Comparison of the Transdermal and Intravenous Administration of Buprenorphine in the Management of Intra- and Postoperative Pain in Dogs Undergoing a Unilateral Mastectomy

Abstract

The aim of this prospective clinical study was to evaluate the effectiveness of transdermal patches of buprenorphine as an alternative route for the management of perioperative pain in dogs undergoing a unilateral mastectomy. Our hypothesis was that the transdermal route would allow the obtainment of an analgesic plan comparable to that of the injectable administration. Twelve dogs were divided in two groups. In the BupreP group (six dogs), buprenorphine patches were applied 40 h before the start of the surgery, guaranteeing a dosage of 5–6 μg/kg/h. In the BupreI group (six dogs), 20 μg/kg of buprenorphine was administered intravenously 30 min before the induction of anesthesia, and this was repeated every 6 h for 24 h. The main physiological parameters, sedation scores (0 = no sedation; 11 = deep sedation), and pain scores were monitored from 30 min before the surgery to 24 h after the end of anesthesia. All p values < 0.05 were defined as statistically significant. Thirty minutes before the surgery, the sedation scores were higher in BupreI (score = 10) compared to the BupreP group (score = 1). Moreover, during the mastectomy, the mean arterial pressure significantly increased in both groups even if nobody required additional analgesia. In the postoperative period, the pain scores did not show statistically significant differences between the two groups, maintaining values below the pain threshold at all times of the study. In conclusion, the transdermal administration of buprenorphine could guarantee an analgesic quality equal to that of the injectable route.

Evaluation of physical variables, thermal nociceptive threshold testing and pharmacokinetics during placement of transdermal buprenorphine matrix-type patch in healthy adult horses

“…Its therapeutic response lasts much longer than other opioids and it has a wider safety profile (5)(6)(7). A transdermal matrix patch buprenorphine formulation which was initially developed for human use, has been successfully investigated in dogs (8)(9)(10)(11), cats (12), pigs (13,14), sheep (15,16) and primates (17). It is evident that with transdermal buprenorphine patch, there exists a discrepancy between species with regards to nociceptive threshold testing, analgesic effects and detectable plasma concentrations.…”

Plasma concentrations of buprenorphine administered via matrix-type transdermal patches applied at three different anatomical locations in healthy adult horses

“…The partial agonism at the µ-receptor is a unique feature of buprenorphine and is attributed to its many distinctive properties, specifically that its analgesic effects plateau at higher doses, and ceiling effects on respiratory depression occur, which makes it safer than pure agonists of the µ-receptor ( 5 – 7 ). A transdermal matrix patch buprenorphine formulation, which was initially developed for human use, has been investigated for extra-label purposes in dogs ( 8 – 11 ), cats ( 12 ), pigs ( 13 , 14 ), sheep ( 15 , 16 ), and primates ( 17 ). Several equine studies report the clinical utility of injectable buprenorphine (i.e., intravenous, intramuscular, subcutaneous, and sublingual) to treat mild to moderate pain ( 18 – 24 ), increase nociceptive threshold ( 21 – 23 ), and offer superior-long lasting antinociception in comparison to butorphanol ( 24 ).…”