Synovial butorphanol concentrations and mechanical nociceptive thresholds after intravenous regional limb perfusion in standing sedated horses

Crabtree, Naomi E; Mochal-King, Cathleen A.; Sloan, None Pearce B.; Eddy, Alison L.; Wills, Robert W.; Meredith, Ashley N.; Fontenot, Robin L.

doi:10.1111/vsu.13309

Cited by 7 publications

(5 citation statements)

References 47 publications

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“…An increase in the nociceptive threshold with butorphanol, levomethadone or with both combined with α-2 adrenergic receptor agonists has been reported [44,[51][52][53][54][55][56]. On the contrary, some studies with butorphanol or fentanyl have not evidenced an increase in nociceptive thresholds [57,58]. Moreover, the analgesic efficacy of morphine is inconsistent both in awake and anaesthetized horses, which could explain our results [56,59].…”

Section: Discussionmentioning

confidence: 55%

Cardiorespiratory, Sedative and Antinociceptive Effects of a Medetomidine Constant Rate Infusion with Morphine, Ketamine or Both

Troya-Portillo

López‐Sanromán

Villalba-Orero

et al. 2021

Animals

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Standing surgery under sedation reduces anesthetic-related mortality in horses. Medetomidine, alone and combined with morphine in a constant rate infusion (CRI), has been described for standing surgery but their cardiorespiratory, sedative and antinociceptive effects have never been compared. The addition of ketamine could improve analgesia in these procedures with minimal cardiorespiratory consequences. The objectives were to compare the cardiorespiratory effects, quality of sedation, antinociception and ataxia produced by administration of a medetomidine-based CRI with morphine, ketamine or both, in standing horses. A prospective, blind, randomized crossover, experimental design with six healthy adult horses was performed, in which four treatments were administered to all horses with at least two weeks of washout period: medetomidine (M); medetomidine and ketamine (MK); medetomidine and morphine (MMo); and medetomidine, morphine and ketamine (MMoK). Dosages were the same in all treatment groups: medetomidine at 5 µg/kg bwt followed by 5 µg/kg bwt/h, ketamine at 0.4 mg/kg/h and morphine at 50 µg/kg bwt, followed by morphine 30 µg/kg bwt/h. Drug infusions were maintained for 120 min. Cardiorespiratory variables, sedation degree and antinociceptive effects were evaluated during the procedure. All combinations produced similar sedation and antinociceptive effects and no clinically relevant alterations in cardiorespiratory variables occurred. Medetomidine CRI combined with morphine, ketamine or both are suitable and safe protocols for standing sedation in horses and the addition of morphine and/or ketamine did not cause any negative effect but no improving effect on sedation and antinociception was detected.

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Section: Discussionmentioning

confidence: 55%

Cardiorespiratory, Sedative and Antinociceptive Effects of a Medetomidine Constant Rate Infusion with Morphine, Ketamine or Both

Troya-Portillo

López‐Sanromán

Villalba-Orero

et al. 2021

Animals

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“…The choice of sites to measures MNTs is an important consideration from both research and clinical perspectives. Some studies only test soft tissue (e.g., abdominal wall) [31] or epaxial musculature [26]; whereas, other studies typically measure MNTs over the metacarpal bone [71]. If the purpose of the study is to measure a treatment response, then it is important to also include distant control sites to better quantify any local treatment effects and differentiate them from other environmental or systemic influences on the recorded MNT values [29].…”

Section: Landmark Selectionmentioning

confidence: 99%

“…Pressure algometry provides a method to semi-quantitatively measure responses to local limb perfusion [57,71] and various systemic medications [62,63]. The most common approach is to use a pressure cuff with an instrumented probe placed over the metacarpal region to induce single point pressure to detect nociceptive thresholds.…”

Section: Systemic Nociceptionmentioning

confidence: 99%

Pressure Algometry for the Detection of Mechanical Nociceptive Thresholds in Horses

