Effect of epidural and intravenous use of the neurokinin-1 (NK-1) receptor antagonist maropitant on the sevoflurane minimum alveolar concentration (MAC) in dogs

Amitriptyline, minocycline and maropitant reduce the sevoflurane minimum alveolar concentration and potentiate remifentanil but do not prevent acute opioid tolerance and hyperalgesia in the rat

“…somatic analgesia 14 and visceral analgesia demonstrating a consistent effect. 32 -35 In addition, maropitant has been shown to decrease the sevoflurane MAC in dogs between 15 and 30% following tail-clamp and visceral nociceptive stimulation, respectively.…”

“…These drugs have been reported to share a potential analgesic action 14,22,23 and an effect against opioid tolerance and OIH. Although no previous experimental evidence suggests that amitriptyline or minocycline has a volatile anaesthetic-sparing effect, maropitant has already been shown to decrease MAC.…”

“…8 Antidepressants such as amitriptyline, 10 neurokinin-1 (NK-1) antagonists such as maropitant 11,12 and inhibitors of microglia activation such as minocycline 13 have shown their efficacy in the treatment of morphine tolerance, but they have not yet been assessed in AOT or OIH during volatile anaesthesia. We hypothesised that, apart from a potential reduction in anaesthetic requirements, these drugs, alone or combined with an opioid such as remifentanil, 14 may prevent the observed increase on the sevoflurane requirements during remifentanil infusion related to AOT and the development of OIH. The aim was to determine the interactions of amitriptyline, minocycline and maropitant on sevoflurane MAC in rats and whether they blunt or block the OIH and AOT produced by remifentanil.…”

Analgesia in the Perioperative Period

“…Intravenous maropitant has been demonstrated to reduce sevoflurane requirements in the dog. 47 This should be considered when using maropitant before inhalant anesthesia and careful monitoring of anesthetic depth should be performed. At times, postsurgical confinement is beneficial to promote healing and prevent damage to surgical repairs.…”

2015 AAHA/AAFP Pain Management Guidelines for Dogs and Cats

“…The true pain-modifying effect of maropitant in dogs remains uncertain despite canine studies revealing an anesthetic-sparing effect and a non-inferior effect to morphine in an ovariohysterectomy model. 85,86 Bisphosphonates Administered by iV infusion, this class of drug exerts antiosteoclast activity and can contribute to pain relief in dogs with bone cancer.…”