOI: 10.1016/j.smallrumres.2004.11.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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DeRossi R, Frazílio FO, e Silva Miguel GL, Ali Kassab T. Comparison of 2% lidocaine and hyperbaric 5% lidocaine for caudal epidural analgesia in horses. J Equine Vet Sci 2005. [DOI: 10.1016/j.jevs.2005.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hamilton SM, Johnston SA, Broadstone RV. Evaluation of analgesia provided by the administration of epidural ketamine in dogs with a chemically induced synovitis. Vet Anaesth Analg 2005; 32:30-9. [PMID: 15663737 DOI: 10.1111/j.1467-2995.2004.00171.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine if epidural ketamine provides analgesia in dogs with a chemically induced synovitis. STUDY DESIGN Prospective randomized experimental trial. ANIMALS Thirty-two healthy, adult mongrel dogs (13-30 kg). METHODS (Part I) Synovitis was induced in the right stifle of 16 dogs and allowed to develop for 12 hours. Epidural injection at the lumbosacral space of either ketamine (2 mg kg(-1); n = 8) or placebo (n = 8) was performed. Limb use and pain were measured using a force platform and numerical rating scale (NRS). Assessments were performed before and at 12, 14, 16, 18, 20, and 24 hours after the induction of synovitis. (Part II) Epidural injection of either ketamine (n = 8) or placebo (n = 8) was performed immediately before the induction of synovitis. Analgesia was assessed as in Part I. Assessments occurred before and at 2, 4, 6, 8, and 12 hours after the induction of synovitis. RESULTS (Part I) Vertical ground reaction forces (VGRF) significantly decreased and NRS scores of total pain significantly increased after the induction of synovitis in all dogs (p < 0.05). No significant differences in VGRF or NRS scores were measured between treatment groups at any assessment period. (Part II) Dogs that received ketamine had significantly lower NRS scores 2 hours after treatment (p < 0.05). NRS scores did not differ between groups at any other evaluation. VGRF did not differ significantly between treatment groups at any assessment period. CONCLUSION Epidural ketamine at a dose of 2 mg kg(-1) administered after the development of synovitis does not provide significant levels of analgesia. Administration of ketamine before the induction of synovitis significantly decreased the NRS score 2 hours post-induction. CLINICAL RELEVANCE Administration of epidural ketamine before tissue injury may provide analgesia of short duration in dogs.
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Affiliation(s)
- Stephanie M Hamilton
- Department of Small Animal Clinical Sciences, Virginia Maryland Regional College of Veterinary Medicine, Blacksburg, VA 24061, USA.
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Singh V, Kinjavdekar P, Aithal HP, Pratap K. Medetomidine with ketamine and bupivacaine for epidural analgesia in buffaloes. Vet Res Commun 2005; 29:1-18. [PMID: 15727287 DOI: 10.1023/b:verc.0000046736.78612.f7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The efficacy of ketamine and bupivacaine in enhancing the epidural analgesia induced by medetomidine was evaluated in 10 buffalo calves utilized repeatedly after a gap of 10 days so that each drug combination was tested in 4 randomly selected animals. In group A, medetomidine (15 microg/kg), in group B ketamine (2.0 mg/kg), in group C bupivacaine (0.125 mg/kg), in group D medetomidine and ketamine (15 microg/kg and 2.0 mg/kg), and in group E medetomidine and bupivacaine (15 microg/kg and 0.125 mg/kg) was administered epidurally. Onset of analgesia was significantly earlier in animals of groups B and D compared to the animals of groups A, C and E. Medetomidine alone or in combination with ketamine/bupivacaine produced complete analgesia of the tail, perineum, inguinal region and upper parts of hind limbs. Ketamine produced a very short duration of complete analgesia at the tail and perineum. Bupivacaine alone produced only mild to moderate analgesia. Both ketamine and bupivacaine prolonged the duration of analgesia. Motor incoordination was mild to moderate in animals of all the groups, but animals remained standing throughout the period of observation. Animals of groups A, D and E showed mild to moderate sedation during the observation period. Ruminal movements decreased nonsignificantly in animals of groups A and E. Mild salivation was observed in animals of all the groups except group C. Significant decrease in heart rate (HR) was recorded after epidural administration of medetomidine or bupivacaine; however, ketamine caused short duration of tachycardia. The administration of ketamine with medetomidine caused lesser decrease in HR compared to medetomidine alone or in combination with bupivacaine. Significant fall in respiratory rate (RR) was recorded after epidural