Haussler

2020

Animals

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The clinical assessment of pain is subjective; therefore, variations exist between practitioners in their ability to identify and localize pain. Due to differing interpretations of the signs or severity of pain equine practitioners may assign varying levels of clinical significance and treatment options. There is a critical need to develop better tools to qualify and quantify pain in horses. Palpation is the most common method to detect local tenderness or sensitivity. To quantify this applied pressure, pressure algometry has been used to gradually apply pressure over specified landmarks until an avoidance response is noted, which is defined as the mechanical nociceptive threshold (MNT). Numerous studies have used pressure algometry in different applications to measure MNTs in horses. There is an acute need to establish normative values within different body regions and to develop standardized methods of testing MNTs to better guide practitioners in the diagnosis and treatment of pain. The aim of this systematic review was to summarize the evidence for the use of pressure algometry in horses. There is good evidence that pressure algometry is a repeatable, semi-objective method that can be used in a wide array of clinical and research applications to assess MNTs in horses.

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“…Synovial fluid concentrations of opioids following intra-articular injection (morphine) 6 and regional limb perfusion (morphine and butorphanol) 12,13 have been reported for 4-24 h in horses. 6,12,13 There also appears to be an analgesic effect of intra-articular morphine in the face of induced synovitis with a substantial improvement in comfort levels without any systemic side effects. 14 There are no studies evaluating local tissue or synovial fluid concentrations following topical opioid administration.…”

Section: Introductionmentioning

confidence: 99%

“…Options for local administration of analgesia for joint pain include topical/transdermal applications, regional limb perfusion, and intra‐articular injection. Synovial fluid concentrations of opioids following intra‐articular injection (morphine) 6 and regional limb perfusion (morphine and butorphanol) 12,13 have been reported for 4–24 h in horses 6,12,13 . There also appears to be an analgesic effect of intra‐articular morphine in the face of induced synovitis with a substantial improvement in comfort levels without any systemic side effects 14 .…”

Section: Introductionmentioning

confidence: 99%

Longitudinal evaluation of fentanyl concentrations in equine plasma and synovial fluid following application of transdermal fentanyl patches over one carpal joint

et al. 2023

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ObjectiveTo determine if transdermally delivered fentanyl can achieve greater concentrations of fentanyl in synovial fluid when applied over a synovial structure.Study designRandomized, experimental study.AnimalsSix healthy adult horses.MethodsEach horse had two 100 μg/h fentanyl matrix patches applied on the dorsal aspect of one, randomly assigned, carpometacarpal joint (CMCJ) for 48 h. Whole blood and bilateral synovial samples from the intercarpal joint were obtained at 0, 2, 6, 12, 24, 36 and 48 h. Fentanyl concentrations were measured with liquid chromatography–mass spectrometry.ResultsAll subjects achieved detectable concentrations of fentanyl in both plasma and synovial fluid. Time to peak synovial and plasma concentration was 12 h. At 6 h, the synovial concentration in the untreated carpus (0.104 ng/mL ± 0.106) was lower than plasma fentanyl concentrations 0.31 ± 0.27 (p = .036). At 12 h, both treated (0.55 ng/mL ± 0.3) and untreated (0.53 ng/mL ± 0.28) synovial fluid fentanyl concentrations were lower than plasma (0.87 ng/mL ± 0.48) concentrations (p < .001 and p = .001, respectively). Synovial concentrations of fentanyl did not differ between treated and untreated joints (p > 0.608 for all time points).ConclusionApplication of fentanyl matrix patches directly over the CMCJ did not result in increased fentanyl concentrations in the synovial fluid of the treated intercarpal joint in normal horses.Clinical significanceThere is likely no analgesic advantage to placing fentanyl patches directly over the affected joint, as it did not result in increased synovial concentrations at the tested site.

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Synovial butorphanol concentrations and mechanical nociceptive thresholds after intravenous regional limb perfusion in standing sedated horses

Cited by 7 publications

References 47 publications

Cardiorespiratory, Sedative and Antinociceptive Effects of a Medetomidine Constant Rate Infusion with Morphine, Ketamine or Both

Cardiorespiratory, Sedative and Antinociceptive Effects of a Medetomidine Constant Rate Infusion with Morphine, Ketamine or Both

Pressure Algometry for the Detection of Mechanical Nociceptive Thresholds in Horses

Longitudinal evaluation of fentanyl concentrations in equine plasma and synovial fluid following application of transdermal fentanyl patches over one carpal joint

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