Antinociceptive effects of levomethadone in standing horses sedated with romifidine

Studer, Nina Salouâ; Bernal, Sabina Diez; Thormann, Wolfgang; Levionnois, Olivier; Spadavecchia, Claudia

doi:10.1016/j.vaa.2020.08.011

Cited by 4 publications

(7 citation statements)

References 47 publications

(66 reference statements)

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“…Another study also observed an increased ataxia during detomidine-mediated sedation after the addition of 5 µg kg −1 IV BUP [37]. LEV has a modest ataxia-enhancing effect during sedation mediated by α-2-adrenergic agonists [38].…”

Section: Sedation and Ataxiamentioning

confidence: 87%

Influence of Butorphanol, Buprenorphine and Levomethadone on Sedation Quality and Postoperative Analgesia in Horses Undergoing Cheek Tooth Extraction

Emanuel

Kästner

Delarocque

et al. 2022

Veterinary Sciences

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The aim of this prospective clinical trial was to compare the influence of butorphanol, buprenorphine and levomethadone on sedation quality and postoperative analgesia in horses undergoing cheek tooth extraction. Fifty horses were assigned to three groups prior to oral cheek tooth extraction. Horses were treated with acepromazine, followed by a detomidine bolus, one of the three opioids and both a nerve block and gingival anaesthesia. During the surgery, sedation was maintained with a detomidine constant rate infusion. After surgery, the quality of sedation, surgical conditions and severity of the extraction were assessed with a numerical rating scale. To evaluate differences in the quality of analgesia between the three treatments, postoperative pain was estimated with the Equine Utrecht University Scale for Facial Assessment of Pain. Additionally, several parameters that are associated with dental pain were added to this validated pain score, and blood samples were taken to measure serum cortisol. Our analysis showed lower pain scores and a greater analgesic effect with levomethadone and buprenorphine compared with butorphanol, with increased locomotor activity induced by buprenorphine. While cortisol values demonstrated higher response in horses treated with levomethadone and buprenorphine compared to butorphanol, these values could be biased by unrelated stressors.

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Section: Sedation and Ataxiamentioning

confidence: 87%

Influence of Butorphanol, Buprenorphine and Levomethadone on Sedation Quality and Postoperative Analgesia in Horses Undergoing Cheek Tooth Extraction

Emanuel

Kästner

Delarocque

et al. 2022

Veterinary Sciences

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“…Plasma cortisol levels [ 5 , 6 , 7 ], responses to pinprick stimulation [ 13 , 15 ], electrodermal activity [ 7 , 30 ] and physiological parameters such as HR or food intake [ 5 ] are the most commonly described ones, but none can be considered specific [ 6 , 7 ]. In order to objectify the assessment of nociception, electrically evoked nociceptive reflexes have been proposed in veterinary research [ 18 , 20 , 22 , 23 , 31 , 32 , 33 ]. There are two main reflexes, the trigeminocervical reflex (TCR) and the nociceptive withdrawal reflex (NWR), the latter being the most frequently reported in veterinary literature [ 18 , 20 , 22 , 23 , 31 , 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…As no species-specific data were available on the extent of antinociceptive effects of opioids in calves, a sample size equal to the one used in Studer et al was used [ 23 ]. In that study, the effects of levomethadone on the nociceptive withdrawal reflex (NWR) threshold were evaluated in 8 horses.…”

Section: Methodsmentioning

confidence: 99%

Antinociceptive, Sedative and Excitatory Effects of Intravenous Butorphanol Administered Alone or in Combination with Detomidine in Calves: A Prospective, Randomized, Blinded Cross-Over Study

Maidanskaia

Mirra

Marchionatti

et al. 2023

Animals

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(1) Background: The diagnostic and therapeutic procedures performed under sedation or general anesthesia in bovines are numerous. The analgesic drugs that can be legally used are few, making perioperative analgesia challenging. (2) Methods: Calves were administered butorphanol 0.1 mg kg−1 alone (SB) or combined with 0.02 mg kg−1 of a detomidine (DB) IV. The antinociceptive effect (trigeminocervical reflex threshold (TCRt)), as well as the behavioral (sedation and excitation) and physiological (heart and respiratory rate) changes were investigated. Five time windows were defined: BL (30 min pre-injection), T1 (0–30 min post-injection (PI)), T2 (31–60 min PI), T3 (61–90 min PI) and T4 (91–120 min PI). (3) Results: Both groups had a significative increase in TCRt at T1-T4 compared to the BL. The TCRt was significatively higher in DB than in SB at T1, T2 and T4. Heart rate decreased significatively in DB compared to that in BL. Calves were significantly more sedated in the DB group, and significantly more excited in the SB group compared to the BL. (4) Conclusions: Butorphanol alone has a statistically significant antinociceptive effect, but it elicits marked excitation, limiting its clinical applicability under this dosing regimen. The co-administration of detomidine eliminated the excitatory effect and induced consistent sedation and a significantly more pronounced antinociceptive effect.

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“…Similarly, both butorphanol and levomethadone, combined with detomidine, significantly increased the nociceptive threshold after electrical stimulation for up to 90 min and prolonged analgesia for up to 45 min [ 4 ]. Additionally, the enhancement of sedation and potentiation of antinociception were reported when levomethadone was co-administered with romifidine continuous infusion in experimental horses [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Methadone or Butorphanol as Pre-Anaesthetic Agents Combined with Romifidine in Horses Undergoing Elective Surgery: Qualitative Assessment of Sedation and Induction

Nannarone

Giannettoni

Laurenza

et al. 2021

Animals

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While butorphanol is the most commonly used opioid in horses, methadone is not licensed in most countries. Our aim was to compare the effects of both drugs, combined with romifidine, regarding the quality of sedation and induction in horses undergoing elective surgery. Results indicate the suitability of both methadone and butorphanol in this patient population. Animals were scored 10 min after intravenous injection of sedatives. Despite lower overall sedation (OS) score in horses receiving methadone (p = 0.002), the quality and time of induction and intubation remained unchanged. None of the horses had the lowest OS score (no sedation), nor the highest score for ataxia (horse falling). Methadone induced a tendency for minor noise reaction yet minor head lowering scores, the latter being probably the most influencing parameter when scoring OS. Measured physiological parameters decreased in both groups, with greater bradycardia recorded after methadone (p = 0.017), including a higher incidence of atrioventricular blocks that resolved during general anaesthesia. The quality of induction was good–excellent in most of the animals. While comparisons between the degree of antinociception were beyond the scope of this study, analgesic potency might influence the choice when considering opioids as pre-anaesthetic drugs in combination with romifidine before surgery in equines.

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Antinociceptive effects of levomethadone in standing horses sedated with romifidine

Cited by 4 publications

References 47 publications

Influence of Butorphanol, Buprenorphine and Levomethadone on Sedation Quality and Postoperative Analgesia in Horses Undergoing Cheek Tooth Extraction

Influence of Butorphanol, Buprenorphine and Levomethadone on Sedation Quality and Postoperative Analgesia in Horses Undergoing Cheek Tooth Extraction

Antinociceptive, Sedative and Excitatory Effects of Intravenous Butorphanol Administered Alone or in Combination with Detomidine in Calves: A Prospective, Randomized, Blinded Cross-Over Study

Methadone or Butorphanol as Pre-Anaesthetic Agents Combined with Romifidine in Horses Undergoing Elective Surgery: Qualitative Assessment of Sedation and Induction

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