Intraoperative end-tidal concentration of isoflurane in cats undergoing ovariectomy that received tramadol, buprenorphine or a combination of both

Bellini, Luca; Mollo, Antonio; Contiero, Barbara; Busetto, Roberto

doi:10.1177/1098612x15615655

Cited by 9 publications

(16 citation statements)

References 20 publications

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“…Among indirect intraoperative indicators of nociception, changes over time in HR and arterial blood pressure are commonly used. 2,3,[16][17][18][19][20] A sudden increase of more than 20% in these parameters suggested a poor analgesic coverage during orthopaedic surgery in sheep. 3 The opioid-based protocols evaluated in our study maintained HR and/or MAP percentage change inferior to 20%.…”

Section: Discussionmentioning

confidence: 99%

Effect of three opioid-based analgesic protocols on the perioperative autonomic-mediated cardiovascular response in sheep

Bellini

Benedictis

2018

Lab Anim

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Few reports evaluate the clinical effects of opioids in sheep during experimental surgical procedures. Catecholamine-mediated haemodynamic changes resulting from surgical noxious stimulation are blunted by opioids. The aim of this study was to evaluate the efficacy of three opioid-based analgesic protocols in avoiding a 20% increase in heart rate (HR) and/or mean arterial blood pressure (MAP) during experimental intervertebral disk nucleotomy in sheep. Eighteen female Brogna sheep were anaesthetized with propofol and maintained with a fixed end-tidal isoflurane concentration of 1.5 ± 0.1%. Sheep were assigned to one of three groups that intravenously received methadone 0.3 mg/kg (group M), fentanyl 2 µg/kg followed by 10 µg/kg/h (group F), or buprenorphine 10 µg/kg and 30 minutes later ketamine 1 mg/kg followed by 5 mg/kg/h (group BK). Intravenous fentanyl at 2 µg/kg would have been used for rescue analgesia in case HR and/or MAP had increased. During surgery, HR and MAP values did not increase over 20% in all groups. All animals maintained the percentage change between -4 and 7% for both variables; only one sheep in group BK had an increase in MAP superior to 20% after ketamine administration before surgical stimulation. In group M, HR decreased over time and in group BK, MAP tended to increase during surgery. All the opioid-based protocols tested were able to control the cardiovascular response to noxious stimulation in sheep undergoing spinal surgery, although ketamine may have represented a confounding factor.

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Section: Discussionmentioning

confidence: 99%

Effect of three opioid-based analgesic protocols on the perioperative autonomic-mediated cardiovascular response in sheep

Bellini

Benedictis

2018

Lab Anim

Self Cite

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“…However, the study was not placebo controlled, and therefore, the increased pCO 2 could not be causally isolated to any particular drug. In other studies that included buprenorphine, there was no clinically meaningful changes to pCO 2 (Bellini et al, 2017;Grint et al, 2009).…”

Section: Discussionmentioning

confidence: 86%

Multicentered masked placebo‐controlled phase 3 clinical study of an extended duration transdermal buprenorphine solution for post‐operative pain in cats

Clark¹,

Linton²,

Freise

et al. 2022

Vet Pharm & Therapeutics

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A prospective, double masked, placebo‐controlled, multicentered phase 3 clinical study was conducted to evaluate the safety and effectiveness of transdermal buprenorphine solution (TBS) for the control of post‐operative pain in cats. A total of 228 cats from 12 US investigational sites met the enrollment criteria of which 107 placebo‐ and 112 TBS‐treated cats were included into the per protocol efficacy analysis. The dose of TBS was 8 mg (0.4 ml) to cats 1.2 to 3 kilograms and 20 mg (1 ml) to cats >3 to 7.5 kilograms applied topically to the dorsal unclipped cervical skin 1–2 h prior to the undergoing elective surgical reproductive sterilization in conjunction with forelimb onychectomy. Interactive pain assessments and physiological variables were quantified through 96 h following recovery from anesthesia, and rescue analgesia was administered any time that pain control was scored inadequate. Cats requiring rescue analgesia or experiencing an adverse event suspected to be treatment related were considered treatment failures. Sixty‐five and 23 cats were considered treatment failures in the placebo and TBS groups, respectively, with most occurring on the day of surgery. The treatment success rates were 0.40 (95% confidence interval [CI]: [0.28–0.53]) and 0.81 (95% CI: [0.70–0.89]) in the placebo and TBS groups, respectively, and the difference was significant (p < .05). Adverse events occurred at a similar frequency and were not clinically meaningful in either treatment group. The post‐operative body temperatures over the duration of the study were on average 0.35 (95% CI: [0.20–0.50]) °C higher than baseline in TBS‐treated cats and were not clinically meaningful, an observation typical of opioids in cats. These results serve as substantial evidence that TBS is safe and effective for the control of orthopedic and soft tissue post‐operative pain in cats when a single topical dose is applied 1–2 h prior to surgery.