administration of medetomidine or bupivacaine alone, but an increase in RR was recorded after ketamine administration. The fall in RR was less pronounced in animals in which medetomidine was used with ketamine compared to the animals in which medetomidine was used alone or in combination with bupivacaine. Mean arterial pressure (MAP) decreased and central venous pressure (CVP) increased significantly after epidural administration of medetomidine in combination with ketamine or bupivacaine. The ECG changes included tall T wave, QS pattern, RS pattern and ST elevation and heart blocks at different intervals, which were more frequent and pronounced in animals given bupivacaine with medetomidine. It can be concluded that epidural administration of medetomidine can produce complete analgesia of the tail, perineum, inguinal region and upper hind limbs in buffaloes. However, significant depression of cardiovascular parameters was recorded. Administration of ketamine along with medetomidine resulted in significantly early onset and slightly longer duration of analgesia with lesser cardiopulmonary side-effects compared to medetomidine alone or medetomidine with bupivacaine. Addition of ketamine to medetomidine thus seems to be useful for producing epidural analgesia; however, addition of bupivacaine failed to provide any advantage over medetomidine alone.
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Affiliation(s)
- V Singh
- Division of Surgery, Indian Veterinary Research Institute, Izatnagar (UP), 243 122, India
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Abstract
There is a plethora of information regarding anesthetic management of horses; however, controlled studies of the critically ill equine patient are few. These patients should be managed like any equine anesthetic candidate but much more stringently:I. Preoperative evaluation and appropriate therapy may represent the difference between life and death during the intraoperative and recovery periods. 2. The anesthetic induction and maintenance protocol should be based on the individual situation of the veterinary facility and personnel("comfort zone"). 3. Appropriate monitoring and intraoperative supportive measures are essential. 4. The anesthetic period is a significant perturbation to homeostasis. Even if the horse seems to have done well (ie, as indicated by the cardiopulmonary values), a problem-free anesthetic period does not guarantee a successful recovery, and close monitoring should continue until the horse is ambulatory. 5. Critically ill patients are often in a negative energy balance. Supportive measures to ensure an adequate caloric intake, such as enteral or parenteral nutrition, facilitate healing and return of homeostasis.
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Duque M JC, Valadão CAA, Farias A, De Almeida RM, Oleskovicz N. Pre-Emptive Epidural Ketamine or S(+)-Ketamine in Post-incisional Pain in Dogs: A Comparative Study. Vet Surg 2004; 33:361-7. [PMID: 15230839 DOI: 10.1111/j.1532-950x.2004.04052.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the pre-emptive analgesic effects of epidural ketamine or S(+)-ketamine on post-incisional hyperalgesia. STUDY DESIGN Prospective randomized study. ANIMALS Twenty-four mongrel dogs (1-5 years, weighing 11.9+/-1.8 kg). METHODS Dogs were anesthetized with propofol (5 mg/kg intravenously) and a lumbosacral epidural catheter was placed. Dogs were randomly allocated to 3 groups, each with 8 dogs. The control group (CG) was administered saline solution (0.3 mL/kg); the ketamine group (KG) ketamine (0.6 mg/kg); and the S(+)-ketamine group (SG) S(+)-ketamine (0.6 mg/kg). The final volume was adjusted to 0.3 mL/kg in all groups. Five minutes after the epidural injection a surgical incision was made in the common pad of the right hind limb and was immediately closed with simple interrupted nylon suture. Respiratory (RR) and heart (HR) rates, rectal temperature (T), sedation (S), lameness score, and mechanical nociceptive threshold by von Frey filaments were evaluated before the propofol anesthesia and at 15, 30, 45, 60, 75, and 90 minutes and then at 2, 4, 6, 8, 12, and 24 hours after epidural injection. RESULTS There were no differences in RR, HR, T, or S between groups. Motor blockade of the hind limbs was observed during 20+/-3.6 minutes in KG and during 30.6+/-7.5 minutes in SG (mean+/-SD). Mechanical force applied to obtain an aversive response was higher from 45 minutes to 12 hours in KG and from 60 to 90 minutes in SG, when compared with CG. CONCLUSIONS Pre-emptive epidural ketamine induced no alterations in RR and HR, and reduced post-incisional hyperalgesia for a longer time than did S(+) ketamine. CLINICAL RELEVANCE Although anesthetic and analgesic potency of S(+) ketamine is twice that of ketamine, the racemic form is seemingly better for post-incisional hyperalgesia.
