Randomized clinical trial comparing outcomes after fentanyl or ketamine‐dexmedetomidine analgesia in thoracolumbar spinal surgery in dogs

Abstract

Background: Opioids are widely used for perioperative pain control in dogs undergoing spinal surgery, but alternatives may be required because data suggest that opioids exacerbate inflammation in the injured spinal cord and veterinary access to opioids may become more restricted in the future.Objectives: To compare recovery of ambulation and other functions between spinal cord-injured dogs receiving peri-operative fentanyl and those receiving a ketaminedexmedetomidine combination. Animals: A total of 102 client-owned dogs undergoing decompressive surgery for thoracolumbar intervertebral disc herniation. Methods: Randomized clinical trial. Dogs were randomized 1:1 to fentanyl or a ketamine-dexmedetomidine combination for intra and postoperative analgesia. Primary outcome was time to recovery of ambulation; secondary outcomes were the postoperative Colorado Acute Pain Scale, the short-form Glasgow Composite Measure Pain Scale, time to recovery of voluntary urination and time to unassisted eating. Results: No difference was found in time to recovery of ambulation between groups

Effect of dexmedetomidine infusion on the analgesic duration of peripheral nerve blocks in dogs: a randomized clinical study

“…In fact, it is possible that the dose of 1 mcg kg − 1 h − 1 dexmedetomidine CRI lls any "analgesic holes" not covered by regional blockade, thus contributing to a multimodal analgesic approach. These ndings are similar to those of Lovell and colleagues, who compared the analgesic e cacy of fentanyl alone to that of dexmedetomidine/ketamine infusion and suggested that the use of dexmedetomidine and ketamine might be a valid alternative for treating opioid-free aesthesia, as no signi cant differences in pain management were reported between the two groups 23 . There are several reasons that may explain the reduced need for intraoperative analgesia in dogs receiving a dexmedetomidine CRI, which are widely discussed in human and veterinary medicine [24][25][26] .…”

“…The ideal CRI dosage of dexmedetomidine required to provide analgesia is not well known and varies within the veterinary literature. The most frequently reported doses range from 0.5 to 1 mcg kg − 1 h − 1 and are administered alone or in combination with other drugs as a CRI 13,22,23 . However, it has been suggested that a CRI dosage of 3 mcg kg − 1 h − 1 is necessary in some cases to achieve an algesia effect in dogs and that 1 mcg kg − 1 h − 1 CRI doses provide only a sedative effect 34 .…”

Manejo Anestésico de Paciente con Síndrome Respiratorio Braquiocefálico Sometido a Cirugía Correctiva: Estudio de Caso

“…En otro estudio realizado por Lovell et al (2022), se evaluó el efecto de la medicación analgésica intra y postoperatoria en un total de 102 perros. De ellos, 56 perros recibieron fentanilo y 46 recibieron la combinación de ketamina y dexmedetomidina.…”

Multiple uses of dexmedetomidine in small animals: a mini review

“…The continuous infusion has been demonstrated to be effective more than 10 years ago with a clinical study in critically ill dogs; dogs that received dexmedetomidine infusion (25 mcg/m 2 /h) required less analgesic rescue compared to the control group (treated with morphine) and were calmer and more relaxed ( 7 ). A more recent clinical study compared the analgesic efficacy of a multimodal protocol based on infusion of ketamine plus dexmedetomidine to fentanyl infusion and the results showed a similar analgesic efficacy of the two protocols ( 49 ).…”