Intranasal Atomization of Ketamine, Medetomidine and Butorphanol in Pet Rabbits Using a Mucosal Atomization Device

Abstract

A non-invasive method of drug delivery, intranasal atomization, has shown positive results in human medicine and in some animal species. The objective of this study was to evaluate the effects of intranasal atomization, compared to intramuscular administration, of a mix of anesthetic drugs in pet rabbits. In total, 104 mixed-breed pet rabbits, undergoing various types of surgery, received a combination of ketamine, medetomidine, and butorphanol (20, 0.4, and 0.2 mg/kg) by intranasal atomization using a Mucosal Atomization Device (Group MAD) or intramuscular administration (Group IM). When required, isoflurane was dispensed through a face mask. At the end of the procedures, atipamezole was administered using the same routes in the respective Groups. There were no differences in time to loss of righting reflex between the groups, while differences were found for the need for isoflurane (higher in Group MAD) and recovery time, occurring earlier in Group MAD. The results suggest that intranasal atomization of a combination of ketamine, medetomidine, and butorphanol produces a lighter depth of anesthesia in pet rabbits, compared to intramuscular administration. Intranasal atomization can be performed to administer sedative and anesthetic drugs, avoiding the algic stimulus related to the intramuscular inoculation of drugs.

Effects of Intratesticular Lidocaine in Pet Rabbits Undergoing Orchiectomy

“…This suggests that, nonetheless, the anesthesiological protocol used would have been adequate for the surgical procedure, ensuring anesthetic stability. In our study, the choice of using a Mucosal Atomization Device to administer the anesthetic drug combination was made, as it was found to produce a lighter anesthetic plane compared to intramuscular administration of the same combination, resulting in faster recovery [16]. A relatively light anesthetic plan would have allowed for a more effective detection of a response to the surgical stimulus in the subjects.…”

“…The study protocol was approved by the Ethical committee of the Department of Veterinary Science of the University of Turin, protocol n. 0004179/2022. Power of 0.80, alpha error of 0.05, and 25% increase in mean heart rate (set at 160 ± 30 beats/min, based on the mean heart rate after anesthetic induction in rabbits using the same protocol as this study [16]; see Supplementary Materials) in non-treated animals compared to treated ones were considered for sample size calculation. Results indicated that the use of at least 18 rabbits (9 per group) would prevent a type II error (www.clincalc.com, accessed on 10 November 2022).…”

“…For the anesthetic induction, a combination of 20 mg/kg ketamine (Lobotor ® 100 mg/mL, Acme S.r.l, Corte Tegge-Cavriago, Reggio-Emilia, Italy), 0.4 mg/kg medetomidine (Dormisan ® 1 mg/mL, ATI Azienda Terapeutica Veterinaria S.r.l., Milan, Italy), and 0.2 mg/kg butorphanol (Nargesic ® 10 mg/mL, Acme S.r.l, Corte Tegge-Cavriago, Reggio-Emilia, Italy) was intranasally administered using a Mucosal Atomization Device (MAD) (MAD Nasal™ Intranasal Mucosal Atomization Device MAD300, Teleflex Medical S.r.l., Varedo, Monza-Brianza, Italy), following the procedure described by Mauthe von Degerfeld et al [16].…”

Comparison between Carprofen and Meloxicam for Post-Neutering Pain Management in Pet Rabbits

“…In the present study, in addition to ketamine and medetomidine, butorphanol was utilized as part of the anesthesiological protocol. This molecule is commonly deemed safe when applied in rabbit anesthesia, with few adverse effects [ 13 , 20 ]. One study reported a temporary reduction in gastric motility following the administration of 10 mg kg −1 of butorphanol intramuscularly [ 37 ].…”

“…To induce anesthesia, a combination of 20 mg kg −1 ketamine (Ketavet 100, MSD Animal Health S.r.l., Segrate, Milan, Italy), 0.4 mg kg −1 medetomidine (Medeson, Industria Italiana Integratori Trei S.p.A., Livisto, Rio Saliceto, Reggio-Emilia, Italy), and 0.2 mg kg −1 butorphanol (Nargesic ® 10 mg/mL, Acme S.r.l., Corte Tegge-Cavriago, Reggio-Emilia, Italy) was intramuscularly administered to all subjects [ 20 ]. After the loss of the righting reflex, each rabbit was positioned on a heating pad in dorsal recumbency and connected to a multiparameter monitoring system (Infinity Delta ® , Dräger Italia S.p.A., Corsico, Italy) to monitor vital parameters via electrocardiography and pulse oximetry.…”