Analgesic efficacy of an intravenous constant rate infusion of a morphine-lidocaine-ketamine combination in Holstein calves undergoing umbilical herniorrhaphy

Abstract

OBJECTIVE To assess the analgesic efficacy of an IV constant rate infusion (CRI) of a morphine-lidocaine-ketamine (MLK) combination in calves undergoing umbilical herniorrhaphy. ANIMALS 20 weaned Holstein calves with umbilical hernias. PROCEDURES Calves were randomly assigned to receive a CRI of an MLK solution (0.11 mL/kg/h; morphine, 4.8 μg/kg/h; lidocaine, 2.1 mg/kg/h; and ketamine, 0.42 mg/kg/h) for 24 hours (MLK group) or 2 doses of flunixin meglumine (1.1 mg/kg, IV, q 24 h) and a CRI of saline (0.9% NaCl) solution (0.11 mL/kg/h) for 24 hours (control group). The assigned CRI was begun after anesthesia induction. A pain-scoring system and incisional algometry were used to assess pain, and blood samples were obtained to measure serum cortisol concentration at predetermined times for 120 hours after CRI initiation. RESULTS Mean pain scores did not differ significantly between the MLK and control groups at any time. Mean algometry score for the MLK group was significantly greater (calves were less responsive to pressure) than that for the control group at 4 hours after CRI initiation. Mean cortisol concentration decreased over time for both groups and was significantly greater for the MLK group than the control group at 1, 4, and 18 hours after CRI initiation. CONCLUSIONS AND CLINICAL RELEVANCE A CRI of MLK provided adequate postoperative analgesia to calves that underwent umbilical herniorrhaphy. However, the technical support required for CRI administration limits its use to hospital settings. Kinetic analyses of MLK infusions in cattle are necessary to establish optimal dosing protocols and withdrawal intervals.

Anaesthetic management of a bovine for ventral midline coeliotomy approach to hysterotomy

“…The recognition and alleviation of pain in farm animals has received significant attention over recent years, in an effort to improve welfare in production animal systems 31 . Pain adversely affects an animal's quality‐of‐life 31 by inducing both emotional distress and pathophysiological states in multiple organ systems 32 .…”

“…The recognition and alleviation of pain in farm animals has received significant attention over recent years, in an effort to improve welfare in production animal systems 31 . Pain adversely affects an animal's quality‐of‐life 31 by inducing both emotional distress and pathophysiological states in multiple organ systems 32 . Visceral pain is considered to be the most painful clinical condition in cattle 32 and by extension, abdominal surgery is the most painful surgical procedure performed in cattle 31 .…”

“…Pain adversely affects an animal's quality‐of‐life 31 by inducing both emotional distress and pathophysiological states in multiple organ systems 32 . Visceral pain is considered to be the most painful clinical condition in cattle 32 and by extension, abdominal surgery is the most painful surgical procedure performed in cattle 31 . In this case, multimodal analgesia was provided by administering boluses of butorphanol and lidocaine and a constant rate infusion of ketamine intra‐operatively, followed by flunixin meglumine post‐operatively.…”

“…The analgesic protocol was likely sufficient, judging by the response of the blood pressure to the lidocaine boluses and titration of the ketamine infusion. Although an infusion of lidocaine may have provided more consistent analgesia, they are associated with increased ataxia and poor quality recoveries 31 . However, terminating the infusion prior to discontinuing the inhalational anaesthetic drug may mitigate the poor recovery quality 31 .…”

“…Although an infusion of lidocaine may have provided more consistent analgesia, they are associated with increased ataxia and poor quality recoveries 31 . However, terminating the infusion prior to discontinuing the inhalational anaesthetic drug may mitigate the poor recovery quality 31 . Anderson and Muir 32 contend that NSAIDs form the cornerstone of multimodal analgesia in cattle.…”