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Affiliation(s)
- Juan Carlos Duque M
- Department of Veterinary Clinic and Surgery of the FCAV/Unesp-Jaboticabal, SP, Brazil.
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Natalini CC, Alves SDL, Guedes AGP, Polydoro AS, Brondani JT, Bopp S. Epidural administration of tiletamine/zolazepam in horses. Vet Anaesth Analg 2004; 31:79-85. [PMID: 15053744 DOI: 10.1111/j.1467-2987.2004.00155.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the analgesic, physiologic, and behavioral effects of the epidural administration of tiletamine/zolazepam in horses. STUDY DESIGN Prospective, double-blind, randomized experimental study. ANIMALS Five adult, healthy horses aged 10-16 years and weighing (mean +/- SD) 400 +/- 98 kg. METHODS The horses were sedated with 1.0 mg kg(-1) intravenous (IV) xylazine, and an epidural catheter was placed into the first intercoccygeal intervertebral space. After a 48-hour resting period, epidural tiletamine/zolazepam, 0.5 mg kg(-1) (treatment I) or 1.0 mg kg(-1) (treatment II), diluted up to 5 mL in sterile water, was administered with a 1-week interval between the treatments. Heart rate, respiratory rate, arterial blood pressure, and sedation were evaluated. In order to evaluate the respiratory effects, blood from the carotid artery was withdrawn at time 0 (baseline), and then after 60 and 240 minutes. Analgesia was evaluated by applying a noxious stimulus with blunt-tipped forceps on the perineal region, and graded as complete, moderate, or absent. Data were collected before tiletamine/zolazepam administration and at 15-minute intervals for 120 minutes, and 4 hours after tiletamine/zolazepam administration. Data were analyzed with anova and Bonferroni's test with p < 0.05. RESULTS The results showed no significant difference between treatments in cardiovascular and respiratory measurements. Sedation was observed with both doses, and it was significantly different from baseline at 60, 75, and 90 minutes in treatment II. Moderate analgesia and locomotor ataxia were observed with both the treatments. CONCLUSIONS AND CLINICAL RELEVANCE The results suggest that caudal epidural 0.5 and 1.0 mg kg(-1) tiletamine/zolazepam increases the threshold to pressure stimulation in the perineal region in horses. The use of epidural tiletamine/zolazepam could be indicated for short-term moderate epidural analgesia. There are no studies examining spinal toxicity of Telazol, and further studies are necessary before recommending clinical use of this technique.
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Affiliation(s)
- Claudio C Natalini
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Skip Bertman Drive, Baton Rouge, LA 70803, USA.