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“…However, the study was not placebo-controlled, and therefore, the increased pCO2 could not be causally isolated to any particular drug. In other studies that included buprenorphine, there were no clinically meaningful changes to pCO2 (Bellini et al, 2017;Grint et al, 2009;Ilkiw et al, 2002). In an echocardiographic study of cats examining buprenorphine (0.01 mg/kg IM)/dexmedetomidine (0.04 mg/kg IM) sedation, blood pressure increased and heart rates decreased postsedation (Johard et al, 2018).…”

Section: Discussionmentioning

confidence: 96%

Margin of safety of extended‐duration transdermal buprenorphine solution following multiple‐dose administrations to cats

Clark¹,

Linton²,

Freise³

et al. 2022

Vet Pharm & Therapeutics

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Transdermal buprenorphine solution (TBS) is approved for the control of postoperative pain in cats where a single preoperative dose provides 4 days of analgesia. It is administered as a unit dose of 8 mg to cats weighing 1.2–3 kg and 20 mg to cats weighing to >3–7.5 kg, which is equivalent to a dosage on a bodyweight basis of 2.7–6.7 mg/kg. In this safety study, the 1X dose was defined as 6.7 mg/kg. Thirty‐two cats (16 males and 16 females) were randomly allocated to placebo, 1, 2, and 3X TBS administered topically to the dorsal cervical skin every 4 days for 3 doses. Clinical observations, behavioral scores, mydriasis score (yes/no), and physiological variables were assessed or measured prior to each dose administration (0 h) and at 1, 2, 4, 8, 12, 24, 36, 48, and 72 h following each treatment and prior to euthanasia on Day 12 or 13. Blood samples for clinical pathology were collected on Days ‐ 1, 4, 8, and prior to euthanasia. There was little evidence of respiratory, cardiovascular, or gastrointestinal effects. Respiratory rates were above the reference range in all groups and lower by 10 breaths/min in the 3X group during the third dosing interval compared to placebo. There were no differences in heart rates. Constipation was transiently observed in approximately equal numbers in placebo‐ and TBS‐treated cats. Behavioral scores showed sedation or euphoria was transient in the first dosing interval but became more prolonged with each dosing interval. Mydriasis was prolonged in the first dosing interval and diminished by the third dosing interval consistent with accommodation. Mean body temperatures in TBS‐treated cats were up to 0.6°C (1.8°F) greater than placebo‐treated cats. There were no clinically relevant changes to serum chemistry, hematology, or urinalysis outcomes nor gross or microscopic observations attributable to TBS. These data demonstrate that TBS is safe and well‐tolerated when administered to 16‐week‐old cats at multiples of the approved dose and duration and supports clinical safety in the event of delayed buprenorphine metabolism, medication errors, or alterations in the dosing regimen.

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Intraoperative end-tidal concentration of isoflurane in cats undergoing ovariectomy that received tramadol, buprenorphine or a combination of both

Cited by 9 publications

References 20 publications

Effect of three opioid-based analgesic protocols on the perioperative autonomic-mediated cardiovascular response in sheep

Effect of three opioid-based analgesic protocols on the perioperative autonomic-mediated cardiovascular response in sheep

Multicentered masked placebo‐controlled phase 3 clinical study of an extended duration transdermal buprenorphine solution for post‐operative pain in cats

Margin of safety of extended‐duration transdermal buprenorphine solution following multiple‐dose administrations to cats

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