Analgesic effect of intra-articularly administered morphine, dexmedetomidine, or a morphine-dexmedetomidine combination immediately following stifle joint surgery in dogs

Soto, Natalia; Fauber, Amy E.; Ko, Jonathan; Moore, George E.; Lambrechts, Nicolaas E.

doi:10.2460/javma.244.11.1291

Cited by 13 publications

(10 citation statements)

References 45 publications

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“…Also up to our knowledge no comparative study between them was performed in humans but in animals only. [26] Moreover a good sample size was done for our patient with randomization and blinding.…”

Section: Discussionmentioning

confidence: 99%

Intra-articular morphine versus dexmedetomedine for knee arthroscopy under local anesthesia

2019

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Background: Knee arthroscopy has both diagnostic and therapeutic applications which can be performed under general, regional, or local anesthesia. Morphine is used as an additive to local anesthetics. Dexmedetomedine, the highly selective alpha-2 (α2)-adrenoceptor agonist with the sedative and analgesic effect can be used also to augment local anesthetic effect. Patients and Methods: Sixty patients submitted for elective knee arthroscopy whose age between 25 and 45 years, of either sex, the American society of anethesiologists physical status Classes I and II at a university hospital were enrolled in this study. Patients were classified into two groups. Morphine Group (M) ( n = 30): Patients received 20 ml of 0.5% bupivacaine plus 5 ml of 0.2% lidocaine with epinephrine 1:200,000 plus 1 mg morphine. Dexmedetomedine Group (D) ( n = 30): Patients received 20 ml of 0.5% bupivacaine plus 5 ml of 0.2% lidocaine with epinephrine 1:200,000 plus 1 μg/kg dexmedetomedine. Results: Demographic data of patients showed no significant difference among the studied groups. Heart rate (HR) was significantly lower in (D) Group compared to that of (M) Group 5 min from the start of procedure to immediately postoperatively. Moreover, (D) Group showed a significant decrease in HR 10 min up to 35 min intraoperatively compared to the basal value. Furthermore, mean arterial blood pressure (MBP) was significantly lower in (D) Group compared to that of (M) Group 15 min from the start of surgery up to 1 h postoperatively. Furthermore, (D) Group showed a significant decrease in MBP 15 min intraoperative up to 2 h postoperatively compared to the basal value. While there was no significant difference in (visual analogue score [VAS], onset and total consumption of ketorolac, surgeon and patients’ satisfaction, side effects in (D) Group compared to (M) Group, respectively. Conclusion: Addition of either morphine or dexmedetomidine to bupivacaine intraarticularly improved both intraoperative anesthesia and postoperative analgesia with minimal side effects or complications in knee arthroscopy, with superiority of dexmedetomidine compared to morphine on hemodynamic stability.

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Section: Discussionmentioning

confidence: 99%

Intra-articular morphine versus dexmedetomedine for knee arthroscopy under local anesthesia

2019

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“…However, Surendar et al [155] noted that Dexmedetomidine and Ketamine produced analgesia both intra- and post-operatively. In a dog model, Soto et al [156] provided intra-articular injections of morphine, dexmedetomidine, saline, or a combination of morphine and dexmedetomidine. While Soto et al [156] noted improved analgesia when a combination of morphine and dexmedetomidine were given, Soto et al [156] noted no difference between morphine and dexmedetomidine when given alone.…”

Section: How Do Pharmacological Interventions Take Advantage Of Pamentioning

confidence: 99%

“…In a dog model, Soto et al [156] provided intra-articular injections of morphine, dexmedetomidine, saline, or a combination of morphine and dexmedetomidine. While Soto et al [156] noted improved analgesia when a combination of morphine and dexmedetomidine were given, Soto et al [156] noted no difference between morphine and dexmedetomidine when given alone. If, in a human model, its analgesic effects rival morphine, dexmedetomidine would represent a significantly under-utilized analgesic.…”