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López-Sanromán J, Cruz J, Santos M, Mazzini R, Tabanera A, Tendillo FJ. Effect of alkalinization on the local analgesic efficacy of ketamine in the abaxial sesamoid nerve block in horses. J Vet Pharmacol Ther 2003; 26:265-9. [PMID: 12887608 DOI: 10.1046/j.1365-2885.2003.00489.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The objective of this study was to determine the effects of the alkalinization on the local analgesic efficacy of 1% ketamine in the abaxial sesamoid nerve block in horses. Thirty-six mature healthy horses were randomly assigned to four groups for the following treatments; an abaxial sesamoid block with 5 mL of saline solution (control saline); an abaxial sesamoid block with 5 mL of a solution containing 1% ketamine (KETs 1%); an abaxial sesamoid block with 5 mL of a solution containing saline solution and 0.5 mEq of sodium bicarbonate (control bicarbonate); and an abaxial sesamoid block with 5 mL of a solution containing 1% ketamine and 0.5 mEq of sodium bicarbonate (KETb 1%). All blocks were performed in one randomly selected front leg. To determine analgesia, hoof withdrawal from thermal stimulus from radiant heat lamp was assessed. Before each block, the hoof withdrawal reflex latency (HWRL) (time between lamp illumination and withdrawal of the hoof) was determined; after the block, local analgesic effects were determined using the heat lamp at 2 and 5 min after the injection and then every 5 min for 1 h. In KETs 1% group, there were significant increases in HWRL between basal values and values from 2 to 10 min after an abaxial sesamoid block. In KETb 1% group, significant increases in HWRL was collected between the basal value and values from 2 to 25 min following an abaxial sesamoid block. In KETs 1% group, of the nine horses, four had an abaxial sesamoid block that was unsuccessful. However, in KETb 1% group, only one of the nine horses had an abaxial sesamoid nerve block that was unsuccessful. The alkalinization of a 1% ketamine solution produced a more consistent and persistent local analgesia in horses when compared with 1% ketamine solution alone.
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Affiliation(s)
- J López-Sanromán
- Departamento de Patología Animal II, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain.
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Olbrich VH, Mosing M. A comparison of the analgesic effects of caudal epidural methadone and lidocaine in the horse. Vet Anaesth Analg 2003; 30:156-64. [PMID: 14498847 DOI: 10.1046/j.1467-2995.2003.00145.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate and compare the effects of caudal epidural administration of methadone (METH) and lidocaine (LIDO) on tolerance to thermal stimulation over the dermatomes of the perineal, sacral, lumbar and thoracic regions in the horse. STUDY DESIGN A blinded, randomized, prospective, experimental cross-over study. ANIMALS Seven healthy horses, 15.7 +/- 4.9 years (mean +/- SD) of age, weighing 536 +/- 37 kg. METHODS The horses were randomly assigned to receive two treatments (group M: METH, 0.1 mg kg-1 or group L: LIDO, 0.35 mg kg-1) at intervals of at least 28 days. An 18-gauge 80-mm Tuohy epidural needle was placed in the first intercoccygeal space (Co1-Co2) in awake standing horses restrained in stocks. Analgesia was assessed by use of a probe maintained at a constant 62 degrees C by circulating hot water. The maximum stimulation time was 30 seconds. Bilateral stimulation was performed at five defined points. Before drug administration, baseline values of response time to thermal stimuli were obtained. Time to response was then measured 15 and 60 minutes after METH or LIDO administration and then hourly until the response returned to baseline at all stimulation points on two further assessments. Development of any ataxia and/or sedation was recorded. Positive pain responses were defined as purposeful avoidance movements of the head, neck, trunk, limbs and tail. Absence of attempts to kick, bite and turning of the head toward the stimulation site were used to indicate analgesia. RESULTS Caudal epidural administration of METH and LIDO significantly increased reaction time to thermal stimulation (one-sample t-test; p = 0.05). Analgesia in the perineal region was present 15 minutes after both METH and LIDO administration and progressed from caudal to cranial dermatones with time. The duration of a significant increase in reaction time was 5 hours after METH injection compared to 3 hours following LIDO. All horses defaecated and urinated normally, and no excitement, sedation or ataxia were observed after METH administration. The horses were unable to defaecate normally and were moderately to severely ataxic with hindlimb weakness after LIDO. CONCLUSIONS Caudal epidural administration of methadone has considerable potential in the management of perineal, lumbo-sacral and thoracic pain in horses. Regional differences exist in the onset, duration and intensity of the pain relief. CLINICAL RELEVANCE Epidural methadone administration provides analgesia with no measured side effects in these healthy adult horses.