Section: How Do Pharmacological Interventions Take Advantage Of Pamentioning

confidence: 99%

“…Concerns with the use of opioids in treating pain have focused on diminishing effects, avoiding addiction, and decreasing negative side effects. As demonstrated by Soto et al [156], it may be possible to combine the administration of opioids with other analgesic drugs to decrease the dose of opioids required to provide effective pain relief. As effective alternatives to opioids are unavailable in many cases, identifying synergistic effects between pain transmission pathways could improve the clinical use of opioids.…”

Section: Five-year Viewmentioning

confidence: 99%

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Transmission pathways and mediators as the basis for clinical pharmacology of pain

Kirkpatrick

McEntire

Smith

et al. 2016

Expert Review of Clinical Pharmacology

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Introduction Mediators in pain transmission are the targets of a multitude of different analgesic pharmaceuticals. This review explores the most significant mediators of pain transmission as well as the pharmaceuticals that act on them. Areas Covered The review explores many of the key mediators of pain transmission. In doing so, this review uncovers important areas for further research. It also highlights agents with potential for producing novel analgesics, probes important interactions between pain transmission pathways that could contribute to synergistic analgesia, and emphasizes transmission factors that participate in transforming acute injury into chronic pain. Expert Commentary This review examines current pain research, particularly in the context of identifying novel analgesics, highlighting interactions between analgesic transmission pathways, and discussing factors that may contribute to the development of chronic pain after an acute injury.

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“…Various studies have been conducted to investigate the relief of postoperative pain using parenteral opioids, local anaesthetics and epidural anaesthetics (Hoelzler et al 2005;Aarnes et al 2014;Abimussi et al 2014;Lewis et al 2014;Albuquerque et al 2015). Opioids such as tramadol, butorphanol and morphine, are well-known and effective analgesics, but they can cause sedation, dysphoria and respiratory and cardiovascular depression (Soto et al 2014).…”

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confidence: 99%

Analgesic effect of intra-articular ropivacaine injection after arthroscopic surgery on the shoulder joint in dogs

Kim¹,

Seok²,

Park³

et al. 2018

Vet. Med. - Czech

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Shoulder joint disorders are a major cause of forelimb lameness in dogs, and osteochondrosis, degenerative joint disease, and bicipital tenosynovitis are common joint disorders that have been reported in dogs. Many studies have investigated pain management after arthroscopy in human medicine, but reports from veterinary medicine are rare. Ropivacaine is a new amide local anaesthetic drug and a single isomer drug that is used more widely than bupivacaine in human medicine because it has fewer side effects. The present study was conducted to evaluate the analgesic effect of intra-articular injection of ropivacaine after arthroscopic surgery in dog shoulder joints. To accomplish this, ten dogs were randomly divided into two groups of five who underwent the same anaesthesia protocol and shoulder arthroscopic examination. After shoulder arthroscopy, ropivacaine or 0.9% NaCl was injected into the shoulder joint cavity and the dogs were evaluated at one hour, two hours, four hours, six hours, 12 hours and 24 hours after surgery. The evaluated parameters were heart rate, respiratory rate, lameness score, visual analogue scale and the short form of the Glasgow composite measure pain scale. Ropivacaine showed a higher analgesic effect than 0.9% NaCl, indicating that it may be useful for pain management following arthroscopic surgery in dogs.

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Analgesic effect of intra-articularly administered morphine, dexmedetomidine, or a morphine-dexmedetomidine combination immediately following stifle joint surgery in dogs

Abstract: Intra-articular administration of the morphine-dexmedetomidine combination provided longer-lasting postoperative analgesia, compared with either morphine or dexmedetomidine alone, in dogs undergoing TTA or TPLO.

Cited by 13 publications

References 45 publications

Intra-articular morphine versus dexmedetomedine for knee arthroscopy under local anesthesia

Intra-articular morphine versus dexmedetomedine for knee arthroscopy under local anesthesia

Transmission pathways and mediators as the basis for clinical pharmacology of pain

Analgesic effect of intra-articular ropivacaine injection after arthroscopic surgery on the shoulder joint in dogs

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