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Affiliation(s)
- Veronika H Olbrich
- Clinic of Internal Medicine for Ungulates and Small Animals, University of Veterinary Medicine, Vienna, Austria.
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Aithal HP, Kinjavdekar P, Singh GR. Interaction Between Epidurally Administered Ketamine and Pethidine in Dogs. ACTA ACUST UNITED AC 2003; 50:254-8. [PMID: 14567513 DOI: 10.1046/j.1439-0442.2003.00497.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The present study was designed to test the hypothesis that a synergistic interaction could be recorded after epidural administration of ketamine-an N-methyl-D-aspartate (NMDA) antagonist and pethidine--an opioid agonist. Twelve adult mongrel dogs of either sex were randomly divided in three groups A, B and C of four animals each. Ketamine (5%) at 2.5 mg/kg and pethidine (3%) 2 mg/kg were injected at lumbosacral epidural space in animals of groups A and B, respectively. In animals of group C ketamine (2.5 mg/kg) and pethidine (2 mg/kg) were injected. Heart rate increased significantly up to 15 min in group A, whereas in groups B and C, the increase was non-significant for a period of 10 and 45 min, respectively. Respiration increased gradually up to 45-60 min in group A and for 15-20 min in group B. However, in animals of group C respiration fell below the baseline during the first 10-15 min and then returned near the baseline. Rectal temperature decreased only marginally in all the groups. Ketamine alone produced complete analgesia at tail and perineal region for a period of 5-10 min and then moderate analgesia for the next 20-30 min. Analgesia at the flank was moderate to complete between 5 and 15 min. In group B complete analgesia was only moderate at the tail and perineal region up to 30 min. In animals of group C, complete analgesia was observed only at perineal region for a very short period (5 min). Analgesia was not associated with sedation in any of the groups but animals of groups A and C showed signs of motor incoordination. Results of the study suggest rather antagonistic than synergistic interaction between epidurally administered ketamine and pethidine. Further studies are needed to confirm the antagonistic interaction between the two drugs.
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Martin CA, Kerr CL, Pearce SG, Lansdowne JL, Bouré LP. Outcome of epidural catheterization for delivery of analgesics in horses: 43 cases (1998-2001). J Am Vet Med Assoc 2003; 222:1394-8. [PMID: 12762385 DOI: 10.2460/javma.2003.222.1394] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine reasons for epidural catheter placement among horses examined at a veterinary teaching hospital, efficacy of epidural administration of analgesics, duration of catheter placement, reasons for catheter removal, and complications encountered. DESIGN Retrospective study. ANIMALS 43 horses. PROCEDURE Medical records were reviewed. RESULTS A total of 50 epidural catheters were placed in the 43 horses. Underlying conditions included fractures, lacerations, septic arthritis, myositis, perineal injuries, and cellulitis. Horses ranged from 2 to 21 years old and weighed between 365 and 795 kg (803 and 1,749 lb). Median duration of catheter placement was 96 hours (range, 1.5 to 480 hours). The response to epidural drug administration was reported as positive in 34 horses and negative in 4. There was no apparent response in 2 horses, and response could not be determined in 3. Three temporary patient-related complications associated with epidural catheter administration were observed. Technical problems associated with the epidural catheters included dislodgement of the catheter itself (7 catheters) or of the adapter or filter (5), obstruction (5), and leakage (5). Twenty-two catheters were removed because of resolution of the underlying condition, and 10 were removed because of complications. For 6 catheters, the reason for catheter removal was not recorded. The remaining 12 catheters were in place when the horses were euthanatized. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that epidural catheterization can be used successfully for repeated epidural delivery of analgesics and anesthetics in horses with various clinical conditions. Complications associated with epidural catheters or epidural drug administration were infrequent and transient.
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Affiliation(s)
- Christine A Martin
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada N1G 2W